Cooper v. New Dominion,
Spess Oil Company, et. al.

United States District Court,
Lincoln County, Oklahoma

Case No. CJ-2015-24

CLAIM FORM INSTRUCTIONS

FILE YOUR CLAIM ONLINE BELOW

OR DOWNLOAD A CLAIM FORM AND MAIL TO:

Cooper v. New Dominion, Spess Oil Company, et al.
c/o Settlement Administrator
1650 Arch Street, Suite 2210
Philadelphia, PA 19103

Your claim must be submitted online or postmarked by April 29, 2019.


Please read the full Notice (available by clicking here) carefully before filling out this Claim Form.

I. ARE YOU A SETTLEMENT CLASS MEMBER?

For you to be eligible for benefits, you must be a member of the Settlement Class and file a timely and valid Claim Form.

The Settlement Class is all persons who own or owned commercial or residential real property in any or some combination of Lincoln, Payne, Logan, Oklahoma, Cleveland, Pottawatomie, Seminole, Okfuskee, and/or Creek counties in Oklahoma or have or had a property interest therein between November 5, 2011 and November 16, 2018, and which suffered earthquake damages from earthquakes with epicenters within 15 miles of Prague, Oklahoma, including but not limited to, those occurring between November 5, 2011 and November 8, 2011.

II. GENERAL INSTRUCTIONS

Read all instructions below before filling out the Claim Form.

  1. Provide proof of your damages with repair bills, repair estimates, photographs, and any other evidence of damages that you have;
  2. Sign the Claim Form. Your claim will not be valid if your Claim Form has not been signed;
  3. Make a copy of your completed Claim Form for your records. Then either submit the form electronically or download a Claim Form and sign and date it and mail it to:

    Cooper v. New Dominion, Spess Oil Company, et al.
    c/o Settlement Administrator
    1650 Arch Street, Suite 2210
    Philadelphia, PA 19103
  4. To be considered timely, your Claim Form must be submitted online or postmarked by no later than April 29, 2019. Failure to submit your claim by this deadline may result in the denial of your claim.
  5. No acknowledgement will be made as to the receipt of your claim, except as follows. You will receive a rejection letter if your claim is untimely or invalid; and you will receive a deficiency letter if your claim is deficient in ways that you can correct. If you want confirmation that your claim was received, please send it via Certified Mail, return receipt requested.
  6. If you have questions about the Settlement, please call toll free 1-877-450-8811.

PART 1: CLAIMANT INFORMATION

* Required









Address of the Affected Property or Properties






Total Dollar Amount of Repair Damages incurred as a result of earthquakes with epicenters within 15 miles of Prague, Oklahoma (not to exceed the repair estimates and/or repair bills or other evidence submitted with the Claim Form).



Yes
No

Documents evidencing damages due to the earthquakes at issue are required.













If you have more than six documents, please contact the Settlement Administrator at Questions@OklahomaQuakes.com.

PART 2: SIGNATURE

I wish to participate in the class action settlement in Cooper v. New Dominion, Spess Oil Company, et al., Case No. CJ-2015-24, in the District Court of Lincoln County, Oklahoma State of Oklahoma (the “Action”).

I declare under penalty of perjury that all information I provided in this Claim Form and documentation, as applicable, in support of my claim is true to the best of my knowledge and belief. I further declare under penalty of perjury that:

The submission of this claim form waives any and all rights I might otherwise have to opt out of the settlement of the Action and bring a lawsuit individually.


Type your name in the Signature box


You must complete and press the "Submit" button to submit your claim. You will be directed to a Confirmation Page to be printed for your records once the claim has been submitted.

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