Claims must be submitted no later than June 24, 2019
This Claim Form relates to the Settlement with the Settling Defendants (as defined in the in the long-form Notice), in the Anadarko
Basin Oil and Gas Lease Antitrust Litigation pending in the United States District Court for the Western District of Oklahoma, Case No.
16-cv-209. In order to determine the amount of any share in the Settlement Fund to which you may be entitled in the Settlement, the
Claims Administrator needs to determine the amount of your net acreage and bonus payments from the Defendants between December 27,
2007 and April 1, 2013.
According to the terms of the Settlement, your share of the Net Settlement Fund will be determined in proportion to a reasonable estimate of
your damages based on acreage, after deduction of any fees and expenses approved by the Court, who file valid and timely Claim Forms. The
Plan of Distribution provides that each Class Member will receive a pro rata distribution, based on how much less the Class Member was
paid during the Class Period as a result of the alleged suppression. Your exact Claim Amount cannot be determined until all Claim Forms
are collected and processed.
ESTIMATE OF NET ACREAGE AND BONUS PAYMENTS
If you believe you meet the definition of a Class Member but did not receive a postcard from the Administrator,
you can contact us at email@example.com or call 1-844-833-3816
and the administrator will research the lease information provided in connection with this Settlement.
Please provide the following information for all leases to Chesapeake or Sandridge between December 27, 2007 and April 1, 2013:
I have more than 5 leases.
SIGN AND RETURN THIS CLAIM FORM
In order to receive money from the Settlement, you must fill out and electronically sign this Claim Form no later than June 24, 2019.
If you fail to submit your Claim Form, you may not receive any money in connection with the Settlement.
If you/your firm appeared in the Defendants’ records under other names or at different locations, you/your firm and related entities and
locations may have received multiple Claim Forms. These forms are unique, and are represented by a unique Claim Number and unique
If you received multiple Claim Forms and you wish to file for the totals of your leases or net acreage as shown on each Claim Form, you must file all Claim Forms
received. You may combine your claims into one claim, but you must submit all Claim Forms together and include a written request that
clearly identifies the specific Claim Numbers that you wish to combine.
Supplement or Dispute Attached:
If you intend to supplement or dispute the amount of your lease information to the Defendants,
please attach documentation and a written explanation to this form and return as directed.
Maximum file size: 10 mb
Allowed file types: .pdf, .jpg, .jpeg, .tif, .tiff, .gif, .png
RELEASE AND VERIFICATION
I submit this Claim Form under the terms of the proposed Settlement in the Anadarko Basin Oil and Gas Lease Antitrust Litigation. I
declare under penalty of perjury that the foregoing information is true and accurate, that I have read and understand the Notice, and agree
to abide by the terms of the Notice and this Claim Form. I understand that in exchange for the benefits provided by these settlements, I am
releasing the Settling Defendants for the claims identified in the Settlement Agreement.