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I understand that, pursuant to the settlement agreement between Sprint Nextel and the Minnesota Attorney General, Minnesota consumers who entered into a contract or contract extension with Sprint Nextel after September 26, 2001 have the opportunity to submit a claim for relief if they believe that (a) Sprint Nextel did not adequately disclose the terms of the wireless contract or extension relating to contract length or early termination fees; and/or (b) Sprint Nextel entered them into a contract or extension without their authorization or knowledge.  I submit this claim for relief, and provide the following information in support of my claim (please print):

 

Name: ________________________________________________________

Address: ______________________________________________________

Current Telephone: ______________________________________________

 

I represent that I was the authorized person on the Sprint Nextel account, or am otherwise authorized to file this claim: □ Yes

1. Do you object to a wireless contract or contract extension with Sprint Nextel for any of the following reasons (check all that apply):

□ I believe that Sprint Nextel did not adequately disclose the terms of the wireless contract or extension relating to contract length or early termination fees.

□ I believe that Sprint Nextel entered me into the wireless contract or extension without my authorization or knowledge.

□ I believe it was improper for Sprint Nextel to impose an early termination fee or related charge because Sprint Nextel did not disclose the contract term length or early termination fee(s).

2. Please provide the following information for any disputed wireless contract or extension:

Telephone number(s) subject to disputed contract or extension (if known): ____________________

Name listed on the Sprint Nextel Account: ______________________________________________

Sprint Nextel Account Number: _______________________________________________________

Are you currently under contract with Sprint regarding this disputed wireless contract or extension?
□ Yes □ No (check one)

3.  Did Sprint Nextel charge you an early termination fee for canceling the disputed wireless contract or extension? □ Yes □ No (check one).

If you answered “Yes,” please provide the following information:

Amount of early termination fee charges $___________

Amount that I paid for such fee/charges (if any): $___________

Amount of this payment that was later refunded to me by Sprint Nextel (if any): $___________

4.  Please indicate the relief that you are seeking (check all that apply):

□ I believe that Sprint Nextel should refund the early termination fees and any related taxes and fees that I paid as a result of canceling my contract (which I understand may be reduced by any refund that I already received from Sprint Nextel)

□ I believe that Sprint Nextel should reverse the early termination fees and any related taxes and fees that I was charged but did not pay (the amount of which I understand may be reduced by any credit or adjustment that I already received from Sprint Nextel)

□ I want Sprint Nextel to report, or cause to be reported, to the credit reporting agencies (if a report was previously filed) that I do not owe any charges that are refunded or reversed as a result of my claim.

□ I believe that I should not be held to my current wireless contract because Sprint Nextel did not adequately disclose the terms of the contract relating to contract length or early termination fees or obtain my consent to the contract.

□ Other non-monetary relief  (please explain):

_______________________________________________________________

5.  Please feel free to provide any additional information that is pertinent to your claim, including any documents you wish to submit (continue on other side if necessary).  You do not need to submit documents in support of your claim at this time, but may be asked to do so at a later date.

_______________________________________________________________________________

 

_______________________________________________________________________________

I hereby certify that the foregoing claim is true and correct to the best of my knowledge.

 

Signature: _______________________________________ Date: __________________________

 

You should mail or deliver this form to the following address on or before March 15, 2010.  Your claim will be processed in accordance with the settlement agreement in this matter.  If you have any questions relating to the settlement, you may contact the Minnesota Attorney General’s Office as follows:

 

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