Your Information

Section 1

Credit Monitoring: Free Service or Cash Payment

You may be eligible to receive free credit monitoring or up to $125 if you already have credit monitoring.

You can receive free, three-bureau credit monitoring at all three national credit reporting agencies (Equifax, Experian, and TransUnion). Experian will provide this service for at least 4 years. You can also enroll in free, single-bureau credit monitoring of your Equifax credit file, provided by Equifax, for up to 6 years after the Experian service ends.

Or, if you have credit monitoring services that you will keep for at least six months, you can request a cash payment of up to $125. Your payment may be less, depending on the number and amount of claims filed.

Please select either Option 1 or Option 2 below, but not both.

You can skip to the next section by clicking NEXT.

Section 2

Cash Payment: Time Spent

If you spent time trying to recover from fraud or identity theft caused by the data breach, or if you spent time trying to avoid fraud or identity theft because of the data breach (placing or removing credit freezes on your credit files or purchasing credit monitoring services), complete the chart below. You can be compensated up to $25 per hour for up to 20 hours. Your payment may be less, depending on the number and amount of claims filed.

If you claim 10 hours or less, you must describe the actions you took in response to the data breach and the time each action took.

If you claim more than 10 hours total, you must describe the actions you took in response to the data breach and include supporting documents showing fraud, identity theft, or other misuse of your personal information.

Would you like to make a claim for time?

You can skip to the next section by clicking NEXT.

Section 3

Cash Payment: Money You Lost or Spent

If you lost or spent money trying to prevent or recover from fraud or identity theft caused by the Equifax data breach and have not been reimbursed for that money, you can receive reimbursement for up to $20,000 total.

It is important for you to send documents that show what happened and how much you lost or spent, so that you can be repaid (except for money you may have spent on Equifax subscription products as explained below). If they are the same as the documents you attached in Section 2, you do not need to upload them again.

Please refer to the FAQs for more details about how cash payments work, information about the types of costs and losses that can be paid back to you, what documents you need to attach, and how the Settlement Administrator decides whether to approve your payment.

Would you like to file a claim for money you lost or spent?

You can skip to the next section by clicking NEXT.

Section 4

How Would You Like to Receive Your Cash Payment

If you made a claim for a cash payment in this claim form, you can elect to receive your payment either by check or pre-paid card to your mailing address.

Checks must be cashed within 90 days. If you select a pre-paid card, the card never expires.

Which do you prefer?

Your Claim Summary

Your Information

First Name

Last Name

Middle Initial

Alternative Name

Mailing Address

Apt No

City

Country

State

Zip Code

Province

Zip Code

Phone Number

Email Address

Year of Birth

Credit Monitoring: Free Service or Cash Payment

Cash Payment: Time Spent

Cash Payment: Money You Lost or Spent

Supporting Documents

How Would You Like to Receive Your Cash Payment

Your Signature

Your claim will not be received by the Settlement Administrator until you click the submit button after your electronic signature. For security reasons, once you hit submit, you will not be able to make any changes to your claim form through this portal, however, you will still be able to go into the portal to upload supporting documentation if you haven’t done so. If you later decide you need to change any of the information on your claim form, you will need to reach out to the Settlement Administrator directly.
August 22, 2019