Deadline to Submit a Claim Form: DECEMBER 31, 2022

• This is the form that you may submit if you want to share in the settlement money received from Ford Motor Company of Canada, Limited. You may only submit this form if you meet the requirements listed under "Can I Submit This Claim Form?" below.

• Throughout this Claim Process, the term “you” means the person or business that purchased or leased the vehicle(s) listed in this form.

Can I Submit This Claim Form?

You are only eligible to submit this Claim Form if all of the following apply to you:

1. You purchased or leased a new motor vehicle (passenger car, light truck or sport utility vehicle (“SUV")) during the period January 1, 2001 to April 30, 2003 (“Eligible Claims Period"); and

2. You purchased or leased the new motor vehicle from an automobile dealer located in California; and

3. The vehicle you purchased or leased was one of the following makes: Acura, Buick, Cadillac, Chevrolet, Chrysler, Dodge, Ford, GMC, Honda, Hummer, Infiniti, Jaguar, Jeep, Land Rover, Lexus, Lincoln, Mazda, Mercury, Nissan, Oldsmobile, Plymouth, Pontiac, Saab, Saturn, Toyota or Volvo; and

4. You resided in California as of November 15, 2010.

If you need any help determining whether you are eligible to submit a claim, please review the Notice available here.

Do I Need to Attach Any Documents to the Claim Form?

No. At this time, you do not need to submit any documents other than this Claim Form. But, by signing in Section 4 of this form and submitting your claim, you are verifying under penalty of perjury that you purchased or leased the vehicle(s) you list on this form. You may be asked by Plaintiffs’ Counsel, the Claims Administrator or the Court for documents showing that you made the purchases you list on this form.