Settlement Pending - Response Form

If a check or replacement is being sent to you, it will be sent to this address. Please verify that your address is entered correctly.

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By typing my name below, I am consenting to the option selected above and to the following terms: 

I understand that multiple copies of my above submission are kept on file at New Leaf Service Contracts for verification purposes. I have reviewed the information above and hereby certify that it is accurate and true. I have been given ample time to review my settlement offer and to ask any questions concerning my settlement offer. I understand that by submitting my response using this form, I may be, depending on the selection above, consenting to receive the exact settlement offered by New Leaf Service Contracts, LLC as governed by my Terms and Conditions. I also understand that this offer is final and cannot be changed, updated, or negotiated. 

Please verify the form for accuracy BEFORE clicking the button below. 

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