Professional Documents
Culture Documents
To exercise administration, general control and supervision over my Legal Claim; Profit Earnings Withheld by
VX Markets Seized by the District Court of New York and to act as my general representative and agent with full
authority to process documents; negotiate, and agree and sign Legal Documents or Contracts for me and my behalf;
To ask, demand, sue for, recover, and receive all sums of money, debts, dues, goods, wares, merchandise, chattels,
effects and things of whatsoever nature or description, which now or hereafter shall be or become due, owing,
payable or belonging to me/us, in or by any right, title, ways or means howsoever, and upon receipt thereof or any
part thereof, to make, sign, execute and deliver such receipts, releases or other discharges; ;
To deposit money and to withdraw same by check, receipt, draft or otherwise in any bank in my name, to sign,
endorse, draw, accept, make, execute, deliver and pay checks, drafts, bills of exchanges, promissory notes, letters
of credit, guarantees, and all other writings, contracts and agreements;
To borrow any sum or sums of money that are urgent and indispensable for the prevention of things which are
under his/their administration on such terms, conditions, and stipulations, and on such security, as my/our
attorney(s) may think fit for that purpose; to execute all promissory notes, bonds, mortgages, and other
instruments which may be necessary and proper;
To make, sign, seal, execute and deliver contracts, documents, agreements and other writings upon such terms and
conditions acceptable to my said attorney; and
In general, to do all other acts, deeds, matters and things whatsoever, in or about my claim and affairs, or to concur
with persons jointly interested with myself therein doing all acts, deeds, matters, and things herein, either
particularly or generally described, as fully and effectually to all intents and purposes as I could do in my proper
person if personally present.
HEREBY GIVING AND GRANTING unto my said attorney full power and authority whatsoever requisite or proper
to be done in or about the premises, as fully to all intents and purposes as I might or could lawfully do if personally
present, and hereby certifying and confirming all that my/our said attorney shall do or cause to be done under these
presents.
Signature/Name/Date
All information collected by Roimano LLP will only be used for the purpose agreed between the claimant
and Roimano LLP. No information will be given or sold to any other party without the claimant’s permission. Data
and information are kept confidential following the regulations as set by The Financial Services Modernization Act
which regulates the collection, use and disclosure of financial information.
CLAIMANT INFORMATION:
Name:
Address:
Phone
Best Time to Reach:
Account Activated (Year):
Alternative Email:
Name of Bank:
Address of the Bank:
Account Name:
Account Number:
Account Owner Address:
Swift Code:
Profit Claim Amount:
I hereby understand that by signing this form, I agree that all the information I have provided are true and correct. I
am bound to keep everything confidential until the court’s verdict/decision. I do agree not to disclose, discuss in any
way provide knowledge of, access to any facts, legal strategy or details, pertaining to my interest to any third party
unless otherwise given with written approval as part of the Client-Attorney Disclosure.
Signature/Name/Date
Being Duly Sworn Deposes and Says: I am one of the witnesses and/or plaintiffs in the following
entitled action. I’m fully aware of foregoing complaint and the contents thereof. The following information are
true to my knowledge, except as to matters therein stated to be alleged on information and belief and as to those
matters I believe them to be true. I agree and understand that by filing this complaint will result to investigation
and lead to legal action. I will be ready to provide any information and documentation to show as proof and
evidence once requested in the court of law.
SWORN STATEMENT:
I understand the terms of the NON-DISCLOSURE AGREEMENT; I shall not divulge or share any information,
file, document, or material concerning the class action lawsuit and the disbursement process to any third-party
company; person, entity until the jury and the judges had reached its verdict and made this information available
to the public by the District Court of New York. “Confidential Information” means any data or information is
related to the lawsuit and the disbursement process which are not known to the public, any other information
that should reasonably be recognized as proprietary or confidential information of the Disclosing Party and/or of
its affiliated/accredited/contracting entities.
Signature/Name/Date