7 I Your claim must be postmarked by: October 19, 2018 UNITED STATES DISTRICT COURT - DISTRICT OF MASSACIfUSET7S Bazerman. e: at. v American Airlines, Inc. AAF CHECKED BAG REFUND CLAIM FORM kyi ANN M RODRIQUF2 NEW YORK NY 10021-4102 IIIIIIIuuI AAF1154508 Confirmation Code: 292913 Notice ID Number: AAF1154508 (If you wish to file your claim online, visit the website at inny,AAavgaggreragusnemscum You will need your Notice ID Number and Confirmation Code printed above.) 13018 Your Signed Claim Form Must Be Submitted Electronically or Mailed and Postmarked No Lateen's" October 19, 2018 or You Will Not Receive Money from this Settlement. If you received this form by mail or email, American Airlines' computerized records indicate that you may have been incorrectly charged fees for checked begs. If you want American to verify whether you have been incorrectly charged to check bags, you must complete and return this Claim Form by the Deadline above. Refunds for verified claims will range from $18.75 to 5200.00 plus interest for each incorrectly charged check bag. PART I: CLASS MEMBER INFORMATION Name Address: Please below. ANN M RODRIQUEZ NEW YORK NY 10021.4102 Email: Frequent Flyer Number': =talon. If your contact information above is blank, inaccurate, or incomplete, please provide corrections Frequent Flyer Number' (Optional) Address 2 Aka X ,1 City State Zip Am you a resident of the United States of America?' Yes ON ' You do in have to have a frequent flyer number to be entitled to a Refund. If you have one or more frequent flyer nurnbcrls) associated with your navel on American Airlines at any time since July 13, 2013, please fill in those numbers, as this will help American process your Claim. Frequent flyer numbers can include American Airlines AAdvaniage, the various programs operated by OneWorld partner, and Alaska Airlines Mileage Plan. If you have used more than one frequent flyer nimiber on your travel with Americ