This Claim Form should be filled out online or submitted by mail if: (1) you were sent notice of the data security incident that occurred between April 7, 2020 and June 12, 2020 announced by Claire's (the "Data Incident"); (2) the notice stated that Data Incident potentially resulted in unauthorized access to customer payment card data, including first and last names, shipping and or billing addresses, credit or debit card numbers and/or bank account numbers; and (3) you had out-of-pocket expenses and/or unreimbursed extraordinary monetary losses as a result of the Data Incident. If you complete this claim form and have a valid claim, you may be entitled to compensation if the Settlement is approved.

The Settlement Notice describes your legal rights and options.