Plains Oil Spill Restitution Form

Unique ID (You can find this number at the top of the letter you received):*

Name:*

First NameMiddle NameLast Name (include any suffixes)

Current Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Telephone 1:*

Please enter a valid phone number.

Telephone 2:

Please enter a valid phone number.

Email Address:

example@example.com

Class License Information: Please enter the number of each license you held that meets the class qualifications described in your letter. More than one license may apply.

The Fisher Class only includes those who:

1. Fished in specified blocks during the period from January 2010 through May 19, 2015;
2. Landed certain species of fish in those blocks, and;
3. Were in operation as of May 2015; or
4. Processors who purchased fish directly from those who meet the definition above.

Fisher License No.:

Vessel License No.:

Vessel Name:

CDFW Commercial Fish Business License No.:

Business Name:

If you have additional documentation you would like to upload in order to share with Judge Anderle to support your claim of damages beyond those for lost profits, please drag and drop that documentation into the area below. Please note that any documentation provided will become part of the public record. Personal information will be redacted. (Document upload limited to 25 documents or 1 GB. If you need to submit more than the limit, please contact info@plainsoilspill.com.)

Please provide a dollar amount estimate of the damages you are claiming beyond lost profits; for example, the total value of damaged gear:

If you have additional information that you would like to share with Judge Anderle to support your claim of damages, do so here:

I certify under the penalty of perjury that the above information is true and correct.

I authorize Class Counsel to disclose identifying information contained in CDFW fishing records (such as name, license number, fishing blocks) to the State of California in the criminal matter People v. Plains (Santa Barbara Superior Court Criminal Case No. 1495091) for the purpose of supporting a restitution claim made on my behalf.