Allina Pixel Settlement

Allina Pixel Settlement

Allina Pixel Settlement

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Allina Pixel Settlement

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ADDRESS AND/OR PAYMENT METHOD UPDATE

GENERAL INSTRUCTIONS

Please follow the steps on the next pages to review and update your information.

You will first be asked to review your address and confirm or update it.

• If your address is correct, select Confirm My Address and continue.
• If your address has changed, select Update My Address and enter your new information.

After that, you will be given the option to update your payment method, if needed.

CLASS MEMBER INFORMATION

NAME:*
Current Address:*
Please choose one option:*
Updated Address:*
This is the 8-digit alpha-numeric identification code included in the Notice sent by mail or email

Payment Selection

Based on our records, your current payment method is as your payment method. Please indicate below if you would like to update this selection.

Please choose one option:*

Please select one payment method for receipt of any Settlement payment to which you are determined eligible:

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Signature

Checkbox Consent*
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