GILES v. ST. CHARLES HEALTH SYSTEM UNITED STATES DISTRICT COURT FOR THE DISTRICT OF OREGON CASE NO. 6:13-cv AA CLAIM FORM

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1 NOTICE ADMINISTRATOR FOR U.S. DISTRICT COURT P.O. BOX 2730 PORTLAND, OR Notice to those who worked for St. Charles between 2005-present. <<Mail ID>> <<CLAIMANT NAME 1>> <<CLAIMANT NAME 2 OR BUSINESS NAME>> <<REPRESENTATIVE>> <<ADDRESS LINE 2>> <<ADDRESS LINE 1>> <<CITY STATE ZIPCODE>> <<COUNTRY>> GILES v. ST. CHARLES HEALTH SYSTEM UNITED STATES DISTRICT COURT FOR THE DISTRICT OF OREGON CASE NO. 6:13-cv AA CLAIM FORM YOU MUST COMPLETE AND RETURN THIS FORM TO RECEIVE YOUR SHARE OF THE PROPOSED CLASS AND COLLECTIVE ACTION SETTLEMENT DESCRIBED IN THE ACCOMPANYING NOTICE. THE MAILING DEADLINE FOR THIS FORM IS AUGUST 30, <<INSERT NAME>> The purpose of this Claim Form is to determine whether you are eligible to participate in the Settlement and, if so, the amount of your Settlement Payment. You are entitled to participate in the Settlement and receive a Settlement Payment if you were in an hourly paid position when you were required by St. Charles to complete at least one of the Certifications specified in Section 1, below, and you engaged in Unpaid Study Time in order to complete said Certification(s). Unpaid Study Time is defined as time you spent outside of your regular working hours preparing for the examination associated with the required Certification(s). SECTION 1: PROVIDE US WITH BACKGROUND INFORMATION NEEDED TO HELP CALCULATE YOUR SETTLEMENT PAYMENT. (A) STUDY TIME FOR REQUIRED CERTIFICATIONS First, tell us which Certifications you were required by St. Charles to complete from , while working in an hourly paid position and for which you engaged in Unpaid Study Time. (Do not include certifications you completed while in a salaried position or while you were not employed by St. Charles.) This information is important because the Settlement provides for a Settlement Payment to you of Unpaid Study Time Wages for these Certifications at agreed-upon rates, shown below, at your last hourly rate of pay shown in St. Charles payroll records, to include any applicable positional differential (e.g., charge nurse, coordinator and/or specialty coordinator, advanced education/certification, BSN, seasonal and/or relief nurse [regular, retiree, positioned weekend], and/or relief and/or casual RN): Study Time Reimbursement Rate CPR/BLS ACLS NRP PALS ENPC TNCC/ TEAM STABLE 1.5 hrs. ea. 9 hrs. ea. 4 hrs. ea. 9 hrs. ea. 10 hrs. ea. 10 hrs. ea. 10 hrs. ea. 01-CA8879 R8561 v

2 Please mark (using your initials, an X, check mark, or any other mark) in the box, on the chart below, each required Certification you completed during the years shown for which you engaged in Unpaid Study Time, as defined above. (Include all of your required Certifications, including any for which you received study time wages as part of St. Charles 2013 Study and Test-Taking Time retro-pay study. The third-party Settlement Administrator will calculate any required deduction for this time from your total.) If St. Charles had an Education Record on file for you covering , that Education Record is included with this Claim Form to assist you in completing the chart. Note that all of your required Certifications may not appear on the enclosed Education Record, so if you have records that would assist you in completing the chart, please refer to those records as well. Please make one mark per box below, as applicable CPR/ BLS ACLS NRP PALS ENPC TNCC/ TEAM STABLE (B) TERMINATION PENALTY Next, tell us whether your employment with St. Charles ended from 2010 present. This information is important because wage and hour law, and the Settlement, provides for a Termination Penalty to be paid if your employment with St. Charles ended from 2010 present (regardless of whether you were later rehired or reinstated by St. Charles) and, at the time your employment ended, you had Unpaid Study Time (even if you later received these wages through the retro-pay process referenced above and discussed in Section 5 of the Notice sent with this Claim Form). To qualify for a Termination Penalty, you must complete Section 1(A), above. If you qualify for a Termination Penalty, the penalty equals your last hourly rate of pay x 8 hours x 30 days, subject to a possible Pro Rata Reduction Formula in the event the Gross Settlement Amount is insufficient to pay each Class Member the Maximum Possible Recovery for his or her Claims. Last hourly rate of pay has the same definition, for purposes of this calculation, as in Section 1(A), above. Please check the appropriate box below: Yes, my employment with St. Charles ended at some point from 2010 present because I quit, was laid off, retired, was terminated, my job position was eliminated, or for some other reason. (Answer yes even if your employment ended, and you were later rehired or reinstated by St. Charles.) To the best of my recollection, my employment with St. Charles ended in MM of, (2010 present). YYYY No, my employment with St. Charles never ended at any point from 2010 present. 02-CA8879 R8562 v

3 (C) OVERTIME PENALTY Finally, tell us about your work schedule with St. Charles from , specifically the number of hours you were regularly scheduled to work every two weeks. This information is important because wage and hour law, and the Settlement, provides for an Overtime Penalty to be paid in certain instances that depend in part on the number of hours you were regularly scheduled to work. To qualify for an Overtime Penalty, you must complete Section 1(A), above. If you qualify for an Overtime Penalty, the penalty equals your last hourly rate of pay x 8 hours x 30 days, subject to a possible Pro Rata Reduction Formula in the event the Gross Settlement Amount is insufficient to pay each Class Member the Maximum Possible Recovery for his or her Claims. Last hourly rate of pay has the same definition, for purposes of this calculation, as in Section 1(A), above. (Note that if you qualify for a Termination Penalty and an Overtime Penalty, you will receive only one penalty.) Under the Settlement, you qualify for an Overtime Penalty if you satisfy the following: (1) (a) engaged in Unpaid Study Time and (b) worked a hour schedule every two weeks ( FTE) for St. Charles in 2010, 2011, and/or 2012, and were required by St. Charles to complete an ACLS, NRP, PALS, ENPC, TNCC, TEAM, and/or STABLE Certification during those years; and/or (2) (a) engaged in Unpaid Study Time and (b) worked an 80 hour schedule every two weeks (1.00 FTE) for St. Charles in 2010, 2011, 2012, and/or 2013, and were required by St. Charles to complete a CPR/BLS Certification during those years. Please check the appropriate box (check one): I do not qualify for an overtime penalty; I believe I qualify for an overtime penalty. By checking this box, I request that the third-party Settlement Administrator check my work records to confirm my belief and, if confirmed, pay me the penalty; or I don t know if I qualify for an overtime penalty. By checking this box, I request that the third-party Settlement Administrator check my work records to determine if I qualify and, if I do, pay me the penalty. SECTION 2: TELL US YOUR DECISION REGARDING THE SETTLEMENT. The information you provided in Sections 1(A) (C), above, will be used by the third-party Settlement Administrator to calculate your Settlement Payment. As stated in Section 4 of the Notice sent with this Claim Form, under the proposed Settlement, at least $6,365, is available to distribute to all Class Members who engaged in Unpaid Study Time and return a valid, properly completed Claim Form. Depending on the number of Claim Forms submitted, however, there may be a shortfall in the Settlement. Were this to occur, each Class Member s Settlement Payment will be reduced, pro rata in other words, by the same percentage. To give an example: If the amount needed to pay all of the Settlement Payments claimed by Class Members is $6,683,250.00, and the amount available to distribute to Class Members is $6,365,000.00, each Class Member s Settlement Payment would be reduced by 5%, so that the total payout equals the amount available. (Check one.) I accept the Settlement. I have reviewed the Notice that accompanies this Form. I consent to join and opt in to this Class and Collective Action Settlement as a party plaintiff for settlement purposes. I understand that I am agreeing to the Settlement and its terms, including the release of claims. I understand that, by signing below, I swear under oath that I engaged in Unpaid Study Time for the required Certifications specified in Section 1(A), above. I want to be excluded from the Settlement. I have reviewed the Notice that accompanies this Form. I understand that, by asking to be excluded from the Settlement, I am not consenting to join or opt in to the Class and Collective Action Settlement as a party plaintiff, I am not releasing any claims, and I will not receive a Settlement Payment. 03-CA8879 R8563 v

4 I swear under oath that the information I completed in Sections 1(A), (B), and (C) is true and accurate to the best of my belief. Please make sure to sign and print your name. Signature Print Name SECTION 3: CONFIRM YOUR NAME AND MAILING INFORMATION Please verify your mailing address and that you are the person this Claim Form was sent to, and provide your telephone number and personal address so that the third-party Settlement Administrator can contact you, if needed. Our records show that your correct mailing address is: <<Insert Name>> <<Insert Address>> <<Insert >> Indicate any changes to your mailing address in the space below: First Name MI Last Name Address City State ZIP Code My telephone number is My personal address is The last four digits of my Social Security number are x x x x x 04-CA8879 R8564 v

5 SECTION 4: IMPORTANT INSTRUCTIONS Please complete, sign, and mail this Form by regular mail, postage paid, to the Giles v. St. Charles Class Action Settlement Administrator at the address listed below. The Form must be postmarked on or before August 30, 2017, or you will forfeit your recovery under the Settlement. You may, but are not required to, return the Form(s) W-4 that accompanied this Claim Form. If you complete and return the enclosed Form(s) W-4, taxes will be withheld on the Unpaid Study Time Wages portion of your Settlement Payment based on the marital status and withholding exemptions you list on the Form(s). (No taxes will be deducted from any Termination and/or Overtime Penalty paid to you.) If you do not return the applicable Form(s) W-4, taxes on the Unpaid Study Time Wages portion of your Settlement Payment will be withheld as follows: (a) for those Class Members who are current St. Charles employees, in accordance with the Class Member s W-4 on file with St. Charles; and (b) for all others, at the rate of a single person claiming no withholding exemptions as required by federal law, and in accordance with any applicable, corresponding state tax law. Oregon uses the IRS Form W-4. Other states with a withholding requirement use their own W-4 tax form. A state tax form corresponding to the address we have for you was sent along with your Claim Form. If a different state tax form is required because you reside in another state, or for any other reason, you are responsible for providing that form with your Claim Form. (These forms can usually be obtained on your state taxing authority s website.) To receive your Settlement Payment, you must (1) complete this Claim Form and verify under oath that the information you provided is true and accurate to the best of your belief; (2) provide the last four digits of your Social Security number to verify your identity; and (3) verify your address and sign and print your name on this Claim Form, so the funds can be sent to the right person. If you have questions, contact the third-party Settlement Administrator at or Class Counsel, Roxanne L. Farra and R. Kyle Busse, at Forms must be mailed to the following address: Giles v. St. Charles Class Action Settlement Administrator P.O. Box 2730 Portland, OR Telephone: IMPORTANT NOTE ABOUT DEADLINE Your Claim Form must be completely filled out, signed, and postmarked on or before August 30, If you fail to complete and mail your Claim Form by the deadline stated on this Form, you will not be entitled to any benefits under this Settlement. 05-CA8879 R8565 v

6 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF OREGON Giles et al. v. St. Charles Health System, Inc., No. 6:13-cv AA NOTICE OF PROPOSED CLASS AND COLLECTIVE ACTION SETTLEMENT IF YOU WORKED FOR ST. CHARLES BETWEEN DECEMBER 12, 2005 AND THE PRESENT, YOU MAY BE ENTITLED TO MONEY FROM A SETTLEMENT. ST. CHARLES MAY NOT TAKE ANY ACTION AGAINST YOU FOR BEING PART OF THIS SETTLEMENT. A federal court authorized this Notice. Your legal rights are affected. Your options and the deadlines to exercise them are explained in this Notice. Please read this Notice carefully. An Oregon Class and Collective Action lawsuit to recover unpaid regular, overtime, and penalty wages against St. Charles Health System, Inc. ( St. Charles ) has been settled. St. Charles has agreed to pay up to $9,500, to settle this case, subject to the terms and conditions described in this Notice. You received this Notice because you have been identified as a current or former Caregiver employed between December 12, 2005 and the present at one or more of the following facilities owned or managed by St. Charles: (1) St. Charles-Bend (formerly St. Charles Medical Center-Bend); (2) St. Charles-Redmond (formerly St. Charles Medical Center-Redmond); (3) St. Charles-Madras; (4) St. Charles-Prineville; (5) Mountain View Hospital; (6) Pioneer Memorial Hospital; and (7) Air Life of Oregon. The Settlement covers Unpaid Study Time associated with certain professional medical Certifications completed between 2006 and You are entitled to participate in the Settlement if you were in an hourly paid position when you were required by St. Charles to complete at least one of the Certifications specified in Section 1, below, and you engaged in Unpaid Study Time in order to complete said Certification(s). Unpaid Study Time is defined as time you spent outside of your regular working hours preparing for the examination associated with the required Certification(s). You are entitled to participate in the Settlement, and to receive a Settlement Payment for unpaid wages and penalties, even if you signed a Study Time - Audit Form and/or Study and Test Taking Time - Release Form as part of St. Charles 2013 Study and Test-Taking Time retro-pay study. A website has been set up to keep you informed of the details of the Settlement. Please visit the website at R8566 v

7 YOUR LEGAL RIGHTS AND OPTIONS in this settlement Submit a Claim Form Only way to get a payment. Included with this Notice is a Claim Form that will help calculate any amount you are entitled to receive as a Settlement Payment. To receive a Settlement Payment, check the box on the Claim Form labeled I accept the Settlement and complete, sign, and return the Form by the deadline stated on the Form. By accepting the Settlement, you will be bound by the release of claims. Ask to Be Excluded To be excluded from the Settlement, check the box on the Claim Form labeled I want to be excluded from the Settlement and complete, sign, and return the Form by the deadline stated on the Form. You will not receive a Settlement Payment and will not be bound by the release of claims. Object to the Settlement Do Nothing To object to the Settlement, you must file a written statement with the Court by the objection deadline, explaining why you object. You may also attend and be heard at the Fairness Hearing with the Court if you object. Objecting to the Settlement does not exclude you from the Settlement. If you do nothing, you will not receive a Settlement Payment, and you will be bound by the release of claims. 1. What is this lawsuit about? On January 4, 2013, Plaintiff Carol Lynn Giles ( Giles ) filed a Class and Collective Action lawsuit against St. Charles in the United States District Court for the District of Oregon. The case, entitled Carol Lynn Giles v. St. Charles Health System, Inc., is Case No. 6:13-cv AA. Subsequently, fifty (50) other St. Charles Caregivers joined the lawsuit by filing a Notice of Consent to Be a Party Plaintiff (called Opt-In Plaintiffs ). On October 22, 2013, the Court certified this case as a class action lawsuit. As part of the Settlement, the Court also certified the case as a collective action under the Fair Labor Standards Act ( FLSA ). In a class action lawsuit, one or more people called Class Representatives (here, Giles, Shawn H. Dunlap, and Cheryl Lee Fisher) sue on behalf of other people who have similar claims. The people together are called a Class or Class Members. The people who sued and all the Class Members like them are called Plaintiffs. The company they sued (here, St. Charles) is called the Defendant. In a class action, one court resolves the issues for everyone in the Class together in one case except for those people who choose to exclude themselves from the Class. This Class and Collective Action lawsuit alleges that St. Charles violated Oregon and federal law by (1) failing to pay regular and overtime wages to Caregivers for Unpaid Study Time related to the following Certifications required by St. Charles: CPR/BLS, ACLS, PALS, ENPC, NRP, TNCC, TEAM, and STABLE; and (2) failing to pay Caregivers in this group who ended their employment their final paycheck wages within the time required by Oregon law. The lawsuit also seeks penalty wages for those Caregivers who qualify, for St. Charles failure to timely pay overtime and final paycheck wages, as required by Oregon law. St. Charles denied and continues to deny that any wrongdoing occurred. There has not yet been a trial of Plaintiffs claims. The Parties have reached a Settlement. The Settlement is the result of arm s-length negotiations between Plaintiffs, and their lawyers, and St. Charles, and its lawyers, through six (6) mediation sessions supervised by the U.S. District Court of Oregon. The Parties have investigated the facts and law throughout the prosecution of this case. Due to the risks and expenses associated with litigation, both sides agree this Settlement is fair and appropriate under the circumstances. 2. Who is covered by the Settlement? The Settlement Class is made up of 3,800+ Caregivers who worked at one or more of the seven (7) facilities owned or managed by St. Charles and listed on page 1 of this Notice, at some point between December 12, 2005 and the present. You received this Notice because you have been identified as a potential Class Member. R8567 v

8 3. Who represents the Settlement Class? The Court has designated Plaintiff Giles and the other two Class Representatives, and has appointed Roxanne L. Farra, of the law firm Roxanne L. Farra, P.C., and R. Kyle Busse, of the law firm Busse & Hunt, to act as Class Counsel. These attorneys represent the interests of the Plaintiffs and all Class Members. 4. What are the basic terms of the Settlement? St. Charles will pay up to $9,500, for (1) Settlement Payments to each Class Member who timely submits a properly completed Claim Form (see attached); (2) the employee and employer tax burden on the wage portion of each Settlement Payment; (3) Class Counsel s fees and litigation expenses for their work in this lawsuit; (4) Incentive Awards to Giles and the 50 Opt-In Plaintiffs; and (5) up to $200, in costs for providing this Notice and Claim Forms, and processing Class Members Claims. Per the proposed Settlement, Plaintiff Giles and the 50 Opt-In Plaintiffs will each receive $9, or $9,803.93, for a gross Incentive Award of $500,000.00, for their time, effort, and willingness to participate in and prosecute this class action lawsuit and achieve the Settlement. Class Counsel has worked on this case for more than four (4) years and has not yet been paid any money for their work or for the out-of-pocket expenses they incurred in litigating this lawsuit. Class Counsel has asked the Court to award attorneys fees equivalent to 25% of the Gross Settlement Amount ($2,375,000.00), and litigation expenses not to exceed $60,000.00, with any amount not spent in finalizing the Settlement remaining for distribution to the Settlement Class. Plaintiffs will pay up to $200, to a third-party Settlement Administrator, Epiq Systems, Inc. ( Epiq ), to send out this Notice and Claim Forms, and process Class Members Claims (St. Charles will pay any excess above this amount). Deduction of these amounts results in $6,365,000.00, to be divided among the Class Members who submit a valid Claim Form, entitling them to a Settlement Payment. (Should the third-party Settlement Administrator s costs and Class Counsel s costs be less, then this amount will be more.) 5. How much will my payment be? Each Class Member s payment is based on his or her specific situation. Each Class Member s payment calculation begins with his or her Unpaid Study Time Wages for , using an agreed-upon number of hours for each required Certification. This part of the calculation appears in Section 1(A) of the Claim Form. To give an example: If a Class Member returns a valid, timely Claim Form attesting that he/she completed a required ACLS Certification in 2006, 2008, 2010, and 2012, and certifies that he or she engaged in Unpaid Study Time for these ACLS Certifications, he/she receives 9 hours of pay for each Certification, or 36 hours total, at his or her last hourly rate of pay as shown by St. Charles payroll records, to include any applicable positional differential (e.g., charge nurse, coordinator and/or specialty coordinator, advanced education/certification, BSN, seasonal and/or relief nurse [regular, retiree, positioned weekend], and/or relief and/or casual RN). Other required certifications result in additional amounts, at agreed-upon and different rates, to reach the Class Member s total Unpaid Study Time Wages. R8568 v Note regarding St. Charles 2013 retro-pay study: 461 Class Members participated in St. Charles 2013 Study and Test-Taking Time retro-pay study regarding ACLS, NRP, PALS, ENPC, and TNCC/TEAM Certifications completed in 2011 and 2012 only. If you received a payment and/or signed a release as part of this process, you are nevertheless eligible to participate in the Settlement. If you received payment for Unpaid Study Time Wages associated with these specific Certifications through the retro-pay process, the Settlement Administrator will make sure that you do not receive the same wages twice through this Settlement. You should, however, still list your 2011 and 2012 ACLS, NRP, PALS, ENPC, and TNCC/TEAM Certifications on your Claim Form, so the Settlement Administrator can calculate any net Unpaid Study Time Wages that remain owing to you, and if you qualify for a Termination Penalty or Overtime Penalty, discussed next. Certain Class Members will receive a penalty equal to their last hourly rate of pay x 8 hours x 30 days. This part of the calculation appears in Section 1(B) of the Claim Form ( Termination Penalty ) and Section 1(C) of the Claim Form ( Overtime Penalty ). Last hourly rate of pay, for purposes of either calculation, has the same definition as discussed above. You receive a Termination Penalty if your employment with St. Charles ended from 2010 present (regardless of whether you were later rehired or reinstated by St. Charles), and at the time your employment ended, you had Unpaid Study Time (even if you later received these wages through the retro-pay process described above). Whether you qualify for an Overtime Penalty depends on your required Certifications, and the number of hours you were regularly scheduled to work in 2010, 2011, 2012, and/or 2013, and whether you engaged in Unpaid Study Time during this time period. If you qualify for both a Termination and an Overtime Penalty, you will receive only one penalty. 8

9 Note regarding Rose Dusan-Speck v. St. Charles Health System ( Speck Case ): If you are a Class Member in the Speck Case, any money you were paid toward a termination penalty in that class action settlement will be offset against any sum you are entitled to receive for a Termination Penalty in this case. If you did not receive termination penalty wages in the Speck Case, you may recover a full Termination Penalty in this lawsuit, if you qualify for this penalty. If you qualify for an Overtime Penalty in this case, you may recover a full Overtime Penalty, whether or not you were paid money toward a termination penalty in the Speck Case. Depending on the number of Claim Forms submitted, there may be a shortfall in the Settlement funds. Were this to occur, each Class Member s Settlement Payment will be reduced, pro rata in other words, by the same percentage. To give an example: If the amount needed to pay all of the Settlement Payments claimed by Class Members is $6,683,250.00, and the amount available to distribute to Class Members is $6,365, (see Section 4, on page 3), each Class Member s Settlement Payment would be reduced by 5%, so that the total payout equals the amount available. For tax purposes, each Class Member s Settlement Payment for Unpaid Study Time Wages will be treated as a W-2 wage-based payment, subject to applicable payroll withholdings and deductions. Each Class Member may, but is not required to, return the Form(s) W-4 accompanying his or her Claim Form sent in the mail. If a Class Member completes and returns the enclosed Form(s) W-4, taxes will be withheld on the Unpaid Study Time Wages portion of the Class Member s Settlement Payment based on the marital status and withholding exemptions listed on the Form(s). If a Class Member does not return the applicable Form(s) W-4, taxes on the Unpaid Study Time Wages portion of the Class Member s Settlement Payment will be withheld as follows: (a) for those Class Members who are current St. Charles employees, in accordance with the Class Member s W-4 on file with St. Charles; and (b) for all others, at the rate of a single person claiming no withholding exemptions as required by federal law, and in accordance with any applicable, corresponding state tax law. Oregon uses the IRS Form W-4. Other states with a withholding requirement use their own W-4 tax form. A state tax form corresponding to the address to which each Class Member s Notice and Claim Form was mailed was included with the Class Member s Claim Form. If a different state tax form is required because the Class Member resides in another state, or for any other reason, the Class Member is responsible for providing that form with his or her Claim Form. (These forms can usually be obtained on the state taxing authority s website.) Each Class Member s Settlement Payment for a Termination or Overtime Penalty will be treated as a non-wage-based payment, not subject to applicable payroll withholdings and deductions, for which the Class Member will receive an IRS Form Each Class Member is responsible for any tax obligations resulting from the Class Member s acceptance of this money. Please consult a qualified tax advisor if you have questions. 6. What happens to my Settlement Payment if I don t take it? Any settlement funds that are not claimed by Class Members belong to St. Charles. 7. The person this Notice was sent to has died. What should I do with this Notice? If you are the heir or legal representative of a Class Member who died, you may complete and submit a Claim Form seeking a Settlement Payment, which would become part of the Class Member s estate. 8. What do I have to do to receive my Settlement Payment? To receive your settlement money, you must submit a valid and timely Claim Form as follows: (1) complete Section 1(A) by showing on the chart provided using your initials, an X, check mark, or any other mark each of your required Certifications for for which you engaged in Unpaid Study Time; (2) complete Section 1(B), regarding your eligibility for a Termination Penalty, by checking one of the two boxes in that Section and providing your best recollection of the end date of your employment in the space provided; (3) complete Section 1(C), regarding your eligibility for an Overtime Penalty, by checking one of the three boxes in that Section; (4) in Section 2, check the box labeled I accept the Settlement and verify under oath that the information you provided is true and accurate to the best of your belief; (5) in Section 3, verify that your name and address information on the Form is correct, and provide your telephone number, personal address, and the last four digits of your Social Security number to verify your identity (so the funds can be sent to the right person); (6) sign the Form and print your name in the space provided; and (7) return the Form to the third-party Settlement Administrator by no later than August 30, 2017 at the following address: R8569 v

10 9. When would I get my payment? Giles v. St. Charles Class Action Settlement Administrator P.O. Box 2730 Portland, OR Telephone: The Settlement has not yet been finally approved by the Court. United States Chief District Judge Ann Aiken is in charge of this Class and Collective Action. Judge Aiken will hold a Fairness Hearing at a date to be determined to decide whether to finally approve the Settlement. If the Court finally approves the Settlement, and there are no appeals by any objectors, you will receive your Settlement Payment approximately days after Judge Aiken s final approval date. 10. What am I giving up to get a payment or stay in the Settlement Class? Unless you exclude yourself, you are staying in the Settlement Class. That means that once the Settlement is approved, you can t sue, continue to sue, or be a part of any other lawsuit against St. Charles (including their directors, officers, employees, and affiliates) about the legal issues arising from the facts in this case. Specifically, the release to which you are agreeing states as follows: The Class Representatives and Class Members who have not opted out of the Settlement Agreement in accordance with Section of this Settlement Agreement, and each of their respective past and present executors, administrators, representatives, agents, heirs, successors, assigns, trustees, and guardians, and all those who claim through them or who assert claims on their behalf (including the federal government or any state government in its capacity as parens patriae), will be deemed to have unconditionally, irrevocably, and completely released and forever discharged St. Charles, including all Released Parties defined in Section 2.31, from any and all matters, claims, charges, demands, damages, causes of action, debts, liabilities, and controversies, foreseen or unforeseen, known or unknown, for unpaid regular or overtime wages, liquidated damages, penalties, attorneys fees, and other damages, which could arise between Class Members and St. Charles, relating to Unpaid Study Time for CPR/BLS, ACLS, NRP, PALS, ENPC, TNCC/TEAM, and/or STABLE Certifications and/or other professional medical certifications, including, but not limited to, claims arising under Oregon wage laws in ORS Chapters 652 and 653, up to the Effective Date of this Settlement Agreement, excluding only claims under the Fair Labor Standards Act, 29 U.S.C. 201, et. seq., which shall be released only by Class Members who opt in to, or accept, the Settlement. The claims that are the subject of this Section 5.1 are collectively hereinafter Released Claims. Entry of final judgment and final approval of the Settlement will extinguish all Released Claims as against the Released Parties, and upon entry, the Class Members who have not opted out of the Settlement Agreement shall have fully, finally, and forever released, relinquished, and discharged all Released Claims against the Released Persons. Notwithstanding the foregoing, nothing in this Settlement Agreement is intended to operate as, nor shall be construed as, a release or waiver of any rights and/or claims that cannot be released or waived as a matter of law. 11. How can I exclude myself from the Settlement? You have the right to ask to be excluded from this Settlement. If you request to be excluded from the Settlement, you will not receive any settlement money and will not be bound by the release of claims. If you wish to be excluded from the Settlement, you must do the following: (1) check the box labeled I want to be excluded from the Settlement in Section 2 of the enclosed Claim Form; (2) in Section 3, verify that your name and address information on the Form is correct, and provide your telephone number, personal address, and the last four digits of your Social Security number to verify your identity; (3) sign the Form and print your name in the space provided; and (4) return the Form to the third-party Settlement Administrator by no later than August 30, 2017, at the address listed in Section 8 of this Notice. R85610 v

11 12. How do I object to the Settlement? You have the right to object to the Settlement. You may object to the Settlement, either personally or through an attorney, by filing a written objection with the Court and by sending a copy of your written objection to Class Counsel and Defendant s Counsel at their addresses listed below. All objections must be filed with the Court and served on Class Counsel and Defendant s Counsel no later than July 17, If you submit a timely objection, you may appear, either personally or through an attorney, and at your own expense, at the Fairness Hearing for the Settlement. You must provide written notice to the Court and counsel listed below if you intend to appear at the hearing. Therefore, your written objection should clearly explain why you object to the proposed Settlement and state whether you or someone on your behalf intends to appear at the Fairness Hearing. Contact information for Class Counsel: Roxanne L. Farra R. Kyle Busse ROXANNE L. FARRA, P.C. BUSSE & HUNT P.O. Box S.W. Morrison Street, Ste. 521 Bend, OR Portland, OR Tel. (541) Tel. (503) Fax (541) Fax (503) Contact information for Defendant s Counsel: Brenda K. Baumgart John B. Dudrey STOEL RIVES LLP 760 S.W. Ninth Avenue, Ste Portland, OR Tel. (503) Fax (503) Class Members who fail to file and timely serve written objections in the manner specified above will be deemed to have waived any objections and will be foreclosed from making any objection (whether by appeal or otherwise) to the Settlement and will be bound by the terms of the Settlement. You must still submit a timely and valid Claim Form in order to receive any proceeds under the Settlement should your objection be denied. 13. What s the difference between objecting and excluding? Objecting is simply telling the Court that you don t like something about the Settlement. You can object only if you stay in the Settlement Class. If the Court approves the Settlement, you will be bound by its terms. Excluding yourself, or opting out, is telling the Court that you don t want to be part of the Settlement Class. If you exclude yourself, you have no basis to object because the case no longer affects you. 14. What if I do nothing? If you do nothing in response to this Notice, you will not receive a Settlement Payment, but you will be bound by the release quoted in Section 10, above. 15. Can St. Charles retaliate against me for being involved in this Settlement? No. The law prohibits retaliation or discrimination by an employer against any employee who chooses to participate in, opt out of, object to, or do nothing in response to a class or collective action. The decision to participate in, opt out of, or object to this Settlement, or do nothing, is entirely your own. St. Charles has agreed in the Settlement Agreement that it will not retaliate or take any adverse employment action against any Class Member who is a current or former employee, or an employment candidate, because that Class Member has participated in the lawsuit or this Settlement Agreement in any way. Each Class Member s Claim Form, all Settlement Payments, and information about who opts in and opts out of the Settlement will be processed through a third-party Settlement Administrator (not affiliated with St. Charles). R85611 v

12 16. When and where will the Court decide whether to approve the Settlement? Judge Aiken will hold a final approval, or fairness, hearing at a date and time to be determined, at the U.S. District Court of Oregon (Eugene Division), 405 East Eighth Avenue, Eugene, Oregon At the hearing, the Court will determine whether the Settlement is fair, reasonable, adequate, and should be approved. If there are objections, Judge Aiken will consider them. Judge Aiken will listen to people who have asked to speak at the hearing. If you exclude yourself from the Settlement, you are not entitled to comment on or object to the Settlement or be heard at the hearing. After the hearing, the Court will decide whether to approve the Settlement. We do not know how long these decisions will take. 17. Do I have to come to the hearing? No. Class Counsel will answer questions Judge Aiken may have. But, you are welcome to come at your own expense. 18. What will happen if the Settlement is approved? What if it is not approved? If the Court approves the Settlement, the third-party Settlement Administrator will begin the process of mailing settlement checks to Class Members who accepted the Settlement. If someone appeals the Court s approval of the Settlement, payments will be delayed until all appeals are resolved. If the Settlement is not approved by the Court, the lawsuit will continue as if no settlement has been attempted. In that event, St. Charles retains the right to contest Plaintiffs Claims and the Judge s previous order that this case be maintained as a class or collective action. If the Settlement is not approved, there can be no assurance that this case will continue as a class action, or be certified as a collective action, or that individuals in the Settlement Class will recover anything at all. 19. What if I need more information? This Notice only summarizes the lawsuit and terms of the Settlement. For the precise terms and conditions of the Settlement, see the Class and Collective Action Settlement Agreement published at Official notices, instructions, and relevant forms are also published on this site. If you want to review the entire case file, you can access the Court docket through the Court s Public Access to Court Electronic Records (PACER) system at ecf.ord.uscourts.gov; or visit the Court s files in person at the clerk s office at the U.S. District Court of Oregon (Eugene Division), Wayne L. Morse U.S. Courthouse, 405 East Eighth Avenue, Eugene, Oregon The hours of the clerk s office are 8:30 a.m. to 4:30 p.m., Monday Thursday, and 9:30 a.m. to 4:30 p.m. on Friday, excluding Court holidays. Please do not call the Court or the Court clerk s office with questions about this lawsuit. Any questions regarding this Notice, the Claim Form, or the Settlement Payment process should be directed to the third-party Settlement Administrator at You may also contact Class Counsel with your questions at (541) , if you prefer. R85612 v