APPENDIX A
NOTICE TO CLASS
ATTENTION
TO ALL FEMALES WHO APPLIED TO
WORK FOR ANY OF THE PALM RESTAURANTS AT ANY TIME DURING 1999 OR
2000:
The Equal Employment Opportunity Commission (“EEOC”), a
In order to be considered for any monetary award under the terms of the
agreement, you must meet ALL of the following
criteria:
a.
You are a
female and you applied to any Palm Restaurant for one of the following
positions at any time during the period of
i.
Server; Server
Assistant; Bartender; Busperson; all Cook positions, excluding Chef and Sous
Chef; Dishwasher; Host/Hostess; Pantry; and Porter;
b.
Were Qualified for
the position applied for;
c.
Were not offered
the position applied for;
d. Were not hired by a Palm Restaurant within one year after applying for the position; and
e. Met all legal requirements to work at the Palm at the time of application, or within one year from the date of applying for employment with the Palm.
If you are not a person who falls within this
definition, you should disregard this notice.
If you believe that you meet the above
requirements, you are eligible to file a claim in this case. If you wish to be considered for a
monetary award in this case, YOU MUST FILE THE ATTACHED “CLAIM FORM” AND
“RELEASE” AS INSTRUCTED BELOW. IF
YOU DO NOT FILE THE ENCLOSED CLAIM FORM AND RELEASE, YOU WILL NOT BE ELIGIBLE TO
RECEIVE ANY MONETARY BENEFITS FROM THE SETTLEMENT IN THIS CASE. PLEASE NOTE, HOWEVER, THAT
RETURNING YOUR CLAIM FORM AND RELEASE DOES NOT GUARANTEE THAT YOU WILL RECEIVE A
MONETARY AWARD.
The deadline for filing this Claim Form and Release is
TOLL FREE NUMBER -
1-866-459-3649
FAX –
612-359-2850
EMAIL –
palmsettlement@visi.com
Please be advised that your failure to completely furnish the information
requested and return it to the Claims Administrator by the date specified, may result in the rejection of your claim. It is in your best interest to
immediately return your completed Claim Form and Release. Please ensure that your Claim Form is
notarized by a Notary.
A determination will be made pursuant to the Commission’s Agreement with
the Palm, in determining what, if any, compensation you may be entitled
to.
ADDITIONAL OPTION:
You have the option to refuse to sign the Claim Form and Release and to
ask the EEOC for a Right to Sue Letter. A Right to Sue Letter will allow
you to sue the Palm in Federal Court.
There is no guarantee that you will be successful and you must hire your
own attorney. The EEOC will not
provide one for you. If you do not
complete the Claim Form and Release and elect to request a Right to Sue
Letter, you will not receive any monies from this settlement. If you wish to request a Right to Sue
Letter, sign and date the attached notice entitled Right to Sue Letter Request
and forward the document to the EEOC at:
EEOC
Attn: Marla Stern, Systemic
Unit
You must submit your completed Right to Sue Letter
Request form within 60 days of your receipt of your claims packet. Your Right to Sue Letter Request must be
postmarked by that date. The EEOC
shall determine whether or not to issue the Right to Sue Letter within five
business days of receipt of the request.
APPENDIX B
CLAIM FORM
PALM MANAGEMENT CORP. CLAIM
FORM
IMPORTANT
TO BE MAILED OR FILED ON OR
BEFORE
Note: If you are a male, do not file this claim
form.
Full Name:
(First, Middle and Last)
If you used a different name at any time during
1999-2000:
(First, Middle and Last)
Gender:
Female
Male
Social Security Number:
Current Mailing Address:
Telephone Numbers:
Home: ( )
Work: (
)
Cell:
(
)
E-mail Address:
Date of Birth:
ANSWER THE QUESTIONS BELOW AS COMPLETELY AS YOU
CAN. ATTACH EXTRA SHEETS OF PAPER,
IF NEEDED.
(e)
Did you apply to any Palm Restaurant for one of the
following positions at any time during the period of
Server; Server Assistant; Bartender; Busperson; all Cook positions,
excluding
Chef and Sous Chef; Dishwasher; Host/Hostess; Pantry; or
Porter:
Yes No
Palm Claim Form
Page 2 of 3
2.
Identify each and every position applied for, the date of application,
the address of the Palm location for which you applied and whether you were
qualified for the position. If
retained, attach a copy of the employment application, resume or cover letter
submitted to the Palm:
(1) Job Title:
Date of application:
Palm location:
Qualified:
Yes
No
(2) Job Title:
Date of application:
Palm location:
Qualified:
Yes
No
(3) Job Title:
Date of application:
Palm location:
Qualified:
Yes
No
(c) Were you offered employment and/or hired by Palm?
Yes
No
(3a)
If YES, when were you offered employment and/or hired and for which
position? Also, if you were offered
a position, yet declined the offer, please indicate why you did not accept the
offer of employment.
Date:
Position:
Reason for not accepting the position, if applicable:
.
Date:
Position:
Reason for not accepting the position, if
applicable: .
Date:
Position:
Reason for not accepting the position, if applicable:
Palm Claim Form
Page 3 of 3
(d) If you were NOT offered employment and/or hired by the Palm, did you meet all legal requirements to work at the Palm at the time of application, or within one year from the date of the applying for employment with the Palm?
Yes
No
In order to be considered to receive benefits, you must
sign and date below, and have this document notarized by a
Notary.
I swear or affirm that I have read the above claim form
and that it is true to the best of my knowledge, information and
belief.
Notary:
Signature of Claimant:
Subscribed and sworn to before me this
date:
APPENDIX C
RELEASE OF CLAIMS
RELEASE OF
CLAIMS
I, ,
Claimant, in consideration for receiving a portion of the $500,000.00 class
fund, in connection with the resolution of EEOC Charge No. 340A11437
initiated by the EEOC against Palm Management Corp., I waive my right to recover
for any claims of discrimination on the basis of sex for Palm Management Corp.’s
failure to hire me arising under Title VII of the Civil Rights Act of 1964,
42 U.S.C. § 2000e et seq., that I may have had against Palm
Management Corp. prior to the date of this release and that were included in the
claims alleged in EEOC Charge No. 340A11437.
Date: ______________
Signature: _______________________________
Print Name: _____________________________