IN ORDER TO BE VALID, THIS CLAIM FORM MUST BE RECEIVED ONLINE OR POSTMARKED NO LATER THAN FEBRUARY 8, 2018.
This Claim Form is to be used to apply for a reimbursement of losses due to the disruption of services that occurred during a processor conversion for certain Green Dot prepaid debit cards and certain Walmart MoneyCard accounts for portions of the period of time from May 15, 2016 through May 22, 2016. In order to submit a Claim, you must have been identified as a potential Settlement Class Member from Defendants’ business records and received Mailed Notice of this Settlement with a Claim Number. If you submit proof of your losses, you may qualify for a payment of up to $750.00. If you do not have documents to support your losses, you may qualify for a payment of up to $100.00.
PLEASE BE ADVISED that any documentation you provide must be submitted WITH this Claim Form. If you are unable to electronically upload a copy of your documents as part of this online Claim Form, you will need to mail a printed Claim Form along with your documentation to the Settlement Administrator. If you are unable to print this form, please call 1-844-319-7640 to have a blank Claim Form mailed to you rather than completing this Claim Form online.
The first step in the online Claim Filing process is to confirm your eligibility as a Settlement Class Member. After your eligibility has been confirmed, you will be asked to provide your contact information, the Claim Number from your Mailed Notice, detailed information about the losses you incurred, and for any documentation you wish to provide to prove those losses. Examples of such proof include receipts, account statements, letters or records from employers confirming payments or losses, and letters from landlords confirming payments or losses.
Please have all of your information ready before you begin your online Claim Form. You will not be able to save your progress and return later to complete your filing.
Click the button below to get started.