Donahue, et al. v. Everi Holdings Inc., et al.

Case No. 2018-CH-15419

Illinois State Circuit Court of Cook County

To update contact information for a claim that was filed online, please enter your Claim Number and Confirmation Code as they appear in your original, personalized notice and the claim filed confirmation email you received.

ONLINE CLAIM FORM

You must submit a completed Claim Form by February 1, 2021 to receive a payment from the Settlement. You may submit a Claim Form electronically by completing the fields below, or download a Paper Claim Form, print, complete, and mail, postmarked by February 1, 2021, to:

Everi FACTA Settlement Administrator
1650 Arch Street, Suite 2210
Philadelphia, PA 19103

Please carefully read the Notice of Class Action Settlement before you submit a Claim Form.

CLAIMANT INFORMATION

Provide your name and contact information below. It is your responsibility to notify the Settlement Administrator of any changes to your contact information after you submit your Claim Form by sending an e-mail to info@everifactasettlement.com. Only one claim may be submitted per person. If you do not have a Claim Number or Confirmation Code from a postcard or email notice, you may leave those fields blank.

* Required Fields
CLAIMANT CERTIFICATION

By submitting this Claim Form, I certify that: (i) between February 16, 2016 and December 31, 2019, I engaged in at least one quasi-cash or manual cash disbursement transaction using a debit card or credit card at a gaming establishment in the United States or on tribal lands; (ii) where such transaction was processed using Everi Payments’ CashClub® technology; and (iii) for which Everi Payments’ system was programmed to generate a printed customer receipt that displayed four digits in a field on said receipt labeled “BIN”.

(Please type your full name to sign electronically)

Your Claim Form has been submitted successfully.

HOWEVER, it appears one or more of the documents you uploaded were not successfully received. Please see below for which file(s) had errors and log back in to your existing Claim online to re-upload your document(s). Alternatively, you can send your documents with your Submitted Claim ID to the Settlement Administrator by email to: info@everifactasettlement.com.

Please print this page for your records.

Your Claim Details

Submitted Claim ID:
Confirmation Code:
You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
CLAIM INFORMATION
First Name
M.I.
Last Name
Street Address
Unit/Apt.
City
State
Zip Code
Current Telephone Number
Email Address
Signature
Date

If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at info@everifactasettlement.com

Click here to edit your Claim.