INSTRUCTIONS

READ ALL INSTRUCTIONS CAREFULLY BEFORE FILLING OUT THE CLAIM FORM

1. Fill in all blank spaces in the claim form with clearly printed or typed information.
2. You must sign and date the claim form.
3. By signing your claim form, you are declaring under penalty of perjury that the information provided is true and correct. Please understand that you could be subject to criminal penalties for submitting any false information on your form.
4. If you have any questions about this form, contact the Claims Administrator at claims@ssiclaims.com or (833) 419-0995. There is no fee for any service or assistance provided by the Claims Administrator. DO NOT CONTACT THE COURT OR THE CLERK OF THE COURT.
5. Complete your claim form below, or mail your signed and completed claim form using the enclosed pre-addressed, stamped envelope, by January 15, 2025. If you do not have the pre-addressed, stamped envelope, you may mail your signed and completed claim form to: Carroll v. Walden University, LLC Claims Administrator, c/o Settlement Services, Inc., PO Box 2715, Portland, OR, 97208-2715. YOUR CLAIM FORM MUST BE SUBMITTED ONLINE OR POSTMARKED ON OR BEFORE January 15, 2025. LATE CLAIM FORMS WILL NOT BE CONSIDERED.
6. If your email address or mailing address changes at any time, mail your new address to the Claims Administrator at the address above or update it here.
7. You do not need an attorney to help you submit a claim form. If you do wish to consult an attorney, however, you may do so at your own expense.
8. Please keep a copy of the completed form for your records.
9. The Claim Form that was sent to you contains the number of capstone credits that you took. The online version of the Claim Form does not show your capstone credits. If you believe that you took more or less capstone credits than indicated on the materials provided to you, you may submit documents to support that claim. Any documents you submit to show that you took a different number of capstone credits at Walden than indicated on the materials provided to you will be considered in determining the amount of any monetary payment you are eligible to receive. Examples of such documents include, but are not limited to:
   1. Transcripts from Walden;
   2. Signed Walden enrollment agreements;
   3. Walden certificate of completion;
   4. Cancelled checks or other documents showing payment to Walden; or
   5. Emails or letters from or to Walden.

If you do not dispute the number of capstone credits that you took, you do not need to submit any documents other than a completed claim form.

10. By completing this Claim Form, you authorize Walden to disclose to Plaintiffs’ Counsel and the Claims Administrator the following information covered by the Family Educational Rights and Privacy Act: social security number, number of capstone credits completed, and number of capstone credits required by Walden’s Course Catalog in effect as of your DBA program start date.