CLAIM FORM

Vagle et al. v. Archstone Communities, LLC, et al. Case No. BC480931

YOU MUST SUBMIT A VALID, SIGNED CLAIM FORM NO LATER THAN APRIL 3,
2018 IN ORDER TO RECEIVE A SETTLEMENT CHECK.

• To submit a Claim Form, you must either:

(1) fill out, sign and return by mailing this Claim Form by April 3, 2018 to Vagle v.
Archstone Communities, c/o Dahl Administration, P.O. Box 3614, Minneapolis, MN
55403-0614 or
(2) submit a Claim Form at www.ArchstoneClassAction.com by April 3, 2018 by
uploading a completed and signed Claim Form to the website.

• If you fail to submit a valid, signed and timely Claim Form you will not receive any money
under the Settlement and will be bound by the terms of the Release.
• If you submit a valid, signed and timely Claim Form, you will receive a settlement check by
mail. You will also be bound by the terms of the Release.
IF THE FOLLOWING THREE STATEMENTS ARE TRUE AND ACCURATE, TO
THE BEST OF YOUR KNOWLEDGE, THEN PLEASE PRINT YOUR NAME, SIGN
AND DATE WHERE INDICATED BELOW:
(1) I signed a lease at an Archstone affiliated apartment community in California;
(2) I moved out of my apartment unit during the time period from March 14, 2008 to February
27, 2013; and
(3) I was assessed charges for apartment cleaning, painting, carpet cleaning and/or carpet
replacement.

Printed Name:

Signature: Date:
If the three statements are not true and accurate, to the best of your knowledge, then do not print
your name, sign, and date, as you are not entitled to recover a payment under the settlement.