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EXHIBIT C
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 1 of 29
Clickhe
reifyoualread
yha
veaRe
gistratio
nID
andPassword
Welcometo
theZeekRe
wards
OnlineClaim
Filin
gWeb
site
Clickhe
reto
Register
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 2 of 29
Claim
PortalID
Login
Registratio
nID
:
Password:
jTest2
OK
Cancel
********
Thisistheloginscreen
forp
artie
sthath
avealreadyregistered
.
Clickhe
reifyouha
veforgottenyour
Registratio
nID
orPassword
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 3 of 29
Claiman
tSum
maryPage
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 4 of 29
Claiman
tInformation
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 5 of 29
Registratio
nVe
rification
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 6 of 29
Create
Claim
PortalRe
gistratio
nID
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 7 of 29
Clickhe
reto
fileaclaim
Registratio
nCo
mplete
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 8 of 29
ZeekRe
wards
UserNam
ean
dPassword
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 9 of 29
Claim
Type
s(Please
checkan
y/alltha
tapp
ly)
Affiliate
RetailAu
ctionUser
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 10 of 29
Affiliate
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 11 of 29
Affiliate
(con
tinue
d)
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 12 of 29
RetailAu
ctionUser(Individu
alstha
tpurchased
retailbids
foru
seon
ZeekRe
wards
auctionsites;no
tparticipan
tsinthemultilevelm
arketin
gprog
ram)
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 13 of 29
Trad
eCred
itoro
rInd
epen
dent
Contractor
AddAn
othe
rLine
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 14 of 29
Form
erEm
ployee
orOfficer
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
AddAn
othe
rLine
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 15 of 29
Taxing
orothe
rGovernm
entalA
utho
rity
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
AddAn
othe
rLine
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 16 of 29
SubrogationClaim
ofFina
ncialInstitution
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
AddAn
othe
rLine
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 17 of 29
Other
(Pleaseup
load
supp
ortin
gdo
cumen
tatio
nde
tailing
theba
siso
fyou
rclaim
)
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
AddAn
othe
rLine
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 18 of 29
Paym
entsMad
eto
ZeekRe
wards
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
AddAn
othe
rPaymen
t
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 19 of 29
Paym
entsRe
ceived
from
ZeekRe
wards
Thisscreen
willbe
displayedon
lyifthisClaim
was
selected
.
AddAn
othe
rPaymen
t
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 20 of 29
Claim
Summary
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 21 of 29
Additio
nalInformation/Que
stions
AddAn
othe
rLine
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 22 of 29
Additio
nalInformation/Que
stions
(con
tinue
d)
AddAn
othe
rLine
AddAn
othe
rLine
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 23 of 29
Additio
nalInformation/Que
stions
(con
tinue
d)
AddAn
othe
rLine
AddAn
othe
rLine
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 24 of 29
Consen
ttoJurisdiction
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 25 of 29
Uploa
dSupp
ortin
gDo
cumen
tatio
n
AddAn
othe
rFile
Back
Save
forLater
Continue
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 26 of 29
Claiman
tSigna
ture
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 27 of 29
Subm
itFina
lized
Claim
Warning:
IfyouSubm
itFinalized
Claim
below,
your
claim
forthisZ
eekRew
ards
UserNam
ewillbe
final.You
willno
thavetheop
portun
ityto
change
oram
endthe
inform
ationthat
youhave
subm
itted
.
Youwillho
wever
have
theop
portun
ityto
subm
itadditio
nalclaim
sonaccoun
tofo
ther
ZeekRe
wards
Usernam
esthat
youmaintaine
d.
Back
Subm
itFinalized
Claim
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 28 of 29
ZeekRe
wards
OnlineClaim
Subm
ission
Complete
Logout
FileAn
othe
rClaim
Case 3:12-cv-00519-GCM Document 138-3 Filed 03/29/13 Page 29 of 29