MUST BE EMAILED, FAXED OR MAILED BY OCTOBER 19, 2011

Marenco v. Visa Inc. c/o The Garden City Group, Inc. P.O. Box 9725 Dublin, OH 43017-5625

VSA
*P-VSA-EXC/1*

Claim No:

Control No:

EXCLUSION FORM
Marenco vs. Visa Inc. United States District Court for the Central District of California Case No. CV 10-8022 DMG (VBK) IN ORDER FOR YOU TO BE EXCLUDED FROM THE CLASS AND FROM THE SETTLEMENT IN THE ABOVE-REFERENCED LAWSUIT, YOU MUST COMPLETE THIS FORM AND SUBMIT IT FOLLOWING THE PROCEDURES SET FORTH BELOW.
You are a member of the Settlement Class if you called one of the telephone numbers listed in the Class Notice before October 1, 2010, and spoke with a live person while you were located or residing in California, Florida, Maryland, Nevada, New Hampshire or Washington. If you wish to be excluded from the Settlement Class, meaning you will not be deemed a Class Member and your rights and remedies with respect to the claims and parties in this action will not be affected, and you will not receive a portion of the net Settlement amount, please fill out this form completely, sign your name, and submit it via email to callrecordingsettlement@gcginc.com, via fax to 206-876-5295 or by postal mail to the address above. If you email or fax your Exclusion Form, you must do so by October 19, 2011. If you mail your Exclusion Form, it must be postmarked by October 19, 2011. Personal Information. Please provide the following information: Name (first, middle and last): ____________________________________________________________________ Street Address: _______________________________________________________________________________ City, State, Zip Code: __________________________________________________________________________ Telephone Number: (________)__________________________________________________________________

I wish to be excluded from the Settlement Class.

Signed: ___________________________________________

Date:____________________________________