Payment Settlement Claim Form

Settlement Claim FORM

Best Phone Number: *

Business Mailing Address: *

Full Legal Name of Company: *

Full Name: *

Contact Name: (If different from Signer)

Email *

2nd Email- (if different from Signer)

Industry Type: *

Business Phone *

Company EIN Number: *

Is your company subject to a franchise agreement? *

Yes

How many years have you been processing Visa/MasterCard transactions and/or accepting Visa/MasterCard as form of payment between 2004 and 2018? *

Please list Merchant ID Number below: (Business Name, MID, EIN) *

Multiple MIDs can be uploaded here: (Biz. Name, Biz. Address, MID, EIN) -Headers

To the best of your knowledge, what is your estimated yearly Gross Processing Volume? *

To the best of your knowledge, what is your estimated Gross Annual Revenue? *

To the best of your knowledge, what is your estimated amount Interchange Fees Paid Annually?

*These numbers can be based on any fiscal year between 2004 and 2018, but no later than 2018.

Today's Date: *

Business Name: SunWest Capital LLC.

Email Address: paymentcardsettlement@sunwestcapitalgroup.com

Association or Affiliation: DCAP Claims / Summit National Advisors

DCAP Claims Representative or Authorized Agent:

DISCLAIMER: On January 24th, 2019, the Court granted preliminary approval of the settlement filed on September 18th, 2018, for Rule 23(b)(3) Class Plaintiffs in this action. Most recently the Court announced claim forms are being delivered and will be online beginning December 1st, 2023. The deadline for claim submissions is August 30, 2024. No-cost assistance will be available from the Class Administrator and Class Counsel during the claims-filing period. There is no guarantee of amount of refund or distribution date of funds. Class members do not need to sign up with a third-party service in order to participate in any monetary relief.

CONFIDENTIAL - This document contains confidential information. Access and use of this information is strictly limited and controlled by SunWest Capital LLC, Summit National Advisors LLC, and DCAP Claims listed within. This document may not be copied, distributed, or otherwise disclosed outside of DCAP Claims except under appropriate precautions to maintain the confidentiality hereof, and may not be used in any way not expressly authorized by the Company. For additional information regarding the settlement, interested persons may visit the Court-approved website for this case at www.paymentcardsettlement.com/en.

Back-To-Home-Page

2024 SunWest Capital LLC.

Information & FAQs

Privacy Policy