7/23/2019 Sprint Government Restitution

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Case Code: SGT

Date: Dec 29, 2015

Email Address: mikepemberton@outlook.com

Previous Address: 6500 VEGAS DR #2133LAS VEGAS, NV 89108

Sprint Phone Number 1: (323) 481-1159

Statement I have not authorized any PSMS charges that were billed tomy Sprint account after July 1, 2010 and I have not received arefund from Sprint for those charges.

Disbursement choice (for former customers):

Check

Certification I certify that I have not authorized the following charges thatwere billed to my Sprint account since July 1, 2010, as

applicable: (1) the specific PSMS charges I selected or identified on the preceding page; or (2) any PSMS charges (if I did not select or identify specific PSMS charges on thepreceding page).

Print

Claim Form Receipt

Thank You. Your claim form has been submitted. Please print this page as your

receipt.

Your Claim Number is 600351536001. Please retain this number for your records.

CLAIMANT INFORMATION

MICHAEL G PEMBERTON44256 1/2 ELM AVE

LANCASTER, CA 93534

CLAIM INFORMATION

Note: Refunds are expected to be disbursed prior to May 1, 2016. You should not expect toreceive your refund for at least 9 months. Also, your refund amount may be lower than the

amount of charges you identified as unauthorized depending on the total number of claims

Sprint Government Restitution

7/23/2019 Sprint Government Restitution

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www.kccllc.com

submitted in this case. If you have not received a refund after May 1, 2016 but believe you

should have, you may contact the Plan Administrator for more information.

Please print this page and retain it for your records.

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