3M Settlement ACH Direct Deposit Information

Full Name (First, Middle, Last) *

Date of Birth - Please use format (MM/DD/YYYY) *

Name of Your Bank *

Your Bank ACH Routing Number (9 Digits) *

Your Checking Account Number *

Captcha

By clicking the Submit Button below, I affirm that I understand I am requesting that my portion of the Gross 3M Earplug Settlement be electronically transferred via ACH (Direct Deposit) to the above bank account that I have provided to my attorney. I understand that Judge Casey Rogers, the presiding judge in the 3M Combat Arms Ear Plug Litigation, has ordered a common benefit fund deduction in all 3M ear plug cases and I understand that this portion of my settlement is not paid to my attorney. I understand that attorney fees and case expenses as explained in my original 3M earplug attorney employment agreement that I signed either in person or electronically will be deducted after the court's common benefit fund is deducted.