Luca Fair Fund
Preliminary Claimant Online Certification Form
Your online certification form must be submitted no later than 11:59 p.m. PST on December 1, 2024
GENERAL INSTRUCTIONS
- By submitting this certification form, you are making a request to share in Luca Fair Fund. If you are NOT a Preliminary Claimant do NOT submit this certification form.
- Submission of this online certification form does not guarantee that you will receive a Distribution Payment from Luca Fair Fund. Your eligibility for a Distribution Payment will be determined in accordance with the approved Distribution Plan (the “Plan”), including the Plan of Allocation attached to the Plan as Exhibit A.
- By submitting an executed certification form, you will be certifying to the truth of the statements contained therein under penalty of perjury under the laws of the United States of America.
- During this online process you will be asked to upload documentation to support your submission. Uploaded documents must be in PDF format and the maximum file size per document is 10 MB.
- You must respond to all questions when submitting your certification form. Incomplete forms will not be accepted through the online portal.
- You will not be eligible to receive a Distribution Payment unless documentation is submitted to confirm the sum of the investments in the Securities made during the Relevant Period net of any payments received in connection with these investments.
- You must select "Submit” when you reach the end of the online certification process, or your information will not be saved. Once you have submitted your certification form, you will not be able to use the "Back" button to review or amend it.
- Exiting before submitting your certification form will cause any information you have entered to be lost!
- When you select "Submit" a confirmation page containing your claim number will be automatically generated and you will be sent a confirmation email.
- Your certification form has not been accepted until you see the confirmation page. You will be able to print and keep the confirmation page for your records.
- Your claim number is your proof of submitting your certification form. If you do not print the confirmation page before exiting the screen, you will not be able to go back and retrieve it.
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 RETAIN THE CONFIRMATION PAGE OF MY ONLINE SUBMISSION FOR MY RECORDS.
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