Request for Settlement Payment

We are assisting in issuing your settlement payment in accordance with the Confidential Settlement Agreement and Release of All Claims and Authorization for Release of Funds that you signed for your settlement with Uber Technologies, Inc., through Potter Handy LLP.

Please provide the following information in order to complete the payment election form.

You recently received a Confidential Settlement Agreement and Release of All Claims.

You can locate your ID NUMBER on that document.

Verification

ID NUMBER

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THE LAST FOUR DIGITS OF YOUR SOCIAL SECURITY NUMBER