United States District Court for the Northern District of California
September 14, 2011
SANDOVAL, ET AL.
AB LANDSCAPING, INC., ET AL.
Date action filed: October 19, 2009
Records show that you are a member of the Class that comprises ALL EMPLOYEES OF AB LANDSCAPING INC. OR VICTOR ARELLANO WHO WERE EMPLOYED ON AN HOURLY BASIS BETWEEN OCTOBER 20, 2005 AND APRIL 1, 2011 (COLLECTIVELY, "CLASS MEMBERS").
Records show that you are owed the following:
Wages Owed: _________________ (Payroll withholdings will be taken out) Amount Paid: _________________
In addition to the unpaid wages owed to you, you are also entitled to corresponding penalties under the California Labor Code, as described in the attached Notice of Class Action Settlement and Settlement Hearing. Unless you sign and return the attached Claim Form, you will waive your rights to these wages and penalties.
To submit this Claim Form, you must complete and mail it to Class Counsel at the following address:
Sandoval et al. v. AB Landscaping Inc., et al. attn: Adam Wang P.O. Box ______
San Jose, CA 95113 408-_______________
The last day to postmark your Claim Form to receive California Labor Code penalties is January 13, 2012. The last day to postmark your Claim Form to receive the unpaid wages in the amount indicated above is _______________. DO NOT WAIT UNTIL THE LAST MINUTE.
The net amount of unpaid wages owed to you will be calculated based on the number of exemptions you claimed while working for AB Landscaping Inc. unless you send a new W-4 Form together with together with this Form.
Note to claimant:
2. To receive California Labor Code penalties, return the attached Claim Form no later than January 13, 2012.
1. You are responsible for income taxes on any recovery you receive.
3. If you are entitled to unpaid wages (as set forth above), you have until ________________ to make a claim for these wages. THE SOONER YOU SUBMIT A CLAIM FORM, THE SOONER YOU WILL RECEIVE YOUR MONEY.
I, the undersigned, wish to participate in the Settlement in Sandoval, et al. v. AB Landscaping, Inc., et al., No. C09-04969 HRL.
Name: Address: Home phone: Work phone: Social Security #:
I verify that I am the above named individual.
I declare, under penalty of perjury under the laws of the United States and the State of California, that the information set forth above is true and correct to the best of my knowledge.
(Print Name) (Signature) (Date)
© 1992-2011 VersusLaw Inc.