Submit a Claim Form - Instructions

UPDATE: The deadlines to File a Claim, Object, or Exclude yourself from the Settlement have been extended to April 18, 2017.

For your Financial Institution to receive a payment from the Settlement fund, you must complete and submit a Claim Form no later than April 18, 2017.

To complete this Claim Form, please select the claim type from below, then carefully read the instructions, provide your requested information and documents, and submit the Claim Form. Make sure you read the descriptions below and have all the documents needed before you get started. You cannot save your progress and come back at a later time.

Claim Types:

There are two types of claim forms in this Settlement: (i) Non GCAR Eligible Claim Form (Tier 1) and (ii) All Class Tier Claim Form (Tier 2). Please read the below descriptions of the Tier 1 and Tier 2 Claims Forms, select the appropriate button for the claim type you wish to file for.

Note: Class members who are eligible to submit a claim in Tier 1 are also eligible to submit a claim in Tier 2. If you have any questions, please contact us.

  • Tier 1: Non GCAR Eligible Tier

    In Tier 1, only Settlement Class Members who issued Visa-branded cards for which an assessment was not paid pursuant to the Global Compromised Account Recovery (“GCAR”) program will be eligible to make a claim for each Non GCAR Eligible Compromised Payment Card that they issued and for which they received an Alert related to the Data Breach. Settlement Class Members eligible to submit a claim in Tier 1 must submit documentation consisting of copies of the Data Breach Alerts that they received on their Non GCAR Eligible Compromised Payment Cards.

    Each Settlement Class Member who makes a valid claim in Tier 1 will be eligible to receive a minimum payout of $1.00 per Non GCAR Eligible Compromised Payment Card up to a maximum payout of $2.38 per card, depending on the total number of eligible claims made in this Tier. The maximum total payments for Tier 1 claims will be capped at $3.4 million. Any Settlement Funds remaining from Tier 1 (if fewer claims are made than will exhaust Tier 1) will move into Tier 2 and be eligible for distribution to any Settlement Class Member (as described below).

  • Tier 2: All Class Tier

    Tier 2 will consist of the remaining Settlement Fund (after accounting for all costs of class notice and settlement administration and Service Payments to the Settlement Class Representatives) minus the payouts in Tier 1. Every Settlement Class Member will be eligible to submit claims for any remaining unreimbursed fraud and card reissuance damages related to the Data Breach by submitting documentation detailing such damages.

    For fraud damages, Settlement Class Members must submit documentation consisting of proof of all fraud expenses incurred within the Fraud Window on Compromised Payment Cards. For card reimbursement damages, Settlement Class Members must submit documentation of proof of the actual costs of replacing physical payment cards on Compromised Payment Cards. Any amounts that the Settlement Class Member recovered through the ADC or GCAR Assessment processes or from Tier 1 payouts will be subtracted from the damages claimed in order to determine the Maximum Payout Amount, which will then be distributed to eligible Settlement Class Members based on the claims submitted. If the total valid claims in the Tier 2 Maximum Payout Amount exceed the remaining Settlement Fund in Tier 2, any payouts will be distributed to eligible Settlement Class Members on a pro rata basis.

Based on the descriptions above, please click the button below for the claim type you would like to file:


Note: The only way to submit a claim for this Settlement is via this website. If you have issues filing your Claim Form, please contact us.

Important Dates

  • September 2014 - October 2014
    Data Breach
  • October 10, 2014
    Data Breach Announcement
  • April 18, 2017
    Claim Filing Deadline
  • April 18, 2017
    Exclusion (Opt-Out) Deadline
  • April 18, 2017
    Objection Deadline
  • May 19, 2017
    Final Approval Hearing