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YVETTE BAKER V. MARTIN LEIGH PC
CASE NO. 1816-CV32043
PROOF OF CLAIM FORM
You may be eligible for a benefit from the Martin Leigh PC Class Action settlement if you responded to a debt collection letter from the defendant in this case, Martin Leigh PC (or its predecessor Martin, Leigh, Laws & Fritzlen), where Martin Leigh PC was acting on behalf of a debt purchaser between July 2, 2014 and April 22, 2024.
If you wish to make a claim, then you must complete this Proof of Claim form and
mail it to the address listed below, postmarked no later than May 31, 2024.
Please return this form to:
Martin Leigh PC Class Action Settlement Administrator
c/o Gregory Leyh, P.C.
1600 Genessee Street, Suite 132
Kansas City, Missouri 64102
CLASS MEMBER INFORMATION
Name: _____________________________ Telephone: _________________
Street Address: ___________________________________
City: _________________________ State: __________ Zip Code: __________
Email Address: __________________________________
DEBT COLLECTION LETTER INFORMATION
Did you receive a debt collection letter from Martin Leigh PC acting on behalf of a debt purchaser between July 2, 2014 and April 22, 2024?
YES _________________ NO _________________
Date of Martin Leigh PC’s debt collection letter:
___________________, ___________
Month/Date Year
Did you attach a copy of the debt collection letter?
YES ________ NO ___________
RESPONSE TO DEBT COLLECTION LETTER INFORMATION
Did you respond to Martin Leigh PC’s debt collection letter?
YES _________ NO __________
Did you attach a copy of your response?
YES _________ NO ___________
AFFIRMATION
I affirm that I received and responded to a debt collection letter from Martin Leigh PC where Martin Leigh PC was acting on behalf of a debt purchaser between July 2, 2014 and April 22, 2024.
Signature: _______________________ Date: _______________________
APPROVED PROOF OF CLAIM FORM (pdf)
DownloadGregory Leyh, PC
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