Toshiba tocf#1026 Manuel D’Utilisation

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ToCF#1026

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By  checking  this  box,  I  hereby  affirm,  under  penalty  of  perjury,  that  the  exclusive  and  direct
reason  for  my  purchase  of  the  non-Toshiba  DVD  player  was  the  manifestation  of  Playback
Incompatibilities on the Toshiba DVD Player at Issue.

I attest under the penalties of perjury that:

1.

I purchased or acquired the Toshiba DVD Player at Issue on or before October 15, 2004.

2.

I am eligible to request the remedy that I am seeking by submitting this Claim Form relating to
the Toshiba DVD Player at Issue.

3.

Any  documents  submitted  with  this  Claim  Form  are  either  the  originals  or  true  and  correct
copies of the originals.

4.

I  have  not  requested,  and  will  not  request,  exclusion  from  the  Settlement  Class  for  the
Toshiba DVD Player at Issue, and I have not previously filed a Claim Form with respect to the
Toshiba DVD Player At Issue, and I will not file in the future a Claim Form with respect to the
Toshiba DVD Player At Issue.

5.

I have read and understand the contents of this Claim Form.

6.

The statements made in this Claim Form are true and correct to the best of my knowledge.  I
realize  that  if  any  of  them  are  willfully  false,  I  am  subject  to  punishment  under  perjury
statutes.

                                                                    

                                                                                                     

IF  YOU  HAVE  ANY  QUESTIONS  ABOUT  THIS  CLAIM  FORM  OR  THE  SETTLEMENT,  PLEASE  SEE
THE  CLAIMS  ADMINISTRATOR'S  WEBSITE  AT  WWW.DVDNOTICE.COM, CALL 1-800-210-5874,  OR
SEND YOUR WRITTEN QUESTIONS TO:

IF  YOU  DO  NOT  RETURN  A  CLAIM  FORM  POSTMARKED  BY  MAY  1,  2005,  YOUR  CLAIM  WILL
BE  REJECTED  AND  YOU  WILL  HAVE  WAIVED  ALL  RIGHTS  TO  RECEIVE  ANY  OF  THE
SETTLEMENT BENEFITS.