Online Opt-out Form

Deadline to Opt-Out: November 13, 2020

Victoria Hernandez v. Acceptance Insurance Agency of Tennessee Inc., et al.
Los Angeles County Superior Court, Case No. 20STCV03873

OPT-OUT FORM

X Click to sign

By:

Date: October 14th 2020

Last 4 Digits of Social Security #

To be effective, this Form must be completed, signed, and submitted no later than November 13, 2020