Wilson v. LSB Industries, Inc. et al
LSB Industries Security Litigation
1:15-cv-07614-RA-GWG

PART I - CLAIMANT IDENTIFICATION

Please complete this part in its entirety. The Claims Administrator will use this information for all communications regarding this Claim Form. If this information changes, you MUST notify the Claims Administrator.

If the account number is unknown, you may leave blank. If the same legal entity traded through more than one account you may write "multiple." Please see paragraph 12 of the General Instructions for more information on when to separate Claim Forms for multiple accounts, i.e., when you are filing on behalf of distinct legal entities.

Claimant Account Type

For More Information

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Mail

LSB Industries Security Litigation
c/o JND Legal Administration
PO Box 91236
Seattle, WA 98111-9336