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Sandoval, et al. v. Ab Landscaping

September 14, 2011

SANDOVAL, ET AL.
v.
AB LANDSCAPING, INC., ET AL.



CLAIM FORM

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:

Name: _________________

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 ...


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