RELEASE OF CLAIMS AND SIGNATURE
I (we) hereby acknowledge that, pursuant to the terms set forth in the Stipulation,
without further action by anyone, upon the Effective Date of the Settlement, I (we),
on behalf of myself (ourselves), and my (our) heirs, executors, administrators,
predecessors, successors, and assigns, in their capacities as such, shall be deemed
to have, and by operation of the Stipulation, of law, and of the judgment shall
have, fully, finally, and forever compromised, settled, released, resolved,
relinquished, waived, and discharged each and every Released Plaintiffs’ Claim
(including, without limitation, any Unknown Claim) against the Defendants and the
other Defendant Releasees, and shall forever be barred, enjoined, and estopped from
prosecuting any or all of the Released Plaintiffs’ Claims against any of the
Defendant Releasees. Please refer to the Notice and the Stipulation for the
definitions of the capitalized terms.
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:
1. that I (we) have read and understand the contents of the Notice and this Claim Form,
including the releases provided for in the Settlement and the terms of the Plan of Allocation;
2. that the claimant(s) is a (are) Settlement Class Member(s), as defined in the Notice, and is (are)
not excluded by definition from the Settlement Class as set forth in the Notice;
3. that the claimant has not submitted a request for exclusion from the Settlement Class;
4. that I (we) own(ed) the Flowers Foods common stock identified in the Claim Form and have not
assigned the claim against any of the Defendants or any of the other Defendant Releasees to another,
or that, in signing and submitting this Claim Form, I (we) have the authority to act on behalf of the
5. that the claimant(s) has (have) not submitted any other claim covering the same purchases of
Flowers Foods common stock and knows (know) of no other person having done so on the claimant’s
6. that the claimant(s) submit(s) to the jurisdiction of the Court with respect to claimant’s
(claimants’) claim and for purposes of enforcing the releases set forth herein;
7. that I (we) agree to furnish such additional information with respect to this Claim Form as Lead
Counsel, the Claims Administrator, or the Court may require;
8. that the claimant(s) waive(s) the right to trial by jury, to the extent it exists, and agree(s)
to the Court’s summary disposition of the determination of the validity or amount of the claim made
by this Claim Form;
9. that I (we) acknowledge that the claimant(s) will be bound by and subject to the terms of any
judgment(s) that may be entered in the Action; and
10. that the claimant(s) is (are) NOT subject to backup withholding under the provisions of Section
3406(a)(1)(C) of the Internal Revenue Code because (a) the claimant(s) is (are) exempt from backup
withholding or (b) the claimant(s) has (have) not been notified by the IRS that he/she/it is subject
to backup withholding as a result of a failure to report all interest or dividends or (c) the IRS has
notified the claimant(s) that he/she/it is no longer subject to backup withholding.
If the IRS has notified the claimant(s) that he/she/it is subject to backup withholding, please
strike out the language in the preceding sentence indicating that the claim is not subject to backup
withholding in the certification above.
1. Please electronically sign the above release and certification. If this Claim Form is being made on behalf of joint claimants, then both must sign.
2. Remember to attach only copies of acceptable supporting documentation as these documents will not be returned to you.
3. Keep copies of the confirmation page and documentation for your own records.
4. If your address changes in the future, please send the Claims Administrator written
notification of your new address. If you change your name, please inform the Claims
5. If you have any questions or concerns regarding your claim, please contact the Claims
Administrator at the address below, by email at info@FlowersSecuritiesLitigation.com, or by
toll-free phone at (877) 227-6101, or you may visit www.FlowersSecuritiesLitigation.com.
Please DO NOT call Flowers Foods, any of the other Defendants, or their counsel with questions
regarding your claim.