IN THE CIRCUIT COURT OF WILL COUNTY, ILLINOIS COUNTY DEPARTMENT, CHANCERY DIVISION Solórzano v. El Guero de Crest Hill, Inc., Case No.: 19 CH 1196 IMPORTANT NOTICE You are receiving this Claim Form because you may be eligible for a monetary recovery due to violation of the Illinois Biometric Information Privacy Act (“BIPA”) as a part of a class action Settlement. If you were employed by Supermercado El Guero de Crest Hill in Illinois between August 15, 2014, and July 14, 2023, you may be eligible to participate in the Settlement. Questions? Please call 1-888-233-2228.ClaimFormNoHiddenHiddenLastName* Claimant ID* CLASS MEMBER INFORMATIONName:* First Last Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Zip Code Daytime Telephone Number*EveningTelephone Number*Email Address* YOU MUST COMPLETE THIS CLAIM FORM IN ORDER TO BE ELIGIBLE FOR MONETARY RECOVERY. INCOMPLETE AND/OR UNTIMELY CLAIM FORMS WILL BE REJECTED. YOU MUST ELECTRONICALLY SIGN THE CLAIM FORM AND SUBMIT NO LATER THAN JANUARY 12, 2024.WAIVER AND RELEASEWAIVER AND RELEASE checkbox* I, the undersigned, hereby irrevocably and unconditionally waive, release, and forever discharge El Guero de Crest Hill, Inc. and its current, former, and future affiliates, including, without limitation, parents, subsidiaries, and related entities, predecessors, successors, divisions, joint ventures and assigns, and its past or present directors, officers, employees, partners, members, employee benefit plans (and their agents, administrators, fiduciaries, insurers and reinsurers), principals, agents, insurers, co-insurers, re-insurers, managers, shareholders, attorneys, and personal or legal representatives, in their individual and representative capacities (collectively referred to as the “Released Parties”), from any and all claims of BIPA violations arising out of my employment at El Guero de Crest Hill, Inc. from August 15, 2014 through July 14, 2023 known or unknown, that I may have against any Released Party. Unique IDEmailThis field is for validation purposes and should be left unchanged.
