If you received a personalized notice in the mail or via email with a Unique Id and Confirmation Code, please enter the codes you were provided below. Please remember to enter the full Unique ID exactly as it appears on your personalized notice, (i.e. 12345678). Unique Id Confirmation Code OR If you did not receive a personalized notice in the mail or via email, click below to complete a Claim Form. You must accurately complete all required portions of this Claim Form and submit the Claim Form under penalty of perjury. YOU MUST SUBMIT YOUR CLAIM FORM NO LATER THAN NOVEMBER 18, 2019 Provide your name and contact information below. This information will be used to deliver your Settlement Benefit and communicate with you if any problems arise with your claim. It is your responsibility to notify the Settlement Notice & Claims Administrator of any changes to your contact information after the submission of your Claim Form. First Name* Invalid characters found Last Name* Invalid characters found Residential Street Address 1 * Invalid characters found Residential Street Address 2 Invalid characters found City* Invalid characters found Country* State* Zip Code* Invalid ZIP code. Format: 12345 Email Address* Emails do not match. Confirm Email Address* Emails do not match. Phone Number Invalid phone number. Format: 1234567890 Unique Identifier * Required Fields CONFIRMATION OF CLASS MEMBERSHIP I certify that I am a member of the Settlement Class defined as: All individuals whose personal information was contained in Aimbridge employee email accounts subject to unauthorized access, identified on or about March 21, 2018 and September 24, 2018, as a result of the Data Breach. I request the free two years of myTrueIdentity single bureau credit monitoring services provided by TransUnion, which includes $1,000,000 in identity theft insurance. I also certify that this is the only claim that I am submitting in connection with the name below. Signature: (Type your name here to electronically sign your Claim Form) Date: