A. GENERAL INSTRUCTIONS
1. It is important that you completely read the Notice of (I) Proposed Settlement and Plan of
Allocation; (II) Settlement Hearing; and (III) Motion for Attorneys’ Fees and Litigation Expenses (the
“Settlement Notice”), including the Plan of Allocation of the Net Settlement Fund set forth in the Settlement
Notice. The Settlement Notice describes the proposed Settlement, how Class Members are affected by the
Settlement, and the manner in which the Net Settlement Fund will be distributed if the Settlement and Plan of
Allocation are approved by the Court. The Settlement Notice also contains the definitions of many of the defined
terms (which are indicated by initial capital letters) used in this Claim Form. By signing and submitting this
Claim Form, you will be certifying that you have read and that you understand the Settlement Notice, including
the terms of the releases described therein and provided for herein.
2. By submitting this Claim Form, you will be making a request to share in the proceeds of the
Settlement described in the Settlement Notice. If you are not a Class Member (see the definition of the Class on
page 7 of the Settlement Notice), or if you, or someone acting on your behalf, submitted a request for exclusion
from the Class in connection with the previously disseminated Class Notice and are listed on Appendix A to the
Stipulation and Agreement of Settlement, do not submit a Claim Form.
You may not, directly or indirectly,
participate in the Settlement if you are not a Class Member
.
3.
Submission of this Claim Form does not guarantee that you will share in the proceeds of the
Settlement. The distribution of the Net Settlement Fund will be governed by the Plan of Allocation set
forth in the Settlement Notice or by such other plan of allocation as the Court approves.
4. On the Schedule of Transactions in Part III of this Claim Form, provide all of the requested
information with respect to your holdings, purchases, acquisitions, and sales of Qualcomm Inc. (“Qualcomm”)
common stock (including free transfers and deliveries), whether such transactions resulted in a profit or a loss.
Failure to report all transaction and holding information during the requested time period may result in
the rejection of your claim
.
5.
Please note: Only purchases or acquisitions of Qualcomm common stock from February 1, 2012
through January 20, 2017, inclusive, are eligible under the Settlement and the proposed Plan of Allocation set
forth in the Settlement Notice. However, under the “90-day look-back period” (described in the Plan of
Allocation), sales of Qualcomm common stock during the period from January 21, 2017 through the close of
trading on April 20, 2017 will be used for purposes of calculating Recognized Loss Amounts under the Plan of
Allocation. Therefore, in order for the Claims Administrator to be able to balance your claim, the requested
purchase information during this period must also be provided.
6. You are required to submit genuine and sufficient documentation for all of your transactions in
and holdings of Qualcomm common stock set forth in the Schedule of Transactions in Part III. Documentation
may consist of copies of brokerage confirmation slips or monthly brokerage account statements, or an authorized
statement from your broker containing the transactional and holding information found in a broker confirmation
slip or account statement. The Parties and the Claims Administrator do not independently have information about
your investments in Qualcomm common stock. IF SUCH DOCUMENTS ARE NOT IN YOUR POSSESSION,
PLEASE OBTAIN COPIES OF THE DOCUMENTS OR EQUIVALENT DOCUMENTS FROM YOUR
BROKER. FAILURE TO SUPPLY THIS DOCUMENTATION MAY RESULT IN THE REJECTION OF
YOUR CLAIM. DO NOT SEND ORIGINAL DOCUMENTS.
7.
Please keep a copy of all documents that you send to the Claims Administrator. Also, do not
highlight any portion of the Claim Form or any supporting documents.
8. Use Part I of this Claim Form entitled “CLAIMANT INFORMATION” to identify the beneficial
owner(s) of Qualcomm common stock. The complete name(s) of the beneficial owner(s) must be entered. If you
held the Qualcomm common stock in your own name, you were the beneficial owner as well as the record owner.
If, however, your shares of Qualcomm common stock were registered in the name of a third party, such as a
nominee or brokerage firm, you were the beneficial owner of these shares, but the third party was the record
owner. The beneficial owner, not the record owner, must sign this Claim Form to be eligible to participate in the
Settlement. If there were joint beneficial owners each must sign this Claim Form and their names must appear as
“Claimants” in Part I of this Claim Form.
9.
One Claim should be submitted for each separate legal entity or separately managed
account
. Separate Claim Forms should be submitted for each separate legal entity (e.g., an individual should not
combine his or her IRA transactions with transactions made solely in the individual’s name). Generally, a single
Claim Form should be submitted on behalf of one legal entity including all holdings and transactions made by
that entity on one Claim Form. However, if a single person or legal entity had multiple accounts that were
separately managed, separate Claims may be submitted for each such account. The Claims Administrator reserves
the right to request information on all the holdings and transactions in Qualcomm common stock made on behalf
of a single beneficial owner.
10. Agents, executors, administrators, guardians, and trustees must complete and sign the Claim Form
on behalf of persons represented by them, and they must:
(a) expressly state the capacity in which they are acting;
(b) identify the name, account number, Social Security Number (or taxpayer identification
number), address, and telephone number of the beneficial owner of (or other person or
entity on whose behalf they are acting with respect to) the Qualcomm common stock; and
(c) furnish herewith evidence of their authority to bind to the Claim Form the person or entity
on whose behalf they are acting. (Authority to complete and sign a Claim Form cannot be
established by stockbrokers demonstrating only that they have discretionary authority to
trade securities in another person’s accounts.)
11. By submitting a signed Claim Form, you will be swearing that you:
(a) own(ed) the Qualcomm common stock you have listed in the Claim Form; or
(b) are expressly authorized to act on behalf of the owner thereof.
12. By submitting a signed Claim Form, you will be swearing to the truth of the statements contained
therein and the genuineness of the documents attached thereto, subject to penalties of perjury under the laws of
the United States of America. The making of false statements, or the submission of forged or fraudulent
documentation, will result in the rejection of your claim and may subject you to civil liability or criminal
prosecution.
13. Payments to eligible Authorized Claimants will be made only if the Court approves the Settlement,
after any appeals are resolved, and after the completion of all claims processing.
14.
PLEASE NOTE: As set forth in the Plan of Allocation, each Authorized Claimant shall receive
his, her, or its
pro rata share of the Net Settlement Fund. If the prorated payment to any Authorized Claimant
calculates to less than $10.00, it will not be included in the calculation, and no distribution will be made to that
Authorized Claimant.
15. If you have questions concerning the Claim Form, or need additional copies of the Claim Form or
the Settlement Notice, you may contact the Claims Administrator, A.B. Data, Ltd., at the above address, by email
at info@QualcommSecuritiesLitigation.com, or by toll-free phone at (877) 390-3401, or you can visit the website,
www.QualcommSecuritiesLitigation.com, where copies of the Claim Form and Settlement Notice are available
for downloading.
16. NOTICE REGARDING ELECTRONIC FILES: Certain claimants with large numbers of
transactions may request, or may be requested, to submit information regarding their transactions in electronic
files. To obtain the
mandatory electronic filing requirements and file layout, you may visit the settlement website
at www.QualcommSecuritiesLitigation.com or you may email the Claims Administrator’s electronic filing
department at info@QualcommSecuritiesLitigation.com.
Any file not in accordance with the required
electronic filing format will be subject to rejection
. The
complete name of the beneficial owner of the securities
must be entered where called for (see ¶ 8 above). No electronic files will be considered to have been submitted
unless the Claims Administrator issues an email confirming receipt of your submission.
Do not assume that
your file has been received until you receive that email. If you do not receive such an email within 10 days
of your submission, you should contact the electronic filing department at
info@QualcommSecuritiesLitigation.com to inquire about your file and confirm it was received
IMPORTANT: PLEASE NOTE
YOUR CLAIM IS NOT DEEMED FILED UNTIL YOU RECEIVE AN ACKNOWLEDGEMENT
POSTCARD. THE CLAIMS ADMINISTRATOR WILL ACKNOWLEDGE RECEIPT OF YOUR
CLAIM FORM BY MAIL, WITHIN 60 DAYS. IF YOU DO NOT RECEIVE AN
ACKNOWLEDGEMENT POSTCARD WITHIN 60 DAYS, CALL THE CLAIMS ADMINISTRATOR
TOLL FREE AT (877) 390-3401.