Quick Instructions

This form will ask for your contact information. You can then fill out one or more of the following sections depending on which benefits you want to claim:


1. Choose free credit monitoring, a cash payment (if you already have credit monitoring and will have it for at least the next six months), or skip to the next section

2. If you spent time recovering from the breach, you can request payment, or skip to the next section

3. If you lost or spent money because of the breach, you can request payment, or skip to the next section

4. Finally, you will confirm how you’d like to get your payment


You can file claims for some or all of the benefits in Sections 1-3 if you are eligible. Before you start, make sure you have your supporting documents ready to upload if you plan to request payment in Section 2 or 3. Click here to see the types of documentation that you may need. You do not need any documents to file Section 1 claims, but you do need to verify the name of the credit monitoring service you already have if you request a cash payment.


Your claim will only be received by the Settlement Administrator after you sign the form electronically and click the submit button. Please note that, if you make a claim for a cash payment, your payment may be significantly reduced based upon the number of claims filed.