• CONSENT TO PARTICIPATE IN SETTLEMENT, JOIN COLLECTION ACTION, & RELEASE OF CLAIMS

  • DEADLINE TO RETURN CLAIM FORM: : To receive your Individual Settlement Payment, you must timely complete, sign, and return this Claim Form. Your Claim Form must be postmarked by or received online, facsimile or email, on or before August 20, 2024. If you lose the envelope, you should send the Claim Form to:

  • Buffalo Wild Wings Settlement
    c/o Atticus Administration
    PO Box 64053
    Saint Paul, MN 55164

  • Please be aware that if your Notice is initially returned as undeliverable, the Settlement Claims Administrator shall promptly attempt to locate your address through an electronic search. If a new address is identified, you will be sent the Notice at your new address. If no new address is identified, then you will be sent an email and text message with the Notice and Claim Form. If you fall within this situation, you will have the longer of the initial 60 days or 15 days after the Reissue of the Notice Packet to submit your Claim Form.

  • CHANGE OF ADDRESS: If you change your address, please inform the Settlement Claims Administrator HERE or by updating below. It is your responsibility to keep a current address on file with the Settlement Claims Administrator.

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  • CONSENT TO JOIN THIS COLLECTIVE, PARTICIPATE IN SETTLEMENT & AGREEMENT TO BE BOUND TO RELEASE: By signing, dating, and returning this Claim Form, you agree to be bound by the Settlement Agreement, you consent to become a party plaintiff to this action under the federal Fair Labor Standards Act (“FLSA”), 29 U.S.C. § 216(b), and you agree to fully, finally and forever release, remise, and discharge Defendant Buffalo Wild Wings, Inc., BWW Resources, LLC, and Blazin Wings, Inc. (including their parents, subsidiaries, affiliates, predecessors, successors and assigns, and each of their respective past and present officers, directors, agents, representatives, attorneys and employees) from any and all wage and hour claims that were asserted or could have been asserted in the lawsuit under Federal and applicable state and local law that accrue from November 18, 2019 through October 24, 2023, including all state and federal claims for unpaid minimum wages, straight time wages, overtime wages, and related claims for penalties, interest, liquidated damages, attorneys’ fees, costs, and expenses. Such release includes but is not limited to state law wage payment and wage assignment statutes.

  • If you wish to review or receive a copy of the Confidential Settlement Agreement, you may contact the attorneys listed in the Notice that you received with this Claim Form.

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