IERP CLAIM FORM INSTRUCTIONS

CLAIM DEADLINE: December 17, 2026

Please read the instructions carefully before filling out this Claim Form (this "Claim Form"). Capitalized terms not otherwise defined shall have the meanings ascribed to them in the Settlement Agreement (the "Settlement Agreement") in Kinlaw v. Sackler, et al., Case No. 1:25-CV-00918 available on the settlement website at www.ierpsettlement.com. Each person or entity making a Claim ("Claimant") must submit a separate Claim Form.

1. Complete the Claim Form electronically, which is a fillable PDF that can be downloaded from www.ierpsettlement.com and must be emailed to info@ierpsettlement.com;
2. Once the Claim Form is received, the Claim Administrator(s) will communicate instructions to you for accessing a secure file transfer protocol ("SFTP"); and
3. Submit all supporting documents and information requested therein, along with the requisite claims data as described in Section F. of the Claim Form, via SFTP.

PLEASE NOTE THAT THE ACCOMPANYING CLAIMS DATA SHALL NOT BE SUBMITTED VIA EMAIL. Instead, by submitting the Claims Form described in Item 1 above, you will receive instructions for accessing an SFTP to which accompanying requisite claims data must be submitted.

IT IS IMPORTANT THAT YOU ANSWER ALL QUESTIONS FULLY AND ACCURATELY. FAILURE TO PROVIDE THE REQUESTED INFORMATION, DATA, AND/OR DOCUMENTATION BY THE DEADLINE WILL CAUSE YOUR CLAIM TO BE REJECTED AND YOU WILL BE PRECLUDED FROM RECEIVING AN ALLOCATED AMOUNT.

To be eligible to make a Claim, the Claimant must satisfy the following:

a. All independent* emergency room physicians ("IERP") in the United States for any five years between January 1, 1996, through Final Judgement and during that time and in that capacity, such IERP (a) treated patients diagnosed with opioid use disorder and/or other opioid-related conditions, and (b) has been damaged in the past and/or reasonably anticipate incurring additional treatment, educational and abatement expenses in the future arising from patients suffering from OUD and opioid misuse.

* "Independent Emergency Room Physician" is defined as an Emergency Room Physician that was a non-hospital employee that worked as an Emergency Room Physician whose billing and

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revenue collection were entirely separate from the billing and revenue collection practices of the medical facility at which such ER Physician practiced, and such ER Physician was not employed by such medical facility; who treated patients with opioid use disorder (who were either uninsured or underinsured), at any time, since 1996 through the present. The Settlement seeks to provide an Allocated Amount to IERPs who qualify as Class Members, for use towards OUD Abatement Purposes. Unclaimed Settlement Funds will be used for OUD Abatement Purposes.

A Claimant that submits a Claim Form may be contacted by representatives of Class Counsel or by the Claims Administrator(s) for additional information regarding the Class Member's claims. The submission of this Claim Form by the claim deadline of 5:00 p.m., on December 17 2026 (the "Claim Deadline") is a prerequisite to eligibility for an Allocated Amount but does not guarantee that a Class Member will be deemed eligible to receive an Allocated Amount for abatement purposes. If a Class Member is deemed eligible to receive an Allocated Amount, the information provided in this Claim Form will be used to determine each such Allocated Amount. Class Members may redact information on this Claim Form or any attached documents as they deem necessary, although redactions may impact the Claim Administrators' determinations as to eligibility or the Allocated Amount. A Class Member shall only submit through the Secure File Transfer Protocol ("SFTP") link copies of any documents that support a claim and shall not mail or transmit hard copies or original documents; documents submitted may be destroyed after scanning and will not be returned to the Class Member.

A person who files a fraudulent claim on behalf of a Class Member may, at a minimum, be fined up to $500,000.00, imprisoned for up to five years, or both, in accordance with 18 U.S.C. §§ 152, 157. Class Members shall provide the information requested that is, to the best of their knowledge, current and valid as of the date this Claim Form is completed and delivered to the Notice and Claims Administrators.

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Please provide the following information to the Claims Administrator(s) by emailing this completed Claim Form to info@ierpsettlement.com. Failure to submit a completed copy of this Claim Form by the Claim Deadline set forth on page 1 of this Claim Form may disqualify you from receiving an Allocated Amount. Additionally, failure to complete any portion of the Claim Form or to subsequently provide requisite claims data (as described herein via SFTP) may result in a reduced Allocated Amount or disqualification from receiving an Allocated Amount.

Please provide the information in Section A for the Claimant:

Independent Emergency Room Physician is defined as an Emergency Room Physician that was a non-hospital employee that worked in an Emergency Room Physician whose billing and revenue collection were entirely separate from the billing and revenue collection practices of the medical facility at which such ER Physician practiced, and such ER Physician was not employed by such medical facility; who treated patients with opioid use disorder (who were either uninsured or underinsured), at any time, since 1996 through the present.

Please provide the information in Section B where notices should be sent:

By filling out this Claim Form, you are deemed to consent to receipt of this notice by email.

For promptness and accuracy, we prefer to contact you by email and will do so if possible. Accordingly, please provide your email address. If necessary, we may also contact you by phone or by U.S. mail.

If yes, please provide your attorney's name, phone number, mailing address, and email:

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By filling out this Claim Form, you are deemed to consent to receipt of this notice by email.

If "Yes" was selected in Section C.2, please complete a W-9 Form for the law firm identified in Section C of this Claim Form and return it with this Claim Form. If you are not working with an attorney, or if "No" was selected in Section C.2, please complete the W-9 Form attached hereto and return it with this Claim Form for the Claimant identified in Section A of this Claim Form.

Unless you defer payment, as indicated below, payment checks will be mailed to the law firm identified in Section C of this Claim Form if "Yes" was selected in Section C.2. If you are not working with an attorney or if "No" was selected in Section C.2, the check will be mailed to the contact person identified in Section B.

You may elect to allow the IERP Trust II to identify an OUD Abatement Program to receive your Allocated Amount.

If YES, your Allocated amount will be used towards an OUD Abatement Program at the discretion of the IERP TRUST II.

In preparing for the next step in the claims process, you will want to begin compiling your supporting data. Please indicate which of the following supporting data you intend to submit to the Claims Administrator(s) via SFTP (to be provided by the Claims Administrator after receipt of your completed Claims Form):

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I certify that I am authorized to sign this Claim Form and I understand that an authorized signature on this Claim Form serves as an acknowledgement that I have a reasonable belief that the information is true and correct. I certify that the Settlement Class Member has authority to release all Released Claims as identified in the following Settlement Agreements on behalf of itself and all other entities who are Releasors by virtue of their relationship or association with it. I certify that the Settlement Class Member I am submitting this Claim Form on behalf of is eligible to receive funds under the following Settlement Agreement in Kinlaw v. Sackler, et al, Case No.: 1:25-CV-00918. I declare under penalty of perjury under the laws of the United States of America that the foregoing is true and correct.

Your typed signature and submission of this Claim Form will have the same force and effect as if you signed the Claim Form on paper, which you may do alternatively.