Mass Arbitrations
TracFone Claims Intake Form: Part 2 of 2
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About how long did you not have cell phone service as a result of the incident?
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As a result of the incident, did you have to spend time fixing the problem with your phone?
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For example, did you have to call your cell phone company or another cell phone company to get your phone number back? Or did you need to reach out to friends, family, or customers to tell them what happened and explain the problem?
Yes
No
About how many hours did you spend?
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Do you use your cell phone for your business?
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Yes
No
Did you or your business lose money as a result of the incident?
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Yes
No
If yes, how much?
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As a result of the incident, did you lose access to or experience any other problems with any financial or stock accounts?
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For example, fraudulent credit card charges, or someone improperly accessing your social media or email accounts?
Yes
No
Please briefly describe what happened?
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Did you lose money as a result of that fraudulent activity?
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Yes
No
If yes, how much?
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Have you lost any other money as related to this incident?
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Yes
No
Please briefly describe what happened and the amount lost.
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Have you had to spend any money because of this incident you would not have otherwise spent?
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For example, did you have to purchase a new phone?
Yes
No
Please briefly describe, including how much you spent.
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Are there any non-monetary issues that resulted from losing service?
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For example, missing important medical related call, family related call, etc.
Yes
No
Please briefly describe:
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Engagement Letter Agreement
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Thank you for choosing our firm. Please find below a Lawyer-Client Agreement (“Agreement”) setting out the terms under which Siri & Glimstad LLP (the “Attorneys”) may represent you (“You”):
1. Scope of Representation. Upon confirmation in writing that the Attorneys have reviewed your information and can agree to represent you in this matter, you hereby engage Attorneys to bring claims against Tracfone Wireless Inc. and its related entities (“Defendants”) regarding a data breach and/or an illegal porting of your phone number (the “Claim”). You understand that the Claim may be brought and/or resolved either on an individual basis or on a class basis. This potential representation will not be for any other matter, unless we agreed to that representation in writing, nor will it require Attorneys to file any appeal.
2. Attorneys’ Fees. Your representation will be handled strictly on a contingent fee basis. We will seek payment of our fees and costs from the Defendants or out of any amount recovered. If there is no recovery, you will not owe Attorneys anything.
Attorneys will be entitled to receive forty percent (40%) (or a lesser percentage if required by law) plus costs from any funds obtained from Defendants.
3. Duties of Attorneys. Attorneys shall take all steps in connection with the Claim which, in the opinion of Attorneys, are required to protect or advance Your interests. Attorneys shall take reasonable steps to keep you informed of the progress of the Claim.
4. Cooperation. You agree to cooperate with Attorneys regarding the Claim and respond to reasonable requests from Attorneys related to the Claim. Your failure to cooperate may require Attorneys to withdraw as your attorneys.
5. Miscellaneous:
(a) Additional Attorneys. Attorneys may associate or affiliate with additional attorneys to assist in the Claim, which additional attorneys shall be included in the reference to “Attorneys” in this Agreement.
(b) Termination. Attorneys may withdraw from this Agreement and/or from representing you regarding the Claim to the extent permitted by law. If Attorneys can resolve the Claim as part of a class, you understand and agree that Attorneys are permitted to withdraw as your individual counsel. If you choose to discharge the Attorneys, the Attorneys will be entitled to fees as provided in Section 2 above on a quantum meruit basis and you will be responsible for all costs previously expended.
(c) Attorneys' Lien. Attorneys shall have a lien for their attorneys’ fees and costs on any amount you recover as a result of the Claim.
(d) Joint Representation. Attorneys may represent more than one client who is seeking recovery from Defendants, and you agree to such multiple representations. When attorneys represent multiple clients in the same matter, potential or actual conflicts of interest may arise. For example, one client may want to settle the case and another client may not agree to settle. You agree that should such a conflict arise in the future, Attorneys may choose to terminate this agreement and their representation of you with regard to the Claim, while continuing to represent another client with regard to a similar claim, but under no circumstances will Attorneys represent any party that is suing you with regard to the Claim nor will Attorneys represent TracFone with regard to the Claim. Nevertheless, we are not currently aware of or presently foresee any such specific conflict. Therefore, you hereby state that you prefer that Attorneys jointly represent you with regard to the Claim, and that you refuse to exercise your right to hire independent lawyers.
(e) No Guarantee. Attorneys cannot and do not make any guarantee of success regarding the Claim. No statement made prior to the execution of this document shall be deemed or construed as a promise or guarantee of success.
(f) Arbitration & Governing Law. Any dispute arising under or relating to the terms of this Agreement or Attorneys’ representation hereunder shall be submitted to binding arbitration in New York. This agreement shall be governed by New York law, without regard to the conflict of law provisions thereof.
(g) Storage and Use of Electronic Data: You are aware of and consent to the retention, maintenance, and storage of client information and records relating to this matter in the following forms and locations: Paper (in office and/or storage files); electronic (e.g., computer, handheld devices for email, fax, and via the Internet using cloud storage); or other like mediums. We will endeavor to take reasonable steps necessary to preserve and maintain the confidentiality of all your information and records, however, you recognize and agree that such information and records may be subject to unauthorized access outside our control, and agree to hold us harmless from any breaches of confidentiality of your information and records that we do not directly cause.
(h) Complete Agreement. This is the complete agreement between you and the Attorneys regarding the matters addressed herein.
(i) Consent. By signing this agreement, you affirm you have read and consent to the terms of this Agreement. Attorneys shall not become your attorneys nor have an obligation to begin the representation until Attorneys have confirmed to you in writing that they agree to this representation.
By clicking here and signing by adding my name and email address in the box below, I agree, and it is my intent, to electronically sign and agree to the above engagement letter terms. By submitting this e-document in this way, I understand that it is the legal equivalent of having placed my handwritten signature on the engagement letter terms, and am affirming my intent to be bound thereby.
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Last
Please re-confirm your email
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Email
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