Part IV
SUBMISSION TO JURISDICTION OF COURT AND ACKNOWLEDGMENTS
By signing and submitting this Claim Form, the Claimant(s) or the person(s) acting on behalf of the Claimant(s)
certify(ies) that: I (We) submit this Claim Form under the terms of the Plan of Allocation described in the accompanying
Settlement Notice. I (We) also submit to the jurisdiction of the United States District Court for the Northern District
of Illinois (the “Court”) with respect to my (our) claim as a Class Member(s) and for purposes of enforcing the releases
set forth herein. I (We) further acknowledge that I (we) will be bound by and subject to the terms of any judgment
entered in connection with the Settlement in the Action, including the releases set forth therein. I (We) agree to
furnish additional information to the Claims Administrator to support this claim, such as additional documentation
for transactions in Allstate common stock, if required to do so. I (We) have not submitted any other claim covering
the same transactions in Allstate common stock during the Class Period and know of no other person having done so on
my (our) behalf.
Part V
RELEASES, WARRANTIES, AND CERTIFICATION
By signing and submitting this Claim Form, the Claimant(s) or the person(s) who represent(s) the Claimant(s) agree(s) to the release
above and certifies (certify) as follows:
I (We) hereby warrant and represent that I am (we are) a Class Member as defined in the Settlement Notice, that I am (we are) not excluded from the Class, and that I am (we are) not one of the “Released Defendant Parties” as defined in the accompanying Settlement Notice.
As a Class Member, I (we) hereby acknowledge full and complete satisfaction of, and do hereby fully, finally, and forever compromise, settle, release, resolve, relinquish, waive, and discharge with prejudice the Settled Plaintiffs’ Claims as to each and all of the Released Defendant Parties (as these terms are defined in the accompanying Settlement Notice). This release shall be of no force or effect unless and until the Court approves the Settlement and it becomes effective on the Effective Date.
I (We) hereby warrant and represent that I (we) have not assigned or transferred or purported to assign or transfer, voluntarily or involuntarily, any matter released pursuant to this release or any other part or portion thereof.
I (We) hereby warrant and represent that I (we) have included information about all of my (our) purchases and sales of Allstate common stock that occurred during the Class Period and the number of shares held by me (us), to the extent requested.
I (We) certify that I am (we are) NOT subject to backup tax withholding. (If you have been notified by the Internal Revenue Service that you are subject to backup withholding, please strike out the prior sentence.)
I (We) declare under penalty of perjury under the laws of the United States of America that all of the foregoing information supplied by the undersigned is true and correct.