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Important Emission Campaign
DaimlerVansUSA,LLCAMacedesBen:AGCompanyIMPORTANTEMISSIONCAMPAIGN2020040002°1°"Thisnoticeappliestoyourvehicle,VIN:WDYFE8CDOGP308414EPA&CARBApprovedEmissionModification-OM642SprinterEMC#1March2021•Anemissionmodificationisavailableforyourvehicle.•ScheduleanappointmentwithyourauthorizedFreightlinerdealerassoonaspossible.•Thismodificationwillbeprovidedfreeofcharge.DearFreightlinerSprinterOwnerorLessee:OnMarch9,2021,asettlementwasapprovedbetweenDaimlerAGandMercedes-BenzUSA,LLC("MBUSA")andtheUnitedStatesDepartmentofJustice(DOJ),theEnvironmentalProtectionAgency(EPA),theCaliforniaAirResourcesBoard(CARB),andtheCaliforniaAttorneyGeneral'sOffice(CAAG),regardingtheemissioncontrolsysteminyourvehicle.Aspartofthissettlement,weareofferingamodificationtoyouremissioncontrolsystem.TheemissionmodificationforyourvehiclehasbeenapprovedbytheEPAandCARB,andisnowreadyforinstallationinyourvehicle.YourauthorizedFreightlinerdealerwillinstallthemodificationatnocosttoyou.ThisletteroutlinestheemissioncontrolsystemmodificationsthatarenowavailableforyourSprintervehicleandthefurtherextendedemissionswarranlycoveragethatwillbeprovidedoncethemodificationhasbeencompletedonyourvehicle.Youcanalsoreadabouttheinstructionsregardingmaintenanceforyourvehiclepost-modification.Weencourageyoutocarefullyreviewtheinformationinthisletter,andifwecanbeoffurtherassistance,pleaseletusknow.Forquestionsaboutanyofthematerialinthisletter,pleasevisithttps://BlueTecUpdate.freightlinersprinterusa.comorcontact1-833-841-9363.I.EmissionModificationAsdescribedabove,yourauthorizedFreightlinerdealerwillinstalltheemissionmodificationthatupdatestheemissionscontrolsystemsoftwareonyourvehicleandinvolvesanexchangeoftheNOxsensors.Youshouldnotnoticeanyadversechangesinvehiclereliability,durability,performance,drivability,fueleconomy,orotherdrivingcharacteristics.Themodificationwillchangethewayyourvehicle'sengineandemissioncontrolsystemsinteract.Theemissionmodificationwillaffectyourcarinthefollowingways:•DieselExhaustFluid(DEF)consumption-TheemissionmodificationisnotexpectedtochangethefrequencywithwhichyouneedtorefillyourDEF(alsoknownasAdBlue')tank.However,undercertainconditions,yourvehiclemayusemoreDEFascomparedtopriorusage.Theexactamountofthechangewillvarydependingondrivingstyleandprofile,aswellasotherfactors.•On-boarddiagnostic(OBD)systemchanges-Theoperationofyourvehicle'sOBDsystemwillbemodifiedbasedupontheagreementwithEPAandCARB.WedonotanticipatethatthemodificationwillaffecttheOBDsysteminamannerthatwouldmakeidentificationandrepairofanycomponentsdifficult,compromisewarrantycoverage,orcompromiseyourvehicle'sabilitytocomplywiththeDaimlerVansUSA,ILC inspectionandmaintenance(SmogCheck)testofyourvehicle.Furthermore,theextendedwarrantycoverageoutlinedinthisletteroffersadditionalprotectionforanycorrespondingOBD-relatedissues.Thesechangesshouldnotbenoticeabletoyouanddonothaveanyimpactupondrivingcharacteristics.Theemissionmodificationisavailableatnocosttoyou.Itwilltakeapproximately1.5hourstoinstalltheemissionmodification.Asamatterofnormalserviceprocess,anauthorizedFreightlinerdealerwillalsocheckforotherrepairmeasureswhichmightbeapplicabletoyourvehicle;thismayincreasetherequiredworkingtime.Youwillnotbechargedforotherserviceorrepairsunlessyourequestthem.Moreinformationregardingthetechnicaldetailsofthisupdatecanbefoundathttps://BlueTecUpdate.freightlinersprinterusa.com.II.EmissionStandards/LabelYourvehiclewasoriginallycertifiedtoEPAandCARBemissionstandards,anditwillmeetthesestandardsaftermodification.Anemissionmodificationcompletionconfirmationlabelwillbeinstalledunderthehoodofthevehicleafterthemodificationiscompleted.III.ChangesinMaintenanceScheduleTheemissionmodificationofyourFreightlinerSprintervandoesnotaffecttherecommendedvehiclemaintenancescheduleforoilchangeintervalsasdescribedinyourmaintenancebooklet.Undercertainoperatingconditions,yourvehicle'sDEFusagemayincrease.ThefrequencywithwhichyourefillyourDEFtankshouldnotchange.IV.SchedulingtheEmissionModificationYouwillreceivetheemissionmodificationatnocosttoyou.Vehiclesreceivingtheemissionmodificationwillalsoreceiveanextendedemissionswarrantycoveringtheemissionssystemofthemodifiedvehicle,whichincludesaremedytoprotectagainstthepossibilitythatthemodificationcausessubsequentserviceproblems.Toreceivetheemissionmodificationdescribedinthisletter,pleasescheduleanappointmentwithyourpreferredauthorizedFreightlinerdealership.Tolocateadditionalauthorizeddealerspleaseseehttps://www.freightlinersprinterusa.com/freightliner/shopping-tools/find-a-dealerFormoreinformationabouttheemissionmodification(includingwhenandhowtovisitadealer),ortocheckeligibility,pleasevisithttps://BlueTecUpdate.freightlinersprinterusa.com.V.ExtendedModificationWarrantyCoverageOncetheemissionmodificationhasbeeninstalledinyourvehicle,DaimlerVansUSA,LLCwillextendyourwarrantycoverageforcertainemissions-relatedcomponents.2 WarrantyPeriod:Thewarrantyperiodforthe"ExtendedModificationWarranty"shallbethegreaterof:•10yearsfromthedateofinitialsaleor120,000milesontheodometer,whicheveroccursfirst;OR•4yearsor48,000milesfromthedateonwhichtheemissionmodificationwasperformed,whicheveroccursfirst.Thevehicle'sdateofinitialsale(alsoreferredtoasthevehicle'swarrantystartdate)isdefinedasthedatethevehiclewasdeliveredtoeitherthefirstretailpurchaserorlessee;orifthevehiclewasfirstplacedinserviceasa"demonstrator"or"company"car,onthedatesuchvehiclewasfirstplacedinservice.Asindicatedinthelistbelow,someemission-relatedcomponentshaveanadditionalextendedwarrantyperiod.TheadditionalextendedwarrantyisaddedtotheapplicableExtendedModificationWarrantyperiodabove.PartsCoveredUnderExtendedWarranty:TheExtendedModificationWarrantycoverstheemissioncontrolsystem,including(1)allcomponentswhicharereplacedaspartoftheemissionmodification,and(2)anycomponentwhichcanreasonablybeimpactedbyeffectsoftheemissionmodification.Theemissioncontrolsystemwarrantyshallcoverthefollowingpartsorsystems:•DOC(additionalextendedwarrantyof6monthsand6,000miles),•DPF(additionalextendedwarrantyof6monthsand6,000miles),•SCRcatalyst(additionalextendedwarrantyof12monthsand12,000miles),•DEFinjector,•DEFinjectorcontroller,•DEFsupplymodule,•DEFpump(additionalextendedwarrantyof6monthsand6,000miles),•Temperaturesensorunit,•Exhausttemperaturesensor(additionalextendedwarrantyof12monthsand12,000miles),•PMsensor,•LambdasensorforEmissionModificationCategories1-5(additionalextendedwarrantyof12monthsand12,000miles),•NOxsensors(additionalextendedwarrantyof24monthsand24,000miles),•Fuelinjectors(additionalextendedwarrantyof6monthsand6,000miles),•Airintakethrottle,•EGRvalve(additionalextendedwarrantyof6monthsand6,000miles),•EGRduct(additionalextendedwarrantyof6monthsand6,000miles),•EGRcooler(includingbypass-control)(additionalextendedwarrantyof6monthsand6,000miles),•Intakemanifold/chargeairdistributor(additionalextendedwarrantyof6monthsand6,000miles),•EGRtemperaturesensor(additionalextendedwarrantyof6monthsand6,000miles),•Turbocharger,includingVGTactuator,3 •ECUhardware,wherereplacedaspartoftheApprovedEmissionModification,•TCUhardware,wherereplacedaspartoftheApprovedEmissionModification,•HCUhardware,wherereplacedaspartoftheApprovedEmissionModification,•OBDSystem:thecostofanyOBDDiagnosticScanformalfunctionsthattriggertheMIL,regardlessofwhetherthemalfunctionisattributabletoapartthatiscoveredundertheExtendedModificationWarranty,aswellasthecostoftroubleshootingtodeterminethereasonforthemalfunction,butonlyifthemalfunctionisdeterminedtobeattributabletoapartthatiscoveredundertheExtendedModificationWarranty,•Cylinderheadassemblycomponents:camshaft,valves,springs,valvespringkeepers,valveseats,cambearingcaps,andmanifoldstuds,•Enginetimingchain,•Intakemanifoldpressuresensor,•Instrumentclusterhardware,wherereplacedaspartoftheApprovedEmissionModification,and•Coolantthermostat,wherereplacedaspartoftheApprovedEmissionModification.InourcontinuingeffortstoassureproperperformanceofyourFreightlinerSprintervan,yourauthorizedFreightlinerdealerwilldiagnoseandreplacetheemissions-relatedcomponentslistedinthissection,ifnecessary,atnocosttoyouaslongasthevehicleremainswithinthetimeandmileagelimitsofthiswarrantyextension.Pleasekeepthisletteranddeliverittoanynewowner,alongwiththeowner'smanual.Thiswarrantyextensioncoversthediagnosisandreplacementoftheemissions-relatedcomponentslistedinthissection.Shouldyoueversellthevehicle,thiswarrantyextensionisfullytransferabletosubsequentowners.Thiswarrantyextensionwillcover:•Anydamageormalfunctionscausedbyinstallationofnon-EPAornon-CARBcertifiedemissionsrelatedparts,includingdamageormalfunctiontopartsneededforproperdiagnosisofacoveredpart.•Damageormalfunctionscausedbyorrelatedtooutsideinfluence,suchasdamageduetoanaccident,orvehiclemisuseorneglect.Allexistingwarrantyprovisionsremainineffect.Theextendedemissionswarrantyincludespartsandlabor.Theextendedemissionswarrantyshallnotvoidorsupersedeanyexistingwarranty.Moreinformationaboutyourextendedemissionswarrantycoverageisavailableathttps://BlueTecUpdate.freightlinersprinterusa.com.Transferability:Thisextendedemissionswarrantyisfullytransferabletosubsequentowners.WarrantyNotices:Allnormalwarrantyprovisionsremainineffect.VI.CheckingYourVehicle'sEligibilityTocheckyourvehicle'seligibilityforrepairunderthisservicecampaign,pleasevisithttps://BlueTecUpdate.freightlinersprinterusa.comorcall1-833-841-9363andprovideyourVehicleIdentificationNumber(VIN),whichforyourconveniencecanbefoundatthetopofthisletter.4 Ifyourvehicleiseligible,youmayscheduleanappointmenttocompletetheemissionmodificationquicklyandeasilydirectlyfromhttps://BlueTecUpdate.freightlinersprinterusa.comorbycalling1-833-841-9363.VII.CustomerNoticesIfyouchoosetodeclinetheemissionmodificationatthistime,youshouldbeawarethatcertainemissions-relatedreplacementandrepairpartsmayatsomepointnolongerbeavailablefromFreightliner.Accordingly,inthefuture,ifyourunmodifiedvehiclerequiresmaintenanceandrepairsoftheemissionssystem,wemayneedtoperformtheemissionmodificationfirst,including,whereapplicable,installingtheenginecontrolunit(ECU)softwareassociatedwiththeemissionmodification.Thismayleadtochangestoyourvehicle'soperationresultingfromthosemodifications,asdiscussedinthisletter.Ifyourvehiclehasbeenmodifiedpriortoreceivingtheemissionmodificationwiththeuseofanyafter-marketemissions-relatedcomponents,parts,and/orsoftwareortheremovalofanyoriginalemissions-relatedcomponents,parts,and/orsoftware,andsuchalterationsarelikelytosubstantiallyaffecttheoperationofthevehiclewiththeemissionmodification,orsubstantiallyimpedeinstallationoftheemissionmodification,yourauthorizedFreightlinerdealermaynotbeabletoperformtheemissionmodificationuntilyoucorrectsuchmodification.Pleasevisithttps://BlueTecUpdate.freightlinersprinterusa.comwithanyquestions,orcontactusat1-833-841-9363.WehopeyouareenjoyingyourFreightlinerSprintervan,andweapologizeforanyinconvenience.Sincerely,DaimlerVansUSA,LLC5 ¡g-¡gVIN:WDYFE8CDOGP308414.•IMPORTANTIfforanyreasonYOUNOLONGEROWNTHISVEHICLEORhaveaCHANGEOFADDRESS,pleaseCOMPLETETHESECTIONBELOW,placeintheENCLOSEDENVELOPE,andDROPINANYMAILBOX.Ifpossible,providethenameandaddressofthepresentownersothatwemaycontactthem.OEXPORTEDOSOLDOLEASE,VEHICLERETURNEDOSTOLENOscRAPPEDOOTHERONEWOWNERINFORMATIONOMYNEWNAMEORADDRESSIS:LastName,FirstNameStreetAptCityStateZIPEmailAddressPhone(numbersonly)Mobile(numbersonly)DateSignature UniqueID:DV3G5YB7MDUnitedStatesDistrictCourtfortheDistrictofNewJerseyescoe22InreMercedes-BenzEmissionsLitigation,16-cv-881(KM)(ESK)IfYouBoughtorLeasedaMercedes-BenzorSprinterBlueTECIIDieselVehicle,YouMayBeEligibleforaCASHPAYMENTfromClassActionSettlementsUNDERTHECLASSACTIONSETTLEMENTS':GETPAIDCASHCurrentownersandlesseescangetupto$3,590ormore,andformerownersandlesseescangetupto$897.50OCURRENTOWNERSANDLESSEESGETYOURAGENCY-APPROVEDEMISSIONMODIFICATIONFREEOFFromaseparatesettlementwithCHARGETOYOUfederalandCaliforniaregulators;thesebenefitsareavailableevenifyoudonotparticipateintheClassActionRECEIVEANEXTENDEDSettlementsMODIFICATIONWARRANTYYOUNIUSTTAKEACTIONTORECEIVETHESEBENEFITS1The"ClassActionSettlements"aretheseparateclasssettlementswiththeMercedesDefendants(the"MercedesClassActionSettlement")andwiththeBoschDefendants(the"BoschClassActionSettlement").Seembbluetecsettlement.comformoredetails.QUESTIONS?VISITMBBLUETECSETTLEMENT.COM,ORCALL1-877-313-0170 IfyoucurrentlyownorleaseaMercedes-BenzorSprinterBlueTECIIdieselvehicle(seethetablebelowshowingtheeligible"SubjectVehicles"2)intheUnitedStates,includingbothMercedes-Benz-andFreightliner-brandedSprinterdieselvehicles,youmaybeeligibleforacashpaymentofupto$3,590($3,290fromtheMercedesClassActionSettlement,andupto$300fromtheBoschClassActionSettlement)ifyougetan"ApprovedEmissionModification"(AEM)installedinyourvehicle(freeofchargetoyou);or$2,692.50(oncetheAEMisinstalled,$2,467.50fromtheMercedesClassActionSettlement,andupto$225fromtheBoschClassActionSettlement)ifaformerownerorlesseesubmitsaValidClaimforthesamevehicle.Youmayalsobeeligibleforadditionalpayments,dependingonthevehicleyouownorlease.FormerownersandlesseesofMercedes-BenzorSprinterBlueTEClldieselvehiclesintheUnitedStatesmaybeentitledtoupto$897.50($822.50fromtheMercedesClassActionSettlement,andupto$75fromtheBoschClassActionSettlement).Pleasevisitmbbluetecsettlement.comformoredetails.Currentownersandlessees_mu_s_thaveanAEMinstalledtoreceivethecashpayments.InstallationisavailablefreeofchargetoyouandyouwillreceiveanExtendedModificationWarrantyaftertheinstallation.AEMsareavailable_n_ow_fortheSubjectVehicleslistedontheenclosedbluesheet.YoucanalsocheckAEMavailabilityatthesettlementwebsite,mbbluetecsettlement.com,whereyoucanaccessalinktotypeinyourVINorreviewalistofallSubjectVehiclemodelsthatarereadyfortheAEMinstallation.Youmayalsocall1-877-313-0170toll-freetofindoutwhetheranAEMisavailableforyourSubjectVehicle.AsAEMsforothervehiclesbecomeavailable,ownersandlesseesofthosevehicleswillreceiveanothermailednotice.UpdatesregardingtheAEMsandtheClassActionSettlementscanbefoundatmbbluetecsettlement.com.Thesettlementwebsitembbluetecsettlement.comwillallowcurrentandformervehicleowners/lesseestoregisterformoreinformation.RegistrationonthewebsitealonedoesnotconstituteaValidClaimforcashbenefits.IfyouwishtoclaimaClassMemberPayment,youmustsubmitaValidClaimbytheapplicableduedate,evenifyouhaveregisteredonthewebsiteforupdates.PleaseseebelowconcerningtherequirementtosubmitaValidClaimtoreceivecashbenefits.WHOISINCLUDEDINTHEPROPOSEDSETTLEMENTS?YouarereceivingthisnoticeasacurrentorformerownerorlesseeofoneoftheSubjectVehicleslistedbelow.IfyoupurchasedorleasedandRegisteredaSubjectVehicleintheUnitedStates,youmaybeaClassMemberandeligibleforacashpayment,evenifyounolongerownorleasetheSubjectVehicle.2AllcapitalizedtermsnotdefinedinthisNoticearedefinedintheClassActionSettlements,copiesofwhichareavailableatmbbluetecsettlement.com.QUESTIONS?VISITMBBLUETECSETTLEMENT.COM,ORCALL1-877-313-01702 MODELMODELYEARSE250BlueTEC2014-2016E350BlueTEC2011-2013GL320BlueTEC2009GL350BlueTEC2010-2016GLE300d2016GLE350d2016GLK250BlueTEC2013-2015ML250BlueTEC2015ML320BlueTEC2009ML350BlueTEC2010-2014R320BlueTEC2009R350BlueTEC2010-2012S350BlueTEC2012-2013Mercedes-BenzorFreightlinerSprinter(4-cylinder)2014-2016Mercedes-BenzorFreightlinerSprinter(6-cylinder)2010-2016WHATAREMYOPTIONS?IfyouareaClassMember,youmay(1)submitaValidClaimforpayment;(2)donothing(andgetnopayment);(3)excludeyourselffromtheClass("optout");(4)objecttotheClassActionSettlements;and/or(5)gotoahearingaboutthefairnessoftheClassActionSettlements.•Ifyoudonothing,youwillgetnopaymentandyouwillgiveupyourrightstosueDaimlerAGandMercedes-BenzUSA,LLC(the"MercedesDefendants")andRobertBoschGmbHandRobertBoschLLC(the"BoschDefendants")aboutanyoftheclaimsinthiscase.•Ifyouexcludeyourself("optout")fromtheClass,youwillnotbeamemberoftheClassandyouwillnotbeeligibleforapaymentundertheClassActionSettlements,butyouwillkeepyourrighttosueagainsttheMercedesDefendantsandBoschDefendantsabouttheclaimsinthiscase,andyoucanstillhavetheAEMinstalledinyourvehicle.•Ifyouobject(i.e.,telltheCourtwhatyoudon'tlikeaboutoneofthesettlementsorbothofthem),youwillstayintheClass.YoumustsubmitaValidClaimtoreceiveacashpayment,evenifyouobject.IfyouobjectandtheCourtapprovestheClassActionSettlements,youwillbeboundbythesettlementsandgiveupyourrighttosuetheMercedesDefendantsandtheBoschDefendantsaboutanyoftheclaimsinthiscase.QUESTIONS?VISITMBBLUETECSETTLEMENT.COM,ORCALL1-877-313-01703 ThepostmarkdeadlineforobjectionsandrequestsforexclusionisMay24,2021.PleaseseetheLongFormNoticeatmbbluetecsettlement.comorcall1-877-313-0170forcompleteinstructionsonhowtofileaclaim,object,orexcludeyourself,andotherimportantinformation.TheCourtwillholdaFairnessHearingonJuly12,2021,at10:30a.m.EasternTimeattheUnitedStatesDistrictCourtfortheDistrictofNewJersey,locatedattheMadinLutherKingBuilding&UnitedStatesCourthouse,50WalnutStreet,Newark,NJ07102.Atthehearing,theCourtwillconsiderwhethertoapprovetheClassActionSettlements,paymentofattorneys'feesandexpenses,paymentstoSettlementClassRepresentatives,andrelatedissues.Anyattorneys'feesandcostsorpaymentstoSettlementClassRepresentativeswillnotreducepaymentstoClassMembersundertheMercedesClassActionSettlement.AnyfeesandcostsawardedbytheCourttoClassCounselinconnectionwiththeBoschClassActionSettlementwillreduceindividualpaymentstoClassMembersunderthatsettlementbynomorethan25%.Themotionsforfees,costs,andincentiveawardswillbeavailableatmbbluetecsettlement.comaftertheyarefiledandbeforetheFairnessHearing.YoumayattendtheFairnessHearing,butyouarenotrequiredto.HOWCANIGETAPAYMENT?Currentandformerownersandlesseesmaybeeligibleforcashpayments.Toclaimacashpayment,ClassMembersmustsubmitaValidClaimbythedeadlinesinthisNotice.IfyouareacurrentownerorlesseeofaRegisteredSubjectVehicleandhavenotopted-outfromtheClass,youcanreceiveapaymentby(1)havingtheAEMinstalledonyourvehicleand(2)submittingaValidClaimbyOctober1,2022.Herearethestepstoreceiveapayment:1.OnceanAEMforyourvehicleisavailable,contactyourpreferredauthorizeddealershiptoscheduleanappointmenttohavetheAEMinstalled.AEMsarefreeofchargetoyou.AuthorizedMercedes-Benzdealershipscanbefoundatmbusa.com/en/dealers.AuthorizedFreightlinerSprinterdealershipscanbefoundatfreightlinersprinterusa.com/freightliner/shopping-tools/find-a-dealer.AEMsareavailable_nowfortheSubjectVehicleslistedontheenclosedbluesheet.YoucanalsocheckAEMavailabilityatmbbluetecsettlement.com.AsAEMsforothervehiclesbecomeavailable,ownersandlesseesofthosevehicleswillreceiveanothermailednotice.Pleasecontinuetocheckmbbluetecsettlement.comforupdatedinformation.Youmayalsocall1-877-313-0170toll-freetofindoutwhetheranAEMisavailableforyourSubjectVehicle.QUESTIONS?VISITMBBLUETECSETTLEMENT.COM,ORCALL1-877-313-01704 2.BringyourvehicletoyourappointmentforinstallationoftheAEM.YoumustcompletetheAEMinstallationbeforeyousubmitaclaim.Makesuretokeepyourrepairordertosubmitwithyourclaim,aswellasreceiptsforanytraveltoandfromthedealershipfortheAEMinstallation.Ifyourappointmenttakesthreehoursormoreandyouarenotofferedaloanervehicle,shuttle,oralternativeformoftransportation,youmaybeeligibletoreceivereimbursementupto$35fortravelexpenses.3.SubmitavalidClaimFormandallrequireddocumentsbyOctober1,2022atmbbluetecsettlement.comorbymail(postmarkedbyOctober1,2022)to:MBBlueTecSettlementcloJNDLegalAdministrationPOBox91310Seattle,WA98111IfyouareaformerownerorlesseeofaRegisteredSubjectVehicle,youmustsubmitaValidClaimbyJuly12,2021,orbythedatetheCourtfinallyapprovestheMercedesClassActionSettlement(ifafterJuly12,2021),atmbbluetecsettlement.comorbymailtotheaddresslisteddirectlyabove.Pleasevisitmbbluetecsettlement.comforupdatesaboutthedeadlinetosubmityourclaim.Checkmbbluetecsettlement.comoftenforinformationaboutthedateoffinalCourtapprovaloftheClassActionSettlementsandotherupdates.AClaimFormisenclosedinthismailing.HOWCANIGETMOREINFORMATION?Visitmbbluetecsettlement.comorcall1-877-313-0170formoredetailsabouttheClassActionSettlements,toregisterforupdates,andtolearnmoreaboutyourrightsandoptions.QUESTIONS?VISITMBBLUETECSETTLEMENT.COM,ORCALL1-877-313-01705 OINDIVIDUALRELEASEOFCLAIMSGBDDV3G5YB7MDInreMercedes-BenzEmissionsLitigationCaseNo.16-cv-88](D.N.J.)MUSTBECOMPLETEDBYCLASSMEMBERPRIORTORECEIVINGANYCLASSMEMBERPAYMENTl.InexchangefortheClassMemberPaymentithatDaimlerAGandMercedes-BenzUSA,LLC(the"MercedesDefendants")andRobertBoschGmbHandRobertBoschLLC(the"BoschDefendants")haveagreedtoprovidetome,shouldtheSettlementAdministratordetermineIameligibletoreceivetheClassMemberPaymentundertheclassactionsettlementagreementsinthiscase2(the"ClassActionAgreements"),thesufficiencyofwhichIherebyacknowledge,I,onbehalfofmyselfandmyagents,heirs,executorsandadministrators,successors,assigns,insurers,attorneys(includinganyofmyattorneyswhoarenotClassCounsel),representatives,shareholders,ownersassociations,andanyotherlegalornaturalpersonswhomayclaimby,through,orunderthem,herebyfully,finally,irrevocably,andforeverrelease,waive,discharge,relinquish,settle,andacquitanyandallclaims,demands,actions,orcausesofaction,ofanykindornaturewhatsoever,whetherinlaworinequity,contractual,quasi-contractualorstatutory,knownorunknown,direct,indirectorconsequential,liquidatedorunliquidated,past,presentorfuture,foreseenorunforeseen,developedorundeveloped,contingentornon-contingent,suspectedorunsuspected,whetherornotconcealedorhidden,thatImayhave,purporttohave,ormayhereafterhaveagainstanyReleasedPartyarisingoutof,inwholeorinpart,orinanywayrelatedtotheBlueTECDieselMatter,exceptforclaimsofpersonalinjuryorwrongfuldeath(the"ReleasedClaims,"asdefinedmorefullyinSection10.3oftheClassActionAgreements).2."BlueTECDieselMatter"meansallclaimsarisingfromorinanywayrelatingto:(l)thedesign,manufacture,assembly,testing,development,installation,performance,presence,disclosure,ornondisclosureofanyauxiliaryemissioncontroldevice("AECD")(asdefinedin40C.F.R.§86.1803-01)ordefeatdevice(asdefmedin40C.F.R.§86.1803-01or42U.S.C.§7522(a)(3)(B))inanySubjectVehicle,asthattermisdefinedintheClassActionAgreements;(2)thedesign,manufacture,assembly,testing,development,installation,orperformanceofemissioncontrolequipmentandmethodsandrelatedhardwareorsoftwareinSubjectVehicles,includingDieselExhaustFluidandassociatedequipment,SelectiveCatalyticReductionsystems,electroniccontrolunits,andemission-relatedsoftwareprogramming,coding,andcalibrations;(3)overpaymentordiminutioninvaluerelatedtothedesign,manufacture,assembly,testing,development,installation,or'Theterms"Action,""ClassCounsel,""ClassMemberPayment,""Court,""FinalApprovalOrder,""Release,""ReleasedClaims,"and"SettlementAdministrator,""ValidClaim,"andanyothertermnotspecificallydefinedherein,havethemeaningsgiventothemintheClassActionAgreements.AcopyofeachClassActionAgreementisavailableatmbblueteesettlement.com.2D.E.299-2,Ex.A(settlementwithMercedesDefendants);D.E.306-2,Ex.A(settlementwithBoschDefendants). performanceofemissioncontrolequipmentandmethodsandrelatedhardwareorsoftwareinSubjectVehicles;(4)theactualorallegednoncomplianceofanySubjectVehiclewithstateorfederalenvironmentaloremissionsstandards;(5)themarketingoradvertisementoftheemissionsorenvironmentalcharacteristicsorperformanceofanySubjectVehicle,includingascleandiesel,clean,lowemissions,green,environmentallyfriendly,and/orcompliantwithstateorfederalenvironrnentaloremissionsstandards;(6)themarketingoradvertisementofthefuelefficiency,fueleconomy,mileage,power,drivability,orperformanceofanySubjectVehicle,totheextentrelatedinanywaytotheemissionsperformance,thedesign,manufacture,assembly,testing,development,installation,orperformanceofemissioncontrolequipmentandmethods,andrelatedhardwareorsoftware;(7)anybadges,signage,orBlueTEClabelsontheSubjectVehicles,includinganybadgesorsignageplacedontheSubjectVehiclesatthepointofsaleorinanadvertisement;(8)performanceoftheAEMinaSubjectVehicle,exclusiveoftheExtendedModificationWarrantyandany"LemonLaw"protectionsavailabletoClassMembers;(9)whethertheSubjectVehiclesmeetorexceed(ormetorexceeded)consumerexpectations,totheextentrelatedinanywaytotheemissionsperformance,thedesign,manufacture,assembly,testing,development,installation,orperformanceofemissioncontrolequipment,andmethodsandrelatedhardwareorsoftware;or(10)thesubjectmatteroftheActionaswellaseventsorallegationsrelatedtotheAction,withrespecttotheSubjectVehicles.Withoutlimitingtheforegoing,"BlueTECDieselMatter"includesallegationsthat(i)arerelatedtoanySubjectVehicle,(ii)relatetoconductbyaReleasedPartythatpredatesthedateoftheClassActionSettlements,and(iii)formedorrelatetothefactualbasisforaclaimthatwasmadeorcouldhavebeenmadeintheComplaint.AsusedinthislndividualRelease,"ReleasedParty"and"ReleasedParties"includestheMercedesDefendantsandBoschDefendants,andanyotherPersonincludedinthedefinitionofthosetermsintheClassActionAgreements.3.ThisIndividualReleaseshallbecomeeffectiveandbindingimmediatelyuponmyreceiptoftheClassMemberPaymentmadetomeundertheClassActionAgreements.IexpresslyunderstandandacknowledgethattheSettlementAdministratorwillmakefmalandunreviewabledecisionsregardingtheClassMemberPaymentundertheClassActionSettlements,andthatthisIndividualReleaseremainseffectiveandbindingevenifIdisagreewiththeamountofmyClassMemberPayment.ItisexpresslyunderstoodandagreedthatthisisacompromiseofadisputedclaimandthattheMercedesDefendantsandBoschDefendantshavedeniedandcontinuetodenythattheyareinanywayliableorresponsiblefortheallegedconductanddamagesclaimedintheAction.NeithertheClassActionAgreements,thecompromiseoftheAction,thisIndividualRelease,noranyactperformedordocumentexecutedpursuanttoorinfurtheranceofthisIndividualReleaseortheClassActionAgreementsis,maybedeemedtobe,ormaybeusedasanadmissionof,orevidenceof,thevalidityofanyoftheReleasedClaims,orofanywrongdoingorliabilityofReleasedParties;ormaybedeemedtobeormaybeusedasanadmissionof,orevidenceof,anyfaultoromissionofReleasedPartiesinanycivil,criminal,oradministrativeproceedinginanycourt,administrativeagency,orothertribunal.If,foranyreason,IreceivetheClassMemberPaymentunderoneClassActionAgreementbutnottheother,thisIndividualReleaseshallbeimmediatelyeffectiveandbindingastotheReleasedClaimsagainsttheReleasedPartiesasthosetermsaredefinedbytheClassActionAgreementunderwhichIreceivetheClassMemberPayment. 4.ThisIndividualReleasesupplementstheReleaseandassociatedprovisionssetforthinSection10oftheClassActionAgreements.Itdoesnotsupersedethem.5.IexpresslyunderstandandacknowledgethatthisIndividualReleaseappliestoclaimsofwhichImightnotpresentlybeaware.IexpresslyunderstandandacknowledgeSection1542oftheCaliforniaCivilCode,whichprovides:"Ageneralreleasedoesnotextendtoclaimswhichthecreditordoesnotknoworsuspecttoexistinhisorherfavoratthetimeofexecutingtherelease,whichifknownbyhimorhermusthavemateriallyaffectedhisorhersettlementwiththedebtor."IacknowledgethatIamawareofthecontentsandeffectofSection1542oftheCalifomiaCivilCodeandhaveconsideredthepossibilitythatthenumber,nature,ormagnitudeofallclaimsmaynotcurrentlybeknown.ToensurethatthisIndividualReleaseisinterpretedfullyinaccordancewithitsterms,IexpresslywaiveandrelinquishanyandallrightsandbenefitsthatImayhaveunderSection1542oftheCaliforniaCivilCodetotheextentthatsuchsectionmaybeapplicabletotheIndividualReleaseandlikewiseexpresslywaiveandrelinquishanyrightsorbenefitsofanylawofanystate,territory,county,municipality,orcityoftheUnitedStates,federallaworprincipleofcommonlaw,orofinternational,foreign,ortriballaw,whichissimilar,comparable,analogous,orequivalenttoSection1542oftheCaliforniaCivilCodetotheextentthatsuchlawsorprinciplesmaybeapplicabletotheIndividualRelease.6.IexpresslyunderstandandacknowledgethatImayhereafterdiscoverclaimspresentlyunknownorunsuspected,orfactsinadditiontoordifferentfromthosethatInowknoworbelievetobetrue,relatedtotheBlueTECDieselMatter,theReleasedClaims,and/ortheIndividualRelease.Nevertheless,itismyintentiontofully,finally,irrevocably,andforeverrelease,waive,discharge,relinquish,settle,andacquitallReleasedClaimswhichexist,hereaftermayexist,ormighthaveexisted(whetherornotpreviouslyorcurrentlyassertedinanyactionorproceeding).Thisincludes,withoutlimitation,anyclaimsIhaveormayhavewithrespecttotheBlueTECDieselMatterundertheTradeRegulationRuleConcerningthePreservationofConsumers'ClaimsandDefenses,16C.F.R.§433.2(the"HolderRule").7.ThisIndividualReleaseshallremaineffectiveregardlessofanyjudicial,quasi-judicial,arbitral,administrative,regulatory,orotherdecisionrelatingtotheliabilityofanyReleasedPartyinconnectionwiththeBlueTECDieselMatterandshallbebindingonmeimmediatelyuponmyreceiptoftheClassMemberPaymentmadetomeundertheClassActionAgreements.If,foranyreason,IreceivetheClassMemberPaymentunderoneClassActionAgreementbutnottheother,thisIndividualReleaseshallbeimmediatelyeffectiveandbindingastotheReleasedClaimsagainsttheReleasedPartiesasthosetermsaredefmedbytheClassActionAgreementunderwhichIreceivetheClassMemberPayment.Fortheavoidanceofdoubt,thisIndividualReleaseshallremaineffectiveeveniftheCourtdoesnotentertheFinalApprovalOrder,theFinalApprovalOrderisreversedand/orvacatedonappeal,oriftheClassActionAgreementsareabrogatedorotherwisevoidedinwholeorinpart.8.ThisIndividualReleasewaivesorreleasesanyrighttoreceivefurthermonetarycompensationbeyondtheClassMemberPaymentundertheClassActionAgreementsortopursueadditionalbenefitsundertheClassActionAgreements,orinanyothermannerrelatingtotheBlueTECDieselMatter,excepttotheextentIsubmitaValidClaimforanothervehicleIownorlease(orformerlyownedorleased)thatiseligibleforcompensationundertheClassActionAgreements.-3- 9.ThisIndividualRelease,andanydisputearisingoutoforrelatedtothisIndividualRelease,shallbegovernedbyandinterpretedaccordingtotheFederalRulesofCivilProcedureandapplicablejurisprudencerelatingthereto,andthelawsoftheStateofNewJerseynotwithstandingitsconflictoflawprovisions.Onceitbecomesbindingonme,thisIndividualReleasewillbebindinguponmysuccessors,transferees,andassigns.10.IntheeventthatIamnotboundbytheReleaseintheClassActionAgreements,anymattersconcerningthisIndividualRelease,includinganydisagreementastowhetherthisIndividualReleaseiseffective,shallbesettledbybindingarbitration.Thearbitratorshallawardtotheprevailingpartyallofitsattorneys'feesandcosts,anditsshareofthecostsandadministrativefeesduetothearbitrator.I1.IexpresslyagreethatthisIndividualReleaseis,andmayberaisedas,acompletedefenseto,andwillpreclude,anylawsuit,action,orotherproceedinginvolvingclaimsencompassedbythisIndividualRelease.Ishallnotnoworhereafterinstitute,maintain,prosecute,assert,and/orcooperateintheinstitution,commencement,filing,orprosecutionofanysuit,action,and/orotherproceedingagainsttheReleasedPartieswithrespecttotheclaims,causesofaction,and/oranyothermatterssubjecttothisIndividualRelease.TotheextentthatIhaveinitiated,orcausedtobeinitiated,anysuit,action,orproceedingsubjecttothisIndividualReleasethatisnotalreadyencompassedbytheAction,Ishallpromptlycausemyclaimsinanysuchsuit,action,orproceedingtobedismissedwithprejudice.IfIcommence,file,initiate,orinstituteanylegalactionorotherproceedingforanyReleasedClaimagainstanyReleasedPartyinanyfederalorstatecourt,arbitraltribunal,oradministrativeorotherforum,(1)suchlegalactionorotherproceedingshallbedismissedwithprejudiceatmycost;(2)anyrefusalorfailuretoimmediatelydismisssuchclaimsshallprovideabasisforanyReleasedPartytoseekaninjunction,sanctions,orotherappropriaterelief;and(3)therespectiveReleasedPartyshallbeentitledtorecoveranyandallreasonablerelatedcostsandexpensesfrommearisingasaresultofmybreachofmyobligationsunderthisIndividualRelease.12.IrepresentandwarrantthatIhavecarefullyreadandunderstandthisIndividualReleaseandthatIexecuteditfreely,voluntarily,andwithoutbeingpressuredorinfluencedby,orrelyingon,anystatementorrepresentationmadebyanypersonorentityactingonbehalfofanyReleasedParty.IcertifythatIunderstandthatIhavetherighttoconsultwithanattorneyofmychoicebeforesigningthisIndividualRelease.13.IrepresentandwarrantthatIhaveauthoritytoexecutethisIndividualReleaseandthatIamthesoleandexclusiveownerofallclaimsthatIamreleasingpursuanttothisIndividualRelease.IacknowledgethatIhavenotassigned,pledged,orinanymannerwhatsoever,sold,transferred,assignedorencumberedanyright,title,interestorclaimarisingoutoforinanywaywhatsoeverpertainingtotheBlueTECDieselMatter,includingwithoutlimitation,anyclaimforbenefits,proceeds,orvalueundertheActionortheBlueTECDieselMatter.Iamnotawareofanyoneotherthanmyselfclaiminganyinterest,inwholeorinpart,inanybenefits,proceeds,orvaluestowhichImaybeentitledasaresultoftheActionorBlueTECDieselMatter.IagreetoholdtheReleasedPartiesharmlessandagreetoindemnifyanddefendtheReleasedPartiesfromallclaims,liability,loss,cost,orexpense,includingattorneyfees,incurredinthefutureduetotheassertionbyanyoneofanyclaim,includinganyclaimfordamages,basedonsuchperson'sallegedownershipof,orinterestin,theclaimsthatIamreleasingpursuanttothisIndividualRelease.-4- 14.IagreethatifanyoftheconsiderationreceivedforthisIndividualReleaseisconstruedtobeincome,itismysoleresponsibilitytopaytaxesontheamountconstruedtobeincomeandIagreetoindemnifyandholdallReleasedPartiesharmlessonanyclaimofliabilityforsuchtaxes,penalties,orinterest.15.Ifanyterm,provision,promise,orconditionofthisIndividualReleaseisdeterminedbyacourtofcompetentjurisdictiontobeillegal,invalid,void,orunenforceable,inwholeorinpart,underanypresentorfuturelaw,theremainderofthisIndividualReleaseshallremaininfullforceandeffectandshallinnowaybeaffected,impaired,orinvalidatedtothemaximumextentpermittedbylaw.IacknowledgethatIhavereadandunderstandthisIndividualReleaseandthatIhavefreelyexecuteditbysigningbelow.Date:Signature:PrintedName:-5- MODELMODELYEARSE250BlueTEC2014-2016GE350BlueTEC2013-2016GLE300dBlueTEC2016GLK250BlueTEC2013-2015ML250BlueTEC2015ML350BlueTEC2012-2014Mercedes-BenzorFreightlinerSprinter2014-2016(4-cylinder)Mercedes-BenzorFreightlinerSprinter2010-2016(6-cylinder)ToverifywhetheranAEMisavailableforyourvehicle,pleasevisit:•bluetecupdate.mbusa.com(ifyouownorleaseapassengercar),•bluetecupdate.mbvans.com(ifyouownorleaseaMercedes-Benz-brandedSprinter),or•bluetecupdate.freightlinersprinterusa.com(ifyouownorleaseaFreightliner-brandedSprinter).AEMsforadditionalSubjectVehicleswillbecomeavailableonarollingbasis.Ifyouhaveanyquestions,pleasecontacttheSettlementAdministratorat1-877-313-0170orinfo@mbbluetecsettlement.com. UÐInreMercedes-BenzEmissionsLitigationE.-ClassActionSettlementClaimFormGBDDV3G5YB7MDClaimFormInstructionsInstructionsforCompletingtheEnclosedClaimFormYoumustcomplete,sign,andreturntheenclosedClaimFormtoreceiveapaymentundertheClassActionSettlements.'PleasereadthefullLongFormNotice,whichisavailableattheSettlementWebsite,mbbluetecsettlement.com,beforecompletingyourClaimForm.IfyouhavequestionsaboutthisClaimForm,pleasevisittheSettlementWebsite,call1-877-313-0170toll-freeoremailinfo@mbbluetecsettlement.com.CLAIMSUBMISSIONINSTRUCTIONSANDDEADLINES:•ToreceiveaClassMemberPayment,youmustsubmitacompletedandsignedClaimForm,includingallrequireddocumentation,bythedeadlinethatappliestoyou.ThesedeadlinesaresetforthindetailattheSettlementWebsite,mbbluetecsettlement.com.Tosummarize:o\fyouareanEligibleCurrentOwner/Lessee,yourclaimmustbesubmittedonlineorpostmarkedbyOctober1,2022.oIfyouareanEligibleFormerOwner/Lessee,yourclaimmustbesubmittedonlineorpostmarkedbyJuly12,2021,orbythedatetheCourtfinallyapprovestheMercedesClassActionSettlement(ifafterJuly12,2021).Pleasevisitmbbluetecsettlement.comforupdatesaboutthedeadlinetosubmityourclaim.oYoumaysubmityourcompletedClaimFormandallrequireddocumentsonlineatmbbluetecsettlement.com.YoumayalsomailyourcompletedClaimFormanddocumentationto:MBBlueTecSettlementcloJNDLegalAdministrationPOBox91310Seattle,WA98111•YoushouldnotwaituntilclosetothedeadlinetosubmityourClaimForm.AllClaimFormsrequireinformationanddocumentationthatyoumightneedtimetocollect,andallEligibleCurrentOwners/LesseesmusthavescheduledandcompletedinstallationoftheAEMfortheirvehiclebeforesubmittingtheirClaimForm.•Thefollowingdocumentationisrequiredtosubmitaclaim:oAcompletedandsignedClaimFormoProofofcurrentorformerownershiporlease,includingdatesofownershiporlease,foryourSubjectVehicleoProofofvehicleregistrationforyourSubjectVehicleoFullyexecutedIndividualRelease(acopyoftheindividualReleaseisincludedwiththisClaimForm)1The"ClassActionSettlements"aretheseparateclasssettlementswiththeMercedesDefendants(the"MercedesClassActionSettlement")andwiththeBoschDefendants(the"BoschClassActionSettlement"),whichcanbefoundatmbbluetecsettlement.com.AllcapitalizedtermsinthisClaimFormaredefinedintheMercedesClassActionSettlement.Ifyouhavequestionsaboutfillingoutthisform,pleasevisitmbbluetecsettlement.comorcall1-877-313-0170ToviewJND'sprivacypolicy,pleasevisithttps://www.indla.com/privacy-policy InreMercedes-BenzEmissionsLitigationClassActionSettlementClaimFormClaimFormInstructionsoIfyouareanEligibleCurrentOwner/Lessee,arepairordershowingtheApprovedEmissionModification("AEM")isinstalledinyourSubjectVehicle•IfyouareanEligibleCurrentOwner/Lessee,youmustscheduleanappointmentandhavetheAEMinstalledbeforesubmittingyourClaimFormandrequireddocuments.YouwillbeeligibleforaClassMemberPayment_onlyaftertheAEMisinstalled(atnochargetoyou).YoucancheckwhethertheAEMisavailable_nowforyourSubjectVehiclebyvisitingtheSettlementWebsite,mbbluetecsettlement.com,whereyoucantypeinyourVehicleIdentificationNumber("VIN")tochecktheAEMavailabilityforyourvehicle,orreviewalistingofallSubjectVehiclemodelsthatarereadyfortheAEMinstallation.Ifyourvehicleisnotlisted,youwillbenotifiedwhentheAEMbecomesavailable.PleasecontinuetochecktheSettlementWebsiteforupdatedinformation.Youmayalsocall1-877-313-0170toll-freetofindoutwhetheranAEMisavailableforyourSubjectVehicle.Youcanfindalistofthetypesofdocumentsthatfulfillthedocumentationrequirementsbelow.CLAIMREVIEWANDPAYMENTPROCESS:•AfteryouhavesubmittedyourClaimForm,theSettlementAdministratorwillreviewyourClaimFormandsupportingdocumentsforcompletenessandeligibility.TheSettlementAdministratorwillalsoscreentheclaimsforfraudanddeterminethepaymentamount.•IftheClaimFormorrequireddocumentationisincomplete,illegible,orotherwisedeficient,theSettlementAdministratorwillnotifyyouthatthereisadeficiencyorthatmoreinformationisneeded.Ifyoudonottimelycomplyand/orareunabletoproducetherequestedinformation,yourclaimwillbedeniedandyouwillnotreceiveaClassMemberPayment.•ThepaymentamountyoumayreceivedependsonwhenyoupurchasedorleasedtheSubjectVehicle,whetheryouownedorleasedtheSubjectVehicleatthetimetheAEMwasinstalledintheSubjectVehicle,thenumberofclaimsmadeperSubjectVehicleand,forEligibleCurrentOwners/Lessees,whetheryourSubjectVehiclequalifiesforpossibleadditionalpayments.TheSettlementAdministratorwillissuethepaymentafteryourclaimisdeemedcompleteandyouaredeterminedtobeeligibleforaClassMemberPayment.Ifyouhavequestionsaboutfillingoutthisform,pleasevisitmbbluetecsettlement.comorcall1-877-313-0170ToviewJND'sprivacypolicy,pleasevisithttps://www.indla.com/privacy-policy-2- InreMercedes-BenzEmissionsLitigationClassActionSettlementClaimFormClaimFormInstructionsSECTIONA:NAMEANDCONTACTINFORMATION--ALLCLAIMANTSMUSTCOMPLETEPleaseprovideyournameandcontactinformationbelow.YoumustnotifytheSettlementAdministratorifyourcontactinformationchangesafteryousubmityourClaimForm;otherwiseyoumaynotreceiveyourClassMemberPayment.FirstNameMiddleInitialLastNameSuffixJamesNaleMailingAddressPOBox1494CityStateZipCodeEllensburgWA98926-1907EmailAddressBestTelephoneNumbertoContactYouSECTIONB:VEHICLEINFORMATION--ALLCLAIMANTSMUSTCOMPLETEAllclaimantsmustcompletethisSectionB.IfyouaremakingaclaimasanEligibleFormerOwnerorLessee,youmustprovidetheinformationfortheSubjectVehiclethatyouformerlyownedorleased.PleaseprovidethemodelandmodelyearofyourSubjectVehicleintheboxbelow.Besuretowriteclearandneatly.IfyouhaveaclaimformorethanoneSubjectVehicle,youmustsubmitaseparateClaimFormforeachSubjectVehicle.ModelModelYearPleaseentertheVINoftheSubjectVehicleyouenteredabove.TheVINmaybelocatedonyourvehicleregistration,yourcartitleorinvehiclemaintenancerecordsfromyourdealer.YourMercedes-BenzOwner'sManualcanalsodirectyoutothephysicallocationoftheVINonyourvehicle.Toavoidconfusionbetweenlettersandnumbers,pleaseenternumbersinthesameformasthechartbelow.Besuretowriteclearandneatly.ZeroOneTwoThreeFourFiveSixSevenEightNineØ123456789WDYFE8CDOGP308414Enterthe17-digitVINintheboxesabove.Ifyouhavequestionsaboutfillingoutthisform,pleasevisitmbbluetecsettlement.comorcall1-877-313-0170ToviewJND'sprivacypolicy,pleasevisithttps://www.¡ndia.com/privacy-policy-3- InreMercedes-BenzEmissionsLitigationClassActionSettlementClaimFormClaimFormInstructionsNEXTSTEPSAFTERCOMPLETINGSECTIONB:IfyouareacurrentownerorlesseeoftheSubjectVehicle,filloutSectionCandSectionEbelow(skipSectionD).IfyounolongerownorleasetheSubjectVehicleanddidnotinstalltheAEMwhileyoupossessedit,skipSectionCandfilloutSectionsDandEbelow.IfyounolongerownorleasetheSubjectVehicle,butyouinstalledtheAEMwhileyoustillpossessedtheSubjectVehicle,filloutSectionsCandEbelowandskipSectionD.SECTIONC:CURRENTOWNERSILESSEESANDFORMEROWNERSILESSEESWHOINSTALLEDTHEAEMIfeyreubeganowningorleasingandregisteredtheSubjectVehicleonorbeforeSeptember14,2020,checkIfyoubeganowningorleasingandregisteredtheSubjectVehicleafterSeptember14,2020,checkhere:IftheSubjectVehiclewasregisteredinyournameatthetimetheAEMwasinstalled,checkhere:PleaseenterthedatetheAEMwasinstalledintheSubjectVehicle(MMIDDIYYYY):IftheSubjectVehiclewasnotregisteredinyournameatthetimetheAEMwasinstalled,youarenoteligibleforaCurrentOwner/LesseePaymentorPost-AnnouncementOwner/LesseePayment.TransportationCostsIfyouhavealreadyinstalledtheAEM,pleaseselecteachofthefollowingthatappliestoyou(ifany):OTheAuthorizedServiceProvidertooklongerthan3hourstoinstalltheAEMinmySubjectVehicle.ONoloanervehicle,shuttleservice,orotheralternativetransportationwasmadeavailabletome.ODuringtheinstallationprocess,IdidnothaveuseofmySubjectVehicleandIincurredcostsfortransportationtoandfromtheAuthorizedServiceProvider.Ifallthreeoftheaboveapplytoyou,youmaybeeligibletoreceivereimbursement(upto$35)fortransportationcoststoandfromtheAuthorizedServiceProviderwhileyoudidnothaveuseofyourSubjectVehicle.Toreceivethetransportationreimbursement,youmustsubmitwithyourClaimFormareceiptdetailingyourtransportationcosts.Ifanyofthethreeabovedoesnotapplytoyou,youarenoteligibleforreimbursementoftransportationcosts.IfyouareclaimingTransportationReimbursement,checkhere:Ifyouhavequestionsaboutfillingoutthisform,pleasevisitmbbluetecsettlement.comorcall1-877-313-0170ToviewJND'sprivacypolicy,pleasevisithttps://www.indla.com/privacv-policy-4- InreMercedes-BenzEmissionsLitigationClassActionSettlementClaimFormClaimFormInstructionsRequiredDocuments-CurrentOwnersandLesseesCurrentOwnersandLesseesmustincludeacopyofthefollowingsupportingdocumentswithyourClaimFormtocompleteyourclaim.Pleasecheckalltheboxesbelowthatapplytoyouinordertoconfirmthatyouhaveincludedalltherequireddocuments.Pleasedonotsendtheoriginalsbecausethedocumentswillnotbereturnedtoyou.(FormerOwnersandLesseesdonotneedtoprovidethesedocuments.)DOCUMENTSREQUIREDTOCOMPLETEYOURCLAIM-CURRENTOWNERS/LESSEES*:Acopyofyourdriver'slicenseorothergovernment-issuedphotoidentificationTherepairorderorinvoiceyoureceivedatthetimetheAEMwasinstalledinyourSubjectVehicleProofthattheSubjectVehiclewasregisteredinyournameatthetimetheAEMwasinstalledDocumentationoftransportationcosts(ifseekingTransportationReimbursement)FullyexecutedIndividualRelease(acopyoftheIndividualReleaseisattachedtotheendofthisClaimForm)ProofthatyouownedorleasedBregisteredtheSubjectVehicle.Permitteddocumentationtoproveownershiporleaseincludesyourbillofsale,leaseagreement,title,registrationfromtimeofpurchaseorlease,DepartmentofMotorVehicles("DMV")registrationhistory,financingagreement,insurancedocumentationlistingyourdateofpurchaseorlease,orproofofleasepayment;insurancedocumentationmaysufficeforproofofregistration.YourdocumentationmustshowthedateyouacquiredorleasedtheSubjectVehicle,aswellasthedateyouregisteredit.*Youmayneedtoprovideadditionaldocumentationincertaincircumstances.Youwillbenotifiedifadditionalinformationisneededtocompleteyourclaim.SECTIOND:FORMEROWNERSANDLESSEESONLYIfyoubeganowningorleasingandregisteredtheSubjectVehicleonorbeforeSeptember14,2020,anddidnothavetheAEMinstalledwhileyouownedorleasedtheSubjectVehicle,checkhere:PleaseenterthedateyousoldtheSubjectVehicleorthedateyouqavebacktheSub|ectVehiclebecauseyourleaseended(MMIDDIYYYY):IfyourSubjectVehiclewastotaled,enterthedatetheSubjectVehiclewasgiventoaninsurancecompany(orgivenorsoldtoajunkyard,salvagedealer,ortheequivalent).IfyoubeganowningorleasingandregisteredtheSubjectVehicleafterSeptember14,2020,andyoudidnothavetheAEMinstalledinyourvehiclewhileyouownedorleasedit,youarenoteligibleforpayment.IfyounolongerownorleasetheSubjectVehicle,butyouhadtheAEMinstalledintheSubjectVehiclewhile(a)youownedorleasedit,and(b)theSubjectVehiclewasregisteredinyourname,pleasefilloutSectionCandSectionE.Ifyouhavequestionsaboutfillingoutthisform,pleasevisitmbbluetecsettlement.comorcall1-877-313-0170ToviewJND'sprivacypolicy,pleasevisithttps://www.india.com/privacv-policv-5- InreMercedes-BenzEmissionsLitigationClassActionSettlementClaimFormClaimFormInstructionsRequiredDocumentation-FormerOwnersandLesseesFormerOwnersandLesseesmustincludeacopyofthefollowingsupportingdocumentationwithyourClaimFormtocompleteyourclaim.Pleasecheckthecorrespondingboxtoconfirmthatyouhaveincludedthespecifieddocumentationwithyourclaim.Pleasedonotsendtheoriginalsasthedocumentswillnotbereturnedtoyou.DOCUMENTSREQUIREDTOCOMPLETEYOURCLAIM*:OAcopyofyourdriver'slicenseorothergovernment-issuedphotoidentificationFullyexecutedIndividualRelease(acopyoftheIndividualReleaseisattachedtotheendofthisClaimForm)Proofthatyouownedorleased_andregisteredtheSubjectVehicleonorbeforeSeptember14,2020.Permitteddocumentationtoproveownershiporleaseincludesyourbillofsale,leaseagreement,title,registrationfromtimeofpurchaseorlease,DepartmentofMotorVehicles("DMV")registrationhistory,financingagreement,insurancedocumentationlistingyourdateofpurchaseorlease,orproofofleasepayment,insurancedocumentationmaysufficeforproofofregistration.YourdocumentationmustshowthedateyoupurchasedorleasedtheSubjectVehicle,aswellasthedateyouregisteredit.ProofthatyousoldortransferredtheSubjectVehicle(permitteddocumentsincludeyourbillofsale,trade-inreceipt,copyoftitletransfer,orproofofleasetermination)*Youmayneedtoprovideadditionaldocumentationincedaincircumstances.Youwillbenotifiedifadditionalinformationisneededtocompleteyourclaim.SECTIONE:CERTIFICATIONSTATEMENTFORENTIRECLAIMFORMALLCLAIMANTSMUSTCOMPLETEIunderstandthatinordertoobtainreliefundertheClassActionSettlements,Imustsignanddatethefollowingcertificationandprovidethedocumentationlistedabove.IrepresentandwarrantthatIhaveauthoritytosubmitaclaimfortheSubjectVehiclelistedabove,andthatanyofmyco-ownersandco-lesseesoftheSubjectVehiclelistedabovehavesignedthisClaimForm.IaffirmunderpenaltyofperjurythatallinformationinthisClaimFormistrueandaccuratetothebestofmyknowledge.SignatureDatePrintNameCURRENTOWNERSClaimFormsmustbesubmittedonlineatmbbluetecsettlement.comorpostmarkedORLESSEES:nolaterthanOctober1,2022.FORMEROWNERSClaimFormsmustbesubmittedonlineatmbbluetecsettlement.comorpostmarkedORLESSEES:byJuly12,2021,orbythedatetheCourtfinallyapprovestheMercedesClassActionSettlement(ifafterJuly12,2021).Pleasevisitmbbluetecsettlement.comforupdatesaboutthedeadlinetosubmityourclaim.Ifyouhavequestionsaboutfillingoutthisform,pleasevisitmbbluetecsettlement.comorcall1-877-313-0170ToviewJND'sprivacypolicy,pleasevisithttps://www.india.com/privacv-policv-6-