CLAIM FORM AND RELEASE
Fitzgerald v. Forest River Manufacturing, LLC
USDC ND IN, Case No. 3:20-cv-01004-DRL-MGG

THIS CLAIM FORM AND RELEASE MUST BE POST-MARKED OR OTHERWISE SUBMITTED TO THE SETTLEMENT ADMINISTRATOR NO LATER THAN JULY 31, 2023.

I. CONSENT TO PARTICIPATE IN SETTLEMENT

I understand that this lawsuit is being brought under the Fair Labor Standards Act of 1938, as amended, 29 U.S.C. §§ 201, et seq. I understand that I have already joined this collective action (Fitzgerald v. Forest River Manufacturing, LLC, Case No. 3:20-cv-01004-DRL-MGG) pursuant to 29 U.S.C. § 216(b). Having already joined this collective action, I agreed to be bound by any Settlement or judgment of the court on all issues in this case. I now consent to participate in the Settlement of this lawsuit.

II. RELEASE

In exchange for my receipt of the Settlement payment, I hereby release and forever discharge Forest River Manufacturing, LLC and all of its parents, subsidiaries, affiliates, predecessors, successors, and assigns, and all of their respective present and former partners, officers, directors, shareholders, agents, independent contractors, employees, and attorneys, in their representative as well as their individual capacities, along with any other persons or entities acting by, through, under, or in concert with, any of these persons or entities (“Releasees”), from any and all claims, demands, damages, attorneys’ fees, costs, expenses, and causes of action of any kind or nature, whether known or unknown, that arise prior to the date I cash the Settlement payment check being provided to me under the Settlement agreement that I have or may have on account of or relating in any way to (a) unpaid wages, unpaid overtime wages, untimely paid wages, wage payments, and/or bonus or incentive compensation, and/or (b) Indiana wage payment laws, Indiana wage laws, and/or the Fair Labor Standards Act, including without limitation any claims for damages, unpaid costs or expenses, penalties, liquidated damages, punitive damages, attorneys’ fees, litigation costs, restitution, or equitable relief.