EZTD Fair Fund

EZTD Fair Fund
Preliminary Claimant Online Certification Form

GENERAL INSTRUCTIONS

I HAVE READ AND UNDERSTAND ALL OF THE ABOVE INFORMATION. I WISH TO CONTINUE WITH THE ONLINE CERTIFICATION PROCESS. I UNDERSTAND I MUST COMPLETE THE PROCESS AND RECEIVE A CLAIM NUMBER IN ORDER FOR MY SUBMISSION TO BE CONSIDERED PROPERLY SUBMITTED. I ALSO UNDERSTAND THAT I SHOULD PRINT AND MAINTAIN THE CONFIRMATION PAGE OF MY ONLINE SUBMISSION FOR MY RECORDS.


1Certain persons and entities are considered Excluded Parties in ¶12 of the Plan of Distribution.

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