Free Other Notice - District Court of Arizona - Arizona

UNITED STATES DISTRICT COURT
I 4 t q DISTRICT OF ARIz0NA I . A
IN RE ALLSTATE INSURANCE MDL Docket N0. 1541
COMPANY FAIR LABOR STANDARDS ALL CASES
LITICATI0N,
WITHDRAWAL on CONSENT TO
JOIN FORM
i Assigned to the Hon. Paul G. Rosenblatt
Dept. 621
WITHDRAWAL OF CONSENT TO JOIN FORM
On, May 15, 2006, I Signed a consent to join form in this action and on May 22, 2006,
that form Was tiled With this Couit. I hereby request that I be completely removed Hom this
action and such form be Withdrawn. I make this request for Withdrawal of my own free volition
for personal reasons.
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Case 2:O3—md—O1541-PGR Document 184-3 Filed O2/O9/2007 Page 1 of 1

Case 2:03-md-01541-PGR

Document 184-3

Filed 02/09/2007

Page 1 of 1