ESTIMATED MINIMUM SETTLEMENT PAYMENTS

If you received email and/or mailed notice of this Settlement from the Settlement Administrator, you are a member of the Settlement Class and may use the login credentials provided on the to review your estimated potential minimum settlement payment and Net Proceeds used to calculate this payment, dispute those net proceeds, and submit a payment method election form which includes options of electronic payments via PayPal, Venmo or a virtual prepaid card. The login credentials provided on the email notice are located HERE and those provided on the postcard notice are located HERE. More information regarding this settlement payment is explained in the detailed Class Notice HERE.

Please remember to enter the full Class ID and Confirmation Code exactly as it appears on your personalized Notice, (i.e., 12345678)

I. DEVELOPER INFORMATION

SERVICE FEES PAID TO GOOGLE ABOVE THE 15% LEVEL BETWEEN AUGUST 17, 2016 AND DECEMBER 31, 2021:

ESTIMATED POTENTIAL MINIMUM PAYMENT:

II. DISPUTE PROCEED AND PROVIDE SUPPORTING DOCUMENTATION

Upload Supporting Documentation

Instructions To Download Sales and Payout Reports

Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected.

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    I. DEVELOPER INFORMATION

    Please provide all of the information requested below. You must notify the Settlement Administrator if any of the information changes after you submit this form.

    Name of all applications you have distributed through the Google Play store:

    + Add Application

    * Required Fields

    II. PAYMENT SELECTION & ATTESTATION

    You have successfully requested a payment. Click here if you would like to choose a different payment method.

    If you elect to receive a physical check, you will have six months to deposit the check from the date the check is issued. Funds that are not deposited within six months of issuance of the physical check will revert to the settlement fund and you will not receive a payment.

    If you elect PayPal, Venmo, or a Virtual Prepaid Card but do not provide sufficient information to receive a payment through the selected method, the Settlement Administrator may attempt to contact you to obtain additional information or may send you a paper check to your mailing address, if available. If the Settlement Administrator is unable to contact you and unable to issue a paper check, then the funds will revert to the settlement fund and you will not receive a payment.

    I declare under penalty of perjury under the laws of the United States of America that the information I provided on this Payment Selection Form is true and correct to the best of my knowledge and that I am the owner of the developer account(s) identified above or authorized to submit this Payment Selection Form on the owner’s behalf. I understand that this Payment Selection Form is subject to audit, review, and validation using all available information.

    Your Payment Selection has been submitted successfully.

    Please print this page for your records.

    Your Payment Selection Details
    Class ID:
    Confirmation Code:
    CLAIM INFORMATION
    Developer Name
    Company Name
    Email Address
    Current Street Address
    City
    State
    Province
    Zip Code
    Postal Code
    Country
    Signature
    Date

    If you have any questions regarding your Payment Selection, please provide the Class ID listed above and email us at Info@GooglePlayDeveloperSettlement.com

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