Amex Antitrust Settlement Intake Form

AMEX ANTITRUST SETTLEMENT INTAKE FORM

Moskowitz v. American Express Co., No. 19-CV-566 Claim Deadline: May 19, 2026
This form is used by T.K. Sheth Law LLC d/b/a The Law Shed to collect information to evaluate, prepare, and submit an AMEX Antitrust Settlement claim.

You are not required to hire an attorney or use a third-party filer. You may file directly for free at www.AmexAntitrust.com, and free help is available from Class Counsel and the Settlement Administrator.

The Law Shed charges a 30% contingency fee only if the Firm accepts your engagement and obtains a recovery for you. No attorney-client relationship is formed unless you sign an Engagement Agreement and The Law Shed accepts and countersigns it.

Engagement Agreement Required: To request representation, you must complete both this intake form and the AMEX Engagement Agreement / Designated Agent Authorization. The Engagement Agreement is available on our website and should be linked in this form - Click Here.

The Law Shed will not review your matter for acceptance or submit a claim on your behalf unless the required engagement documents are completed and the Firm accepts and countersigns the Engagement Agreement.
SECTION 1: Your Contact Information
Name

First NameLast Name
Email
example@example.com
Mobile Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Mailing Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
SECTION 2: ELIGIBILITY
Illinois credit card billing address for all or part of January 29, 2016 through June 1, 2022
Illinois Billing Address During Claim Period - all or part of January 29, 2016 through June 1, 2022
Certification - Non-Rewards / No Annual Fee Card
No AMEX card
Certification - Qualified Purchase
SECTION 3: QUALIFYING ESTABLISHMENT
Please identify at least one Qualifying Merchant / establishment where you made an in-person Illinois purchase using your non-rewards, no annual fee Visa, Mastercard, or Discover credit card or charge card between January 29, 2016 and June 1, 2022.
SECTION 4: NOTICE INFORMATION
Did you receive a notice about this settlement from the Settlement Administrator?
If YES — Claimant ID:
(10-character alphanumeric code from your notice)
If YES — PIN:
(6-digit number from your notice)
SECTION 5: DOCUMENT UPLOADS
Government-Issued ID - Front

Cancelof
Government-Issued ID - Back, if applicable

Cancelof
Upload Notice, if available

Cancelof
SECTION 6: EXCLUSIONS/OPT-OUTS

The following are excluded from the Settlement Class: (1) Discover Financial Services, DFS Services LLC, or Discover Bank (2) Directors, officers, or immediate family members of the above (3) Certain persons and entities listed on Exhibit A to the Settlement Agreement
Did you previously ask to be excluded or opt out from the AMEX Antitrust lawsuit or settlement?
SECTION 7: AUTHORIZATION, ACKNOWLEDGMENTS, AND SIGNATURE
Authorization to review and proceed
Claim-related communications and additional information

I consent to claim-related communications from the Settlement Administrator, Class Counsel, and/or The Law Shed concerning my AMEX Antitrust Settlement claim, including by email, mobile phone, text message, or other electronic means. I understand that communications may be sent to me, to The Law Shed as my attorney/designated agent if my engagement is accepted, or to both. I agree to provide additional information, documents, signatures, verification, or claim support if requested in connection with my claim. Message and data rates may apply.
Attorney advertising disclosures

ATTORNEY ADVERTISING. Class members are not required to use a third-party filer. Free help is available from Class Counsel and the Settlement Administrator at www.AmexAntitrust.com. T.K. Sheth Law LLC d/b/a The Law Shed is an Illinois-licensed law firm, and all services are overseen by Tanvi K. Sheth, Principal Attorney. The Law Shed’s role is limited to preparing, submitting, and managing eligible claims under the AMEX Antitrust Settlement if the Firm accepts my engagement. The Law Shed charges a 30% contingency fee if the Firm accepts my engagement and obtains a recovery for me. Eligibility, payment timing, and payment amount are determined by the Settlement Administrator and/or the Court, not The Law Shed. No outcome, payment, eligibility determination, or recovery amount is guaranteed. I have the right to consult with an independent attorney of my choice.
Attorney advertising acknowledgment
Certification under penalty of perjury
Office Review
Should be Empty:

AMEX ANTITRUST SETTLEMENT INTAKE FORM

SECTION 1: Your Contact Information

SECTION 2: ELIGIBILITY

SECTION 3: QUALIFYING ESTABLISHMENT

SECTION 4: NOTICE INFORMATION

SECTION 5: DOCUMENT UPLOADS

SECTION 6: EXCLUSIONS/OPT-OUTS

SECTION 7: AUTHORIZATION, ACKNOWLEDGMENTS, AND SIGNATURE