Discover Merchant Settlement Intake Form

Discover Card Merchant Class Action Settlement Intake Form

(Claim Deadline May 18, 2026)
SECTION 1: Your Contact Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Mailing Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
SECTION 2: ELIGIBILITY
Did you or your business accept or process Discover credit cards in the United States between January 1, 2007 and December 31, 2023?*

YesNo
Are you a franchisor or franchisee?*

NeitherFranchisorFranchiseeBoth
SECTION 3: CLAIMANT INFORMATION

Submit a separate intake form for each business/entity with a different Taxpayer Identification Number (TIN).
Entity Structure*

Individual/Sole-proprietorshipPartnershipCorporationLimited Liability Company (LLC)TrustOther
Provide Complete Details About Your Business/You

(the entity for which you are completing this application)
Legal name of business, entity or person that accepted and/or processed Discover credit cards 2007–2023*
DBA / Trade Name(s) (if applicable)
(List all "doing business as" names used between 2007–2023)
Taxpayer Identification Number (TIN) *
(SSN, EIN, or ITIN)
Business Address (if different from mailing address above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone (if different from above)
Please enter a valid phone number.
Business Email (if different from above)
example@example.com
SECTION 4: NOTICE INFORMATION

(If you received a notice but don't have these handy, leave blank — we can proceed without them.)
Did you receive a notice about this settlement from the Settlement Administrator?*

Yes, by mailYes, by emailYes, both mail and emailNo, I did not receive a notice
If YES — Claimant ID:
(10-character alphanumeric code from your notice)
If YES — PIN:
(6-digit number from your notice)
SECTION 5: EXCLUSIONS

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
Are you or your business part of the above exclusion list?*

No, I am not excludedYes, I am excluded (STOP — you do not qualify)Not sure — contact office to discuss
SECTION 6: OPT-OUT STATUS
Have you submitted a request to exclude yourself ("opt out") from the Discover Card Merchant Settlement?*

NoYes (If Yes, you cannot file a claim)Not sure — contact office to discuss
SECTION 7: DOCUMENT UPLOADS
Govt-Issued ID (Front)*

Cancelof
Govt-Issued ID (Back)

Cancelof
Taxpayer Identification Number (Document showing your name and SSN/TIN/EIN)

(e.g., IRS letter, W-9, SS card, EIN confirmation)
Cancelof
Proof of Business Authority (One document showing you are the owner or authorized representative):

(e.g., IRS EIN Confirmation Letter, Articles of Incorporation/Organization, Business license or state registration, Operating Agreement, Merchant account agreement showing you as authorized signer)
Cancelof
SECTION 8: AUTHORIZATION
Do you have signatory authority for the above-listed entity?*

YesNo
Acknowledgment
I confirm that the information provided in this intake form is accurate and complete to the best of my knowledge.
ATTORNEY ADVERTISING

By submitting this form, CLIENT ACKNOWLEDGES AND AGREES THAT:
1. Class members are not required to use a third-party filer.
2. Free help is available from Class Counsel and the Class Administrator. Additional information is available on the Court-approved Settlement website at www.DiscoverMerchantSettlement.com.
3. T.K. Sheth Law LLC DBA The Law Shed is an Illinois-licensed law firm, and all services provided under this Agreement are overseen by Tanvi K. Sheth, Principal Attorney.
4. Scope of Services & Jurisdiction: The Law Shed's role as a third-party filer is limited to preparing and submitting eligible claims under the Discover Card Merchant Class Action Settlement. We do not offer or provide legal services in jurisdictions where we are not admitted to practice, and nothing in this Agreement is intended to authorize the practice of law outside Illinois.
5. No Guarantee of Outcome: While The Law Shed will use reasonable efforts to pursue your claim, we do not guarantee any specific outcome or recovery amount.
6. Notwithstanding these acknowledgments, Client still desires to retain Attorney to assist with preparation, submission, and management of Client's Claim.
Client understands that Client has the right to consult with an independent attorney of Client's choice with respect to any and every aspect of this Attorney Representation Agreement.
Office Review
Should be Empty:

Discover Card Merchant Class Action Settlement Intake Form

SECTION 1: Your Contact Information

SECTION 2: ELIGIBILITY

SECTION 3: CLAIMANT INFORMATION

Provide Complete Details About Your Business/You

SECTION 4: NOTICE INFORMATION

SECTION 5: EXCLUSIONS

SECTION 6: OPT-OUT STATUS

SECTION 7: DOCUMENT UPLOADS

SECTION 8: AUTHORIZATION

Acknowledgment