Free Other Notice - District Court of Arizona - Arizona

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· IN RE ALLSTATE COMPANY FAIR LABOR STANDARDS LITIGATION
United States District Court for the District 0f Arizona, MDL N0. 1541
I CONSENT TO JOIN COLLECTIVE ACTION I
1, the unldersigned, consent to be a party plaintiff in the In Re Allstate Insurance Company Fair Labor Standards Litigation
(NID?. lilo. 1541), in \ er to seek re%ess for violations(s) of the Fair Labor Standards Act, pursuant to 29 U.S.C. § 216(b).
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Sign your name here ' Date ' l
If you would like to receive e-mail ¤ ation from the plaintiffs’ attorneys that your __ , J., - ,, _
Consent to Join form has been filed withthe Court, provide a non-Allstate e-mail address: { ililti l G YG 53 41%} vii lit
Must be postmarked on or before July 7, 2006.
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Vanessa R Allen I
945 Chapel Hill Dr _ A J
Lawrenceville, GA 30045-2378 _ p
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Area Code i__ _ i_ Daytime Telephone Number _v __Area_Code _ _ _ Evening Telephone Number
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IN RE ALLSTATE INSURANCE COMPANY FAIR LABOR STANDARDS LITIGATION
United States District Court for the District of Arizona, MDL N0. 1541
CONSENT TO JOIN COLLECTIVE ACTION
I, the undersigned, consent to be a party plaintiff in the In Re Allstate Insurance Company Fair Labor Standards
Litigation (MDL N0. 1541), in order to seek redress for vio1ati0ns(s). of the Fair Labor Standards Act, pursuant to °
29 U.S.C. 2l6(b).
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igh your name here Date
Must be postmarked on or before July 7, 2006.
Claim #: ALR-3-102506-O-01 Name/Address Changes (if any):
John William Cilento .
846 Miller Creek Ln
Newport News, VA 23602
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Am Code asa .¥a‘n"!F'7'6 liF!<» '¢l1H1- I ocument I e • zi? aifgfa r pho rr- at
If you would like to receive e-mail confirmation from the plaintiffs’ attorneys that your
Consent to Join form has been tiled with the Court, provide a non-Allstate e-mail address: C.? E \:C\Tc;» 63 C,©>L. -V'\&.—L~

Case 2:03-md-01541-PGR

Document 175-2

Filed 07/25/2006

Page 1 of 2

Case 2:03-md-01541-PGR

Document 175-2

Filed 07/25/2006

Page 2 of 2