Project 1599 settlement fund claim application form

Applicant information

Full name

Current mailing address

City/Town

State/Province

ZIP/Postal Code

Country

Current phone number

Current email

Do you have reason to believe that you received a robocall on August 26, 2020 containing false information about voting in the 2020 election, either by receiving the call live or by voicemail?

What phone number received the robocall?

Certification

I hereby certify that the phone number listed above belonged to the applicant on August 26, 2020.