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IN THE UNITED STATES DISTRICT COURT FOR ... - Cleveland.com

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CONSENT TO OPT <strong>IN</strong>TO LAWSUIT, RELEASE AND DISMISSAL OF CLAIMS<br />

I consent to opt into the lawsuits, Warren, et al. v. Race, et al., Case No. 1:09-CV-2670 (“the Lawsuit”) and<br />

Warren, et al. v. Kettlewell, et al., Case No. 1:09-CV-2285 (the “Related Lawsuit”) pending in the U.S. District Court<br />

for the Northern District of Ohio. I agree to be represented by Cohen, Rosenthal & Kramer LLP and The Lazzaro Law<br />

Firm, LLC, to be bound by the settlement, and fully and finally release any claims or rights I may have in connection<br />

the Lawsuit and Related Lawsuit.<br />

In exchange, I hereby release all wage and <strong>com</strong>pensation claims – including, but not limited to, all claims for<br />

non-payment of wages, vacation pay, paid time off, and expense reimbursement – that I now have or may have, both<br />

known and unknown, against InkStop, Inc., its parent <strong>com</strong>pany(ies), subsidiaries, division, affiliated businesses,<br />

predecessors and assigns, if any, together with its and their respective past and present owners, stockholders, assigns,<br />

agents, directors, officers, employees, representatives, attorneys, benefit plans, plan fiduciaries and/or administrators,<br />

and all persons acting by, through, under, or in concert with any of them, including (but not limited to) any party that<br />

was or could have been named as a defendant in the Lawsuit or the Related Lawsuit (collectively, “Releasees”). I also<br />

hereby waive and release any <strong>com</strong>pensation-related claims I have or may have in the bankruptcy proceedings<br />

involving InkStop, Inc. My releases and waivers include all claims under the Fair Labor Standards Act, 29 U.S.C.<br />

§201, et seq., and any applicable state laws.<br />

I understand that I will receive a one-time payment of $__________ (“Payment”), less federal and state tax<br />

withholdings and deductions required by law.<br />

I also hereby consent to the dismissal of the Lawsuit and the Related Lawsuit and any and all claims that were<br />

or could have been raised in the Lawsuit and the Related Lawsuit by and through the Named Plaintiffs and/or my<br />

above-approved legal counsel. I hereby designate counsel for the Named Plaintiffs to execute all appropriate<br />

documents to effectuate my payment and the settlement of the Lawsuit or the Related Lawsuit.<br />

I have carefully read and fully understand all items in this agreement and am voluntarily signing it. I<br />

understand that if I have any questions, I know I have the right to discuss this agreement with my own private<br />

attorney. I also understand that any issues relating to this agreement will be addressed under the laws of the State of<br />

Ohio.<br />

PLEASE READ AND CONSIDER THIS AGREEMENT CAREFULLY BE<strong>FOR</strong>E EXECUT<strong>IN</strong>G. THIS<br />

AGREEMENT <strong>IN</strong>CLUDES A RELEASE OF ALL WAGE AND COMPENSATION CLAIMS.<br />

<br />

<br />

<br />

___________________________________<br />

Signature<br />

___________________________________<br />

Social Security No. (required for a payment)<br />

___________________________________<br />

Date<br />

FAX to: 216-696-7005<br />

E-MAIL to: inkstop@lazzarolawfirm.<strong>com</strong>; or<br />

MAIL to: InkStop Settlement<br />

c/o The Lazzaro Law Firm, LLC<br />

920 Rockefeller Building<br />

614 W. Superior Avenue<br />

<strong>Cleveland</strong>, OH 44113<br />

3<br />

Name/Address Corrections:<br />

___________________________________<br />

___________________________________<br />

___________________________________<br />

___________________________________<br />

Phone Number<br />

___________________________________<br />

Email Address<br />

On or before April __, 2010 to receive priority.<br />

The final deadline is June __, 2010.

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