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ToCF#1026
SECTION C: PRIOR ACCOMMODATION OR COMPENSATION Check all categories that apply:
❏ I have never been reimbursed for any firmware upgrades, or been provided with any other relief, for
Playback Incompatibilities with my Toshiba DVD Player at Issue.
❏ I received reimbursement or refund of $________ for a firmware upgrade (or upgrades) that I paid
for resulting from Playback Incompatibilities with my Toshiba DVD Player at Issue.
❏ I received a free replacement DVD player from Toshiba.
❏ I received a free repair or firmware upgrade for my DVD Player at Issue from Toshiba.
SECTION D: CHECK THE REMEDY YOU ARE APPLYING FOR (check only one box):
❏ REFUND REMEDY (COMPLETE SECTION E, below)
If you paid either Toshiba or a third party service center to upgrade the firmware on a Toshiba DVD
player specifically to resolve Playback Incompatibilities experienced with your Toshiba DVD Player
before October 15, 2004, you will receive a reimbursement of that amount if you provide the required
documentation. Class members who have received a free firmware upgrade from either Toshiba or a
third party service center are not entitled to this remedy.
❏ UPGRADE OR REPLACEMENT REMEDY (COMPLETE SECTION F below)
If you purchased or acquired a Toshiba DVD Player on or before December 31, 2001, Toshiba will,
at its option, either upgrade or replace your Toshiba DVD Player.
❏ REBATE CERTIFICATE REMEDY (COMPLETE SECTION G, below)
If you purchased or acquired a Toshiba DVD Player on or before December 31, 2001, and you
replaced your Toshiba DVD Player before October 15, 2004 with a DVD player of another
manufacturer that you purchased specifically as a result of experiencing Playback Incompatibilities,
you will receive a Rebate Certificate if you provide the required documentation.
SECTION E: REFUND FOR FIRMWARE UPGRADE COSTS REMEDY
If you paid Norman’s Electronics, Inc. to upgrade the firmware on a Toshiba DVD player specifically
to resolve Playback Incompatibilities experienced with that Toshiba DVD Player, you will receive a
reimbursement of that amount according to Norman’s Electronics, Inc.’s records and you do not have
to submit this Claim Form. However, if you paid Norman’s Electronics, Inc. to upgrade the firmware
on a Toshiba DVD player specifically to resolve Playback Incompatibilities experienced with your
Toshiba DVD Player, but your address has changed from the address that was provided to Norman’s
Electronics, Inc. at the time of the upgrade, you must complete this Claim Form.
If you paid either Toshiba or a third party service center (other than Norman’s Electronics, Inc.) to
upgrade the firmware on a Toshiba DVD player specifically to resolve Playback Incompatibilities
experienced with that Toshiba DVD Player, you will receive a reimbursement of that amount if you
provide the required documentation.
CHECK ONLY ONE BOX BELOW:
❏ I paid Norman’s Electronics, Inc. to upgrade the firmware on the Toshiba DVD Player At Issue
specifically to resolve Playback Incompatibilities experienced with the Toshiba DVD Player At