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Roehl Claim

CLAIM FORM AND CONSENT TO JOIN LAWSUIT

I hereby opt in to this case and consent to participate in this settlement and receive a monetary payment. I understand that I am releasing any and all claims, demands, rights, liabilities, and/or causes of action relating to my participation in Roehl’s orientation and the Roehl Transport Safety and Job Skills Training Program, for which I received trainee pay, that were brought on behalf of the Rule 23 Wisconsin Minimum Wage Class and the FLSA Collective in the lawsuit Milford, et al. v. Roehl Transport, Inc., Case No. 2:22-cv-00879-BHL in the Eastern District of Wisconsin. These released claims include but are not limited to claims under the Wisconsin minimum wage statute and the Fair Labor Standards Act.

I hereby designate Class Counsel (as identified in Section 4 of the Notice) as my attorneys for all purposes in connection with this case, including the settlement.

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