Im V. Phoebe Micro, Inc. CLASS ACTION SETTLEMENT CLAIM FORM



You must fill out and submit this Claim Form, and mail it to the address at the bottom of this page, within 45 days of the date of purchase.You will receive a rebate check within 10 weeks after receipt of a qualifying submission.
A. PERSONAL INFORMATION:

Name:

Company:

Address:

City, State Zip Code:

Daytime Phone

Email:

FAILURE TO SUBMIT A VALID E-MAIL ADDRESS WILL RESULT IN A LOSS OF BENEFITS. THE PROMOTIONAL CODE AND ALL FURTHER COMMUNICATIONS ABOUT THE SETTLEMENT WILL BE SENT TO THE EMAIL ADDRESS PROVIDED.
B. DESCRIPTION OF THE COVERED AIRLINK+ WIRELESS PRODUCT:

1. You are eligible to submit this Claim Form if you purchased any of the Covered Airlink+ Wireless Products which are listed in Email Notice from Court Regarding Class Action Settlement for Purchase Of Wireless Product on or before August 31 of 2004.

2. I purchased a (Insert model #, of Covered Airlink+ Wireless Product)

3. Please choose a number from the following statement below:

  • 1. I purchased the Covered Airlink+ Wireless Product on or before August 31 of 2004;
  • 2. My Purchase of the Covered Airlink+ Wireless Product was not for resale purpose;
  • 3. I purchased the Covered Airlink+ Wireless Product at a location within the United States;
  • 4. I purchased the Covered Airlink+ Wireless Product new or refurbished (i.e., not second hand).
  • 5. All of the above statements are accurate.
  • 6. Not all of the above statements are accurate.

If you checked the box indicating that not all of the above statements are accurate, you are not eligible to make a claim and you should not submit this Claim Form.

C. SUBMITTING PROOF OF PURCHASE

1. You have to attach a copy of your proof of purchase for the product as listed in Email Notice from Court Regarding Class Action Settlement for Purchase of Wireless Product.
2. You have to attach the section of the Box of the product that has the UPC code.
Note: If you do not have a proof of purchase or the section of the UPC code, you are not eligible to receive a 15% discount refund.

D. RELEASE

By signing and dating this form below, I confirm that, if the settlement is approved, I, on my own behalf and on behalf of my heirs, executors, administrators, representatives, agents, partners, successors and assigns, hereby fully and irrevocably release and forever discharge Phoebe Micro, Inc. and, whether or not specifically named herein, each of its past or present directors, officers, employees, agents, insurers, shareholders, attorneys, advisors, consultants, representatives, partners, affiliates, parents, subsidiaries, joint ventures, consultants, independent contractors, wholesalers, resellers, distributors, retailers, vendors, suppliers, related companies, and divisions, and each of their predecessors, successors, heirs and assigns ("Released Persons") from any of all liabilities, claims, cross-claims, causes of action, rights, actions, suits, debts, liens, contracts, agreements, damages, restitution, disgorgement, costs, attorney's fees, losses, expenses, obligations or demands, of any kind whatsoever, whether in arbitration, administrative, or judicial proceedings, whether as individual claims or claims asserted on a class basis or on behalf of the general public, whether known or unknown, suspected or unsuspected, threatened or unthreatened, asserted or unasserted, actual or contingent, liquidated or unliquidated, whether under federal statutory law, federal common law or federal regulation, or the statutory or common laws or regulations of any and all states or subdivisions, that were or could have been alleged or asserted against any of the Released Persons in the Actions that arise out of or relate to the claims set forth in the Complaints filed in either of the Actions, including claims relating to the advertising of, and the signal and data transfer rates performed by, the Covered Airlink+ Wireless Products ("Released Claims"). Notwithstanding the foregoing, Released Claims shall not include claims for personal injury and claims involving product defects unrelated to the Mbps signal and data transmission rates.
I have not requested exclusion from the Settlement Class and I have not previously filed a Claim Form with respect to the Covered Airlink+ Wireless Product listed in Part B.2. of this Claim Form; I attest under penalty of perjury that all information provided by me in this Claim Form (and attachment(s) if applicable) is true and accurate; I have read and understand the contents of the Notice of Pendency and Proposed Settlement of Class Action, the Instructions, Claim Form and Release; I agree to be bound by the terms of the Release set forth in Section D above; and I am voluntarily submitting to the jurisdiction of the California Superior Court for the County of Alameda for purposes of the settlement of this Action.

*Signature: _________________________
*Date: _______________________

IF YOU PURCHASED MORE THAN ONE COVERED AIRLINK+ WIRELESS PRODUCT, YOU MUST COMPLETE AND SUBMIT A SEPARATE CLAIM FORM FOR EACH COVERED AIRLINK+ WIRELESS PRODUCT PURCHASED.

If your Claim Form is valid and has been timely submitted, you will receive the confirmation at the email address you provided above after your Claim Form has been processed. If the settlement is not approved,you will receive an email notice.

*Products subject to the rebate can be any Airlink101 wireless product, except wireless Internet Cameras.
If you have any questions about completing the Claim Form, please contact Phoebe Micro, Inc. Customer Service at (408)849-2852.

*After you submit this form , please print a copy of your completed claim form with signature and date, and mail it together with the UPC bar code cut out from the box of the purchased product, as well as a copy of the original purchase receipt, to the address below.
Phoebe Micro, Inc.
Rebate Department
P. O. Box 14235
Fremont, CA94539