Proof Of Claim And Release Form - New York District Court Page 3
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4IV.
SUBMISSION TO JURISDICTION OF COURT AND ACKNOWLEDGMENTS
On behalf of myself (ourselves) and each of my (our) heirs, agents, executors, trustees, administrators, predecessors,
successors and assigns, I (we) submit this Proof of Claim Form under the terms of the Stipulation described in the Notice. I (We)
also submit to the jurisdiction of the United States District Court for the Southern District of New York with respect to my (our)
claim as a Class Member and for purposes of enforcing the release set forth herein. I (We) further acknowledge that I am (we are)
bound by and subject to the terms of the Stipulation and any judgment that may be entered in the Litigation. I (We) agree to furnish
additional information to the Claims Administrator to support this claim if requested to do so. I (We) have not submitted any other
claim based on the same purchases, acquisitions or sales of Barclays ADS during the Class Period and know of no other person
having done so on my (our) behalf.
V.
RELEASE
1.
I (We) hereby acknowledge full and complete satisfaction of, and do hereby fully, finally, and forever settle, release,
and discharge from the Released Claims each and all of the Released Persons as provided in the Stipulation.
2.
“Released Persons” means each and all of Barclays, Marcus Agius, Robert Diamond, Jr., and John Varley, as well
as their respective former, present or future parents, subsidiaries, divisions and affiliates, and the respective employees, members,
partners, principals, officers, directors, controlling shareholders, attorneys, advisors, accountants, auditors, and insurers of each
of them; and the predecessors, successors, estates, spouses, heirs, executors, trusts, trustees, administrators, agents, legal or
personal representatives and assigns of each of them, in their capacity as such.
3.
“Released Claims” means any and all claims and causes of action of every nature and description, whether known
or unknown, arising under federal, state, common or foreign law, whether class or individual in nature, that you or any Class Member
asserted or could have asserted in the Litigation or any forum, which arise out of or relate to both (i) Barclays ADS, and (ii) any
disclosures, public filings, registration statements or other statements by Barclays or any Defendant in the Litigation based upon or
arising out of any facts, matters, allegations, transactions, events, disclosures, statements, acts or omissions which have been or
could have been asserted by any Class Member in the Litigation, except any claims to enforce the Settlement.
4.
This release shall be of no force or effect unless and until the Court approves the Stipulation and the Settlement
becomes effective on the Effective Date.
5.
I (We) hereby warrant and represent that I (we) have not assigned or transferred or purported to assign or transfer,
voluntarily or involuntarily, any matter released pursuant to this release or any other part or portion thereof.
6.
I (We) hereby warrant and represent that I (we) have included information about all of my (our) purchases,
acquisitions, and sales of Barclays ADS between July 10, 2007 and September 25, 2012, inclusive, and the number of Barclays
ADS held by me (us) at the close of trading on July 9, 2007, June 27, 2012, and September 25, 2012.
I declare under penalty of perjury under the laws of the United States of America that the foregoing information supplied by
the undersigned is true and correct.
Executed this _______________ day of _________________________ in __________________________________________
(Month/Year)
(City/State/Country)
_____________________________________________
_____________________________________________
(Sign your name here)
(Sign your name here)
_____________________________________________
_____________________________________________
(Type or print your name here)
(Type or print your name here)
_____________________________________________
_____________________________________________
(Capacity of person(s) signing, e.g.,
(Capacity of person(s) signing, e.g.,
Beneficial Purchaser or Acquirer, Executor or Administrator)
Beneficial Purchaser or Acquirer, Executor or Administrator)
*BARCLAYSFIFTH*
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