Thank you for completing your online agreements.

You are now requested to provide us with information related to your case.

Instructions

In completing this Plaintiff Profile Form (“PPF“), you are under oath and must provide information that is true and correct to the best of your knowledge. Please answer every question and do not leave any blanks. If you do not know or recall the answer to a question, please state the same. If you cannot recall the month and year of the date requested, there will be a checkbox where you can indicate the same, along with a text field to denote a best date estimate. You are obligated to supplement your responses if you learn that they are incomplete or incorrect in any material respect.

If you need further room to provide additional responses to any question, please submit your additional responses via the LMI platform OR write or type your additional responses on a separate sheet of paper attached to this PPF. If you write or type your additional responses on a separate sheet of paper and upload it to the LMI platform, you will be charged an additional fee for the data entry of that additional information. If you submit your additional responses via the LMI platform, you will not be charged an additional fee.

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Definitions

You or your or user: The person who was otherwise exposed (including in utero exposure) to water at Camp Lejeune and/or MCAS New River for at least 30 days between August 1^st, 1953 and December 31^st, 1987?.

Document: Any handwriting, typewriting, printing, photostating, photographing, photocopying, transmitting by electronic mail or facsimile, and every other means of recording upon any tangible thing, any form of communication or representation, including letters, words, pictures, sounds, or symbols, or combinations thereof, and any record thereby created, regardless of the manner in which the record has been stored within your possession, custody, or control.