Culbertson v. Deloitte Consulting LLP

Case No. 1:20-cv-03962

UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF NEW YORK

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Please remember to enter the full Notice ID exactly as it appears on your personalized Notice, (i.e. 12345678).

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If you did not receive a personalized Notice in the mail or via email, click below to complete a Claim Form.

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PUA Data Security Incident Claim Form

Please click the link for GENERAL INSTRUCTIONS

SETTLEMENT BENEFITS – WHAT YOU MAY GET

If you received notice that your personal information may have been compromised in the Deloitte Consulting LLP PUA Data Security Incident announced in May 2020, and if you do not opt out of this settlement, you may submit a claim for monetary benefits.

The easiest way to submit a claim is on this page, or you can complete and mail a claim form to the mailing address above.

You may submit a claim for one or more of these benefits:

Cash Reimbursement. Use the claim form to request money for one or more of the following:

  1. Reimbursement for Money You Spent. If you spent money to purchase credit monitoring or identity theft protection services between the date you received Notice of the PUA Data Security Incident and August 30, 2020, then you can submit a claim for reimbursement up to $120. You must submit documents supporting your claim.
  2. Reimbursement for Time Spent. If you spent time dealing with or taking efforts to protect against fraud or identity theft or to protect yourself from future harm that is fairly traceable to the PUA Data Security Incident, then you may make a claim for monetary reimbursement for that time. All Settlement Class Members may submit a claim for reimbursement of undocumented Attested Time up to four (4) hours at $20.00 per hour for self-certified Attested Time. However, if you spent time dealing with fraud or identity theft or to protect yourself from future harm that is fairly traceable to the PUA Data Security Incident and can provide Reasonable Documentation of your claim for this time, then you may also make a claim for reimbursement for up to eight (8) additional hours at $20 per hour. Reasonable Documentation includes documents such as receipts, telephone records, or contemporaneous correspondence.

Claims must be submitted through this website or mailed by 1/17/2022. Use the address at the top of the Claim Form for mailed claims.

Please note: the Settlement Administrator may contact you to request additional documents to process your claim. Your cash benefit may decrease depending on the number of claims filed.

Settlement benefits will be distributed after the Settlement is approved by the Court and final. If you submit a claim, it will be maintained as confidential and not shared with either Deloitte Consulting or your State Agency.

Your Information

We will use this information to contact you and process your claim. It will not be used for any other purpose. If any of the following information changes, you must promptly notify us by emailing info@puasettlement.com.

* Required Fields
Cash Payment: Money You Spent

If you spent money to purchase credit monitoring or identity theft protection services between the date you received Notice of the PUA Data Security Incident and August 30, 2020, you can receive reimbursement for up to $120.

It is important for you to send documents that show how much you spent, so that you can be repaid. Acceptable documents include invoices or email confirmations from the credit monitoring or identity theft protection services.

To look up more details about how cash payments work, call toll-free (833) 352-1116. You will find more information about the types of costs that can be paid back to you, what documents you need to attach, and how the Settlement Administrator decides whether to approve your payment.

Loss Type and Documents Amount and Date Description of Money Spent and Supporting Documents
(Identify what you are attaching, and why it’s related to the PUA Data Security Incident)

Examples of Loss Type and Documents

Credit monitoring or identity theft protection purchased between May 18, 2020 and August 30, 2020

Examples: Receipts or statements for credit monitoring services

Amount and Date

$
Date:

Description of Money Spent and Supporting Documents
(Identify what you are attaching, and why it’s related to the PUA Data Security Incident)

250
Cash Payment: Time Spent

If you spent time trying to recover from fraud or identity theft caused by the PUA Data Security Incident, or if you spent time trying to avoid fraud or identity theft because of the PUA Data Security Incident (for example, researching the breach, placing or removing credit freezes on your credit files, purchasing credit monitoring services, or monitoring your bank or credit card accounts), complete the chart below.

All Settlement Class Members may submit a claim for reimbursement of undocumented Attested Time up to four hours at $20 per hour for self-certified Attested Time. If you spent time dealing with fraud or identity theft or to protect yourself from future harm that is fairly traceable to the PUA Data Security Incident and can provide Reasonable Documentation of your claim, then you may also make a claim for reimbursement for up to eight additional hours at $20 per hour. Reasonable Documentation includes documents such as receipts, telephone records, or contemporaneous correspondence.

Mark the category of time you are seeking reimbursement for (choose one or both):

How much time did you lose related to the data breach?
(Do not answer this question if you are not claiming lost time.)

:

By signing and submitting this Claim, I certify as being true to the best of my knowledge and recollection that I spent the amount of time indicated above dealing with fraud or identity theft or to protect myself from future harm and that this time spent is fairly traceable to the PUA Data Security Incident.

250

**PLEASE BE SURE TO ATTACH YOUR SUPPORTING DOCUMENTS.**

If you only marked “Attested Time” above, you do not need to submit supporting documents.

How You Would Like to Receive Your Cash Payment

If you made a claim for a cash payment in this claim form, you can elect to receive your payment either by check or electronically by PayPal or Venmo. Checks must be cashed within 90 days.

Which do you prefer?

Supporting Documentation

Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

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    Signature

    I affirm under the laws of the United States that the information supplied in this claim form is true and correct to the best of my knowledge and that any documents that I have submitted in support of my claim are true and correct copies of original documentation.

    I understand that I may be asked to provide more information by the claims administrator before my claim is complete.

    Your Claim Form has been submitted successfully.

    HOWEVER, it appears one or more of the documents you uploaded were not successfully received. Please see below for which file(s) had errors and log back in to your existing Claim online to re-upload your document(s). Alternatively, you can send your documents with your Submitted Claim ID to the Settlement Administrator by email to: info@puasettlement.com.

    Please print this page for your records.

    Your Claim Details

    Submitted Claim ID:
    Confirmation Code:
    You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
    CLAIM INFORMATION
    First Name
    M.I.
    Last Name
    Street Address
    Apt. No.
    City
    State
    Zip Code
    Phone Number
    Email Address
    Signature
    Date

    If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at info@puasettlement.com

    Click here to edit your Claim.