UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF TENNESSEE NASHVILLE DIVISION ) ) ) ) ) ) ) ) ) ) ) ) ) )

Similar documents
EIGHTH JUDICIAL DISTRICT COURT CLARK COUNTY, NEVADA PROOF OF CLAIM AND RELEASE

IXIA CLAIM FORM GENERAL INSTRUCTIONS

Doral Securities Litigation Claims Administrator c/o GCG P.O. Box Dublin, OH

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA SOUTHERN DIVISION

PROOF OF CLAIM AND RELEASE FORM

PROOF OF CLAIM AND RELEASE

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WISCONSIN. Case No. 12-C-884-JPS CLASS ACTION PROOF OF CLAIM AND RELEASE FORM

Uniroyal Technology Corporation Securities Litigation c/o The Garden City Group, Inc. Claims Administrator PO Box 9000 #6388 Merrick, NY

PROOF OF CLAIM AND RELEASE

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA SAN FRANCISCO DIVISION ) ) ) ) ) ) ) ) ) CLASS ACTION

PROOF OF CLAIM AND RELEASE FORM

01-CA4180. X0791 v.05 1

x : : : : : : : x INSTRUCTIONS FOR COMPLETING PROOF OF CLAIM AND RELEASE FORM

PROOF OF CLAIM AND RELEASE FORM

PROOF OF CLAIM AND RELEASE

PROOF OF CLAIM AND RELEASE

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF TEXAS HOUSTON DIVISION. No. 4:10-MD Honorable Keith P. Ellison PROOF OF CLAIM AND RELEASE

IN THE UNITED STATES DISTRICT COURT WESTERN DISTRICT OF NORTH CAROLINA CHARLOTTE DIVISION MDL DOCKET NO: 3:12-MD-2384-GCM ALL MEMBER CASES

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK. Civ. No. 09-CIV-1951 (DLC) ECF CASE PROOF OF CLAIM AND RELEASE

PROOF OF CLAIM FORM AND RELEASE INSTRUCTIONS FOR COMPLETING PROOF OF CLAIM AND RELEASE FORM

UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS WESTERN PENNSYLVANIA ELECTRICAL ) No. 1:08-cv EMPLOYEES PENSION FUND, Individually and )

Nathan v. Matta et al. Shareholder Litigation c/o GCG PO Box Dublin, OH

UNITED STATES DISTRICT COURT DISTRICT OF COLUMBIA In re Harman International Industries Inc. Securities Litigation Case No.

Case5:09-cv JW Document146-3 Filed08/25/11 Page1 of 13. Exhibit A-2

PROOF OF CLAIM AND RELEASE

Proof of Claim and Release Form DEADLINE FOR SUBMISSION: AUGUST 4, 2017

PROOF OF CLAIM AND RELEASE FORM

UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF NEW YORK

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK CASE NO. 1:11-CV JGK PROOF OF CLAIM AND RELEASE FORM

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK PROOF OF CLAIM AND RELEASE

Case 1:12-cv VEC Document Filed 03/26/15 Page 1 of 7 EXHIBIT A-3

PROOF OF CLAIM AND RELEASE FORM

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA ) ) ) ) ) ) ) Case No. 3:16-cv WHA CLASS ACTION

PROOF OF CLAIM AND RELEASE. Gentiva Securities Litigation PO Box 3058 Portland, OR

Esposito v. American Renal Assocs. Holdings, Inc. et al. Claims Administrator c/o GCG P.O. Box 10538

x : : : : : : : : x CLASS ACTION

UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA ) ) ) ) ) ) ) )

UNITED STATES DISTRICT COURT DISTRICT OF CONNECTICUT ) ) ) ) ) ) ) ) CLASS ACTION PROOF OF CLAIM AND RELEASE

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF CALIFORNIA SAN DIEGO DIVISION

UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS ) ) ) ) ) ) ) ) ) ) ) ) CLASS ACTION

PROOF OF CLAIM AND RELEASE PART I - CLAIMANT IDENTIFICATION... 2 PART II - SCHEDULE OF TRANSACTIONS IN KINROSS COMMON STOCK... 3

Puda Securities Litigation Claims Administrator PO Box 2838 Portland, OR PROOF OF CLAIM AND RELEASE FOR THE CLASS ACTION

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA ) ) ) ) ) ) ) ) ) ) ) ) ) ) ) Lead Case No. C EMC. (Derivative Action)

Representative or Custodian Name (if different from Beneficial Owner(s) listed above) City State ZIP Code

PROOF OF CLAIM AND RELEASE FORM

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA SAN FRANCISCO DIVISION ) ) ) ) ) ) ) ) ) )

PROOF OF CLAIM AND RELEASE

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF TEXAS SHERMAN DIVISION

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF OHIO EASTERN DIVISION ) ) ) ) ) ) ) ) )

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF CALIFORNIA

GLS Dublin OH *P-GLS$F-POC/1*

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA WESTERN DIVISION Case No. CV MMM (JCG) (Consolidated)

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF OHIO EASTERN DIVISION ) ) ) ) ) ) ) ) CLASS ACTION PROOF OF CLAIM AND RELEASE

UNITED STATES DISTRICT COURT DISTRICT OF ARIZONA ) ) ) ) ) ) No. CIV PHX-RJB CLASS ACTION

P.O. Box Dublin, OH Toll-Free: (877) Settlement Website:

JP Morgan RMBS Settlement c/o GCG P.O. Box Seattle, WA Toll-Free: (877)

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF KENTUCKY AT BOWLING GREEN ) ) ) ) ) ) ) ) )

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF NORTH CAROLINA NO. 1:04-CV ) ) ) ) ) ) ) ) PROOF OF CLAIM AND RELEASE

PROOF OF CLAIM AND RELEASE

PROOF OF CLAIM AND RELEASE. Address: City: Zip Code:

Polycom, Inc. Settlement c/o Garden City Group, LLC PO Box 10281

UNITED STATES DISTRICT COURT, WESTERN DISTRICT OF WASHINGTON AT SEATTLE

PROOF OF CLAIM AND RELEASE FORM

PROOF OF CLAIM AND RELEASE

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF TEXAS HOUSTON DIVISION

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK NOTICE OF PENDENCY AND PROPOSED SETTLEMENT OF CLASS ACTION

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA WESTERN DIVISION

UNITED STATES DISTRICT COURT PROOF OF CLAIM AND RELEASE FORM AND SUBSTITUTE FORM W-9

COURT Case 2 : 04-cv RC Document 264 Filed 11/08 /20 NOV ^ [CENL-7'^AL

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF TEXAS DALLAS DIVISION

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF GEORGIA ATLANTA DIVISION CIVIL ACTION NO. 1:11-CV RWS

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA SAN FRANCISCO DIVISION ) ) ) ) ) ) ) ) CLASS ACTION

UNITED STATES DISTRICT COURT DISTRICT OF NEVADA ) ) ) ) ) ) )

INSTRUCTIONS FOR COMPLETING PROOF OF CLAIM FORM

UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF CALIFORNIA. Master File No. 05-CV-2335-H(CAB) CLASS ACTION

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA SAN FRANCISCO DIVISION ) ) ) ) ) ) ) ) ) ) ) Case No. 13-cv VC

Case 1:09-md BSJ Document Filed 02/16/11 Page 1 of 150 EXHIBIT A

NOTICE OF PROPOSED SETTLEMENT OF CLASS ACTION AND SETTLEMENT HEARING

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA OAKLAND DIVISION

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF WISCONSIN : : : No. 01-C-1034 Judge Adelman

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF TENNESSEE NASHVILLE DIVISION ) ) ) ) ) ) ) ) ) ) ) ) ) ) STIPULATION OF SETTLEMENT

UNITED STATES DISTRICT COURT WESTERN DISTRICT OF PENNSYLVANIA. -against- Civil Action No

NOTICE OF PENDENCY AND PROPOSED CLASS ACTION SETTLEMENT

District of New Hampshire X :: : X

Case 9:14-cv WPD Document 251 Entered on FLSD Docket 02/10/2017 Page 1 of 16 UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF FLORIDA

NOTICE OF PENDENCY OF CLASS ACTION, PROPOSED SETTLEMENT OF CLASS ACTION AND SETTLEMENT HEARING

United States District Court District Of New Hampshire

Cause No THE CITY OF DALLAS, TEXAS Defendant. ROCKWALL COUNTY, TEXAS. Cause No

[QIJ$&J ORDER PRELIMINARILY APPROVING SETTLEMENT AND

Plaintiff, Defendants.

UNITED STATES DISTRICT COURT DISTRICT OF MINNESOTA ) ) ) ) ) ) ) )

UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION

UNITED STATES DISTRICT COURT DISTRICT OF NEW JERSEY : : : : : : : : :

Case 2:06-cv R-CW Document 437 Filed 10/12/12 Page 1 of 11 Page ID #:7705

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF TENNESSEE NASHVILLE DIVISION ) ) ) ) ) ) ) ) ) ) ) )

PROOF OF CLAIM AND RELEASE POSTMARK DEADLINE FOR SUBMISSION: JANUARY 24, 2009

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA ) ) ) ) ) ) ) ) ) PROOF OF CLAIM AND RELEASE

Area Code Telephone Number (Day) Area Code Telephone Number (Evening) Area Code Fax Number

UNITED STATES DISTRICT COURT CENTRAL DISTRICT OF CALIFORNIA NOTICE OF PENDENCY AND PROPOSED SETTLEMENT OF CLASS ACTION

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF CALIFORNIA SAN FRANCISCO DIVISION

Transcription:

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF TENNESSEE NASHVILLE DIVISION CAROLYN LYNN, individually and on behalf of all others similarly situated, v. Plaintiffs, ARTHUR F. HELF, H. LAMAR COX, MICHAEL R. SAPP, FRANK PEREZ and TENNESSEE COMMERCE BANCORP, INC. and KraftCPAs PLLC, Defendants. Case No. 3:12-CV-01137 CLASS ACTION Judge Todd J. Campbell PROOF OF CLAIM AND RELEASE EXHIBIT A-2 1 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 1 of 9 PageID #: 5233

I. GENERAL INSTRUCTIONS 1. To recover as a member of the Class based on your claims in the class action entitled Lynn v. Helf, et al., Case No. 3:12-CV-01137 (the Litigation, you must complete and, on page hereof, sign this Proof of Claim and Release form ( Proof of Claim. If you fail to timely file a properly addressed (as set forth in paragraph 3 below Proof of Claim, your claim may be rejected and you may be precluded from any recovery from the Net Settlement Fund created in connection with the settlement of the Litigation. 2. Submission of this Proof of Claim, however, does not assure that you will share in the proceeds of settlement in the Litigation. 3. YOU MUST MAIL YOUR COMPLETED AND SIGNED PROOF OF CLAIM POSTMARKED ON OR BEFORE, 2015, ADDRESSED AS FOLLOWS: Tennessee Commerce Bancorp Settlement c/o GCG PO Box 10096 Dublin, OH 43017-6696 4. If you are NOT a Class Member (as defined in the Notice of Pendency and Proposed Settlement of Class Action (the Notice, DO NOT submit a Proof of Claim. 5. If you are a Class Member and you did not timely request exclusion in connection with the settlement, you are bound by the terms of any judgment entered in the Litigation, including the releases provided therein, REGARDLESS OF WHETHER YOU SUBMIT A PROOF OF CLAIM. II. CLAIMANT IDENTIFICATION 1. If you purchased or otherwise acquired Tennessee Commerce Bancorp, Inc. ( TNCC common stock between April 18, 2008 and January 27, 2012, inclusive ( Class Period and held the certificate(s in your name, you are the beneficial purchaser or acquirer as 1 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 2 of 9 PageID #: 5234

well as the record purchaser or acquirer. If, however, you purchased or otherwise acquired the common stock of TNCC during the Class Period and the certificate(s were registered in the name of a third party, such as a nominee or brokerage firm, you are the beneficial purchaser or acquirer and the third party is the record purchaser or acquirer. 2. Use Part I of this form entitled Claimant Identification to identify each purchaser or acquirer of record ( nominee, if different from the beneficial purchaser or acquirer of the common stock of TNCC which forms the basis of this claim. THIS CLAIM MUST BE FILED BY THE ACTUAL BENEFICIAL PURCHASER(S OR ACQUIRER(S, OR THE LEGAL REPRESENTATIVE OF SUCH PURCHASER(S OR ACQUIRER(S, OF THE COMMON STOCK OF TNCC UPON WHICH THIS CLAIM IS BASED. 3. All joint purchasers or acquirers must sign this claim. Executors, administrators, guardians, conservators, and trustees must complete and sign this claim on behalf of persons represented by them and their authority must accompany this claim and their titles or capacities must be stated. The Social Security (or taxpayer identification number and telephone number of the beneficial owner may be used in verifying the claim. Failure to provide the foregoing information could delay verification of your claim or result in rejection of the claim. III. CLAIM FORM 1. Use Part II of this form entitled Schedule of Transactions in TNCC Common Stock to supply all required details of your transaction(s in TNCC common stock. If you need more space or additional schedules, attach separate sheets giving all of the required information in substantially the same form. Sign and print or type your name on each additional sheet. 2. On the schedules, provide all of the requested information with respect to all of your purchases or acquisitions and all of your sales of TNCC common stock which took place at 2 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 3 of 9 PageID #: 5235

any time between April 18, 2008 and January 27, 2012, inclusive, whether such transactions resulted in a profit or a loss. You must also provide all of the requested information with respect to all of the TNCC common stock you held at the opening of trading on April 18, 2008 and as of the close of trading on January 27, 2012 and April 26, 2012. Failure to report all such transactions may result in the rejection of your claim. 3. List each transaction during the Class Period separately and in chronological order, by trade date, beginning with the earliest. You must accurately provide the month, day, and year of each transaction you list. 4. The date of covering a short sale is deemed to be the date of purchase of TNCC common stock. The date of a short sale is deemed to be the date of sale of TNCC common stock. 5. Copies of broker confirmations or other documentation of your transactions in TNCC common stock should be attached to your claim. Failure to provide this documentation could delay verification of your claim or result in rejection of your claim. NOTICE REGARDING ELECTRONIC FILES: Certain claimants with large numbers of transactions may request, or may be requested, to submit information regarding their transactions in electronic files. All claimants MUST submit a manually signed paper Proof of Claim form whether or not they also submit electronic copies. If you wish to file your claim electronically, you must contact the Claims Administrator at eclaim@gcginc.com to obtain the required file layout. No electronic files will be considered to have been properly submitted unless the Claims Administrator issues to the claimant a written acknowledgment of receipt and acceptance of electronically submitted data. 3 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 4 of 9 PageID #: 5236

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF TENNESSEE NASHVILLE DIVISION Lynn v. Helf, et al. Case No. 3:12-CV-01137 PROOF OF CLAIM AND RELEASE Must be Postmarked No Later Than:, 2015 Please Type or Print PART I: CLAIMANT IDENTIFICATION Beneficial Owner s Name (First, Middle, Last Street Address City State or Province Zip Code or Postal Code Country Email Address 1 1 While an email address is not required, if you provide it, you authorize the Claims Administrator to contact you through it rather than through the United States Postal Service, to request from or provide to you through it information about your claim. 4 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 5 of 9 PageID #: 5237

Social Security Number or Taxpayer Identification Number Individual Corporation IRA Trust Joint Tenancy Other (specify Area Code Telephone Number (work Area Code Telephone Number (home Record Owner s Name (if different from beneficial owner listed above PART II: SCHEDULE OF TRANSACTIONS IN TNCC COMMON STOCK A. Number of shares of TNCC common stock held at the opening of trading on April 18, 2008:. B. Purchases or acquisitions of TNCC common stock (April 18, 2008-January 27, 2012, inclusive:. Trade Date Mo. Day Year Number of Shares Purchased or Acquired Total Purchase or Acquisition Price 1. 2 1. 2. 1. 2. IMPORTANT: (i If any purchase listed covered a short sale, please mark Yes: No: (ii If you received shares through an acquisition or merger, please identify the date, the share amount and the company acquired: Mo. Day Year Merger Shares Company 5 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 6 of 9 PageID #: 5238

C. Sales of TNCC common stock (April 18, 2008-April 26, 2012, inclusive: Trade Date Mo. Day Year Number of Shares Sold Total Sales Price 1. 2 1. 2. 1. 2. D. Number of shares of TNCC common stock held at the close of trading on January 27, 2012:. E. Number of shares of TNCC common stock held at the close of trading on April 26, 2012:. If you require additional space, attach extra schedules in the same format as above. Sign and print your name on each additional page. PART III: SUBMISSION TO JURISDICTION OF COURT AND ACKNOWLEDGMENTS I (We submit this Proof of Claim under the terms of the Stipulation of Settlement described in the Notice. I (We also submit to the jurisdiction of the United States District Court for the Middle District of Tennessee, Nashville Division, with respect to my (our claim as a Class Member and for purposes of enforcing the release set forth herein. I (We further acknowledge that I am (we are bound by and subject to the terms of any judgment that may be entered in the Litigation. I (We agree to furnish additional information to the Claims Administrator to support this claim if requested to do so. I (We have not submitted any other claim covering the same purchases or sales of TNCC common stock during the Class Period and know of no other person having done so on my (our behalf. 6 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 7 of 9 PageID #: 5239

PART IV: RELEASE 1. I (We hereby acknowledge full and complete satisfaction of, and do hereby fully, finally, and forever settle, release, and discharge all Released Claims against the Released Persons, as set forth in the Notice of Settlement. 2. I (We hereby warrant and represent that I (we have not assigned or transferred or purported to assign or transfer, voluntarily or involuntarily, any matter released pursuant to this release or any other part or portion thereof. 3. I (We hereby warrant and represent that I (we have included information about all of my (our purchases or acquisitions and sales of the common stock of TNCC which occurred between April 18, 2008 and January 27, 2012, inclusive, and the amount of TNCC common stock held by me (us at the opening of trading on April 18, 2008, and at the close of trading on January 27, 2012 and April 26, 2012. I declare under penalty of perjury under the laws of the United States of America that the foregoing information supplied by the undersigned is true and correct. Executed this day of 2015, in (City (State/Country (Sign your name here (Type or print your name here (Capacity of person(s signing, e.g., Beneficial Purchaser or Acquirer, Executor or Administrator 7 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 8 of 9 PageID #: 5240

ACCURATE CLAIMS PROCESSING TAKES A SIGNIFICANT AMOUNT OF TIME. THANK YOU FOR YOUR PATIENCE. Reminder Checklist: 1. Please sign the above release and declaration. 2. Remember to attach supporting documentation, if available. 3. Do not send original stock certificates. 4. Keep a copy of your claim form for your records. 5. If you desire an acknowledgment of receipt of your claim form, please send it Certified Mail, Return Receipt Requested. 6. If you move, please send us your new address. 8 Case 3:12-cv-01137 Document 100-2 Filed 12/01/14 Page 9 of 9 PageID #: 5241