Claim Form - Jiayin Securities Litigation - Strategic Claims Services

Jiayin Securities Litigation Proof of Claim and Release Form

Step 1 of 6 - Help

This form allows you to file your claim online securely through our website. If you wish to file a paper claim or review any of the documents related to this case, please click Notice of Proposed Settlement of Class Action and Proof of Claim and Release Form links found in the Important Documents section.

Before you begin
Please have the following items ready to go before you begin filing your online claim form; it will make the process easier for you.
• You should have copies of your statements for the relevant date ranges so that you can enter your transactions.
• You should have copies of these statements scanned and saved on your computer so that you can upload them as proof. We prefer files in PDF format, but we can accept most file formats.

Step 1 – General Instructions
Please read this important information about the case. It provides important details you should understand before you file your claim.

Step 2 – Claimant Information
Please enter your current contact information to assist us in identifying your claim and contacting you for additional information and updates. We recommend you turn off auto-fill settings in your browser to ensure incorrect information is not added by mistake. You will receive a confirmation email that we received your claim at the email address you provide. Double check the information before you click next as you will not have the opportunity to review it again prior to submitting.

Step 3 – Schedule of Transactions
Please read the instructions carefully and enter your relevant transactions. You need to ensure that your number of shares in purchases/acquisitions minus sales and minus ending holdings equals zero. This is to ensure that all relevant transactions are accounted for. The form will not allow you to continue until all outstanding shares are accounted for.

Step 4 – Documentation
Please drag and drop your files or click select files and choose the files that you will provide as proof of your transactions. Broker statements are usually the best documents to use as proof. Please note that when the file upload completes, the file name will be listed below the upload box. You can click the red x to remove the file if it was added in error.

Step 5 – Certification
Please read the Certification. By typing your name and date in these fields, you are signing the document and certifying that everything is true, correct and complete. After you click the submit button, you will receive a confirmation that your claim was submitted. You will also receive a confirmation number; please record this number for future reference.

After submitting your claim
Within a few minutes of submitting your claim, you will receive a confirmation email from us that contains your Form ID along with the information you submitted. If you need to make any amendments to your claim, please reference the Form ID you received.

GENERAL INSTRUCTIONS
Deadline for Submission: December 9, 2022

IF YOU PURCHASED JIAYIN GROUP, INC. (“JIAYIN”) AMERICAN DEPOSITORY SHARES (“ADSs”) BETWEEN MAY 10, 2019 AND SEPTEMBER 2, 2020, PURSUANT AND/OR TRACEABLE TO JIAYIN’S INITIAL PUBLIC OFFERING (“IPO”), YOU ARE A “SETTLEMENT CLASS MEMBER” AND YOU MAY BE ENTITLED TO SHARE IN THE SETTLEMENT PROCEEDS. (EXCLUDED FROM THE SETTLEMENT CLASS ARE DEFENDANTS, CURRENT AND FORMER OFFICERS AND DIRECTORS OF JIAYIN, AND MEMBERS OF THEIR IMMEDIATE FAMILIES; ANY ENTITY IN WHICH DEFENDANTS HAVE OR HAD A CONTROLLING INTEREST; AND THE LEGAL REPRESENTATIVES, HEIRS, SUCCESSORS, AND ASSIGNS OF ANY SUCH EXCLUDED PERSON OR ENTITY. ALSO EXCLUDED FROM THE CLASS ARE THOSE PERSONS WHO TIMELY AND VALIDLY REQUEST EXCLUSION FROM THE CLASS.)

IF YOU ARE A SETTLEMENT CLASS MEMBER, YOU MUST COMPLETE AND SUBMIT THIS FORM IN ORDER TO BE ELIGIBLE FOR ANY SETTLEMENT BENEFITS.

YOU MUST COMPLETE AND SIGN THIS PROOF OF CLAIM AND RELEASE FORM (“PROOF OF CLAIM AND RELEASE FORM”) AND SUBMIT IT TO THE CLAIMS ADMINISTRATOR AT WWW.STRATEGICCLAIMS.NET/JIAYIN/ NO LATER THAN 11:59PM ON DECEMBER 9, 2022. IF YOU ARE UNABLE TO COMPLETE AND SUBMIT THIS PROOF OF CLAIM AND RELEASE FORM ELECTRONICALLY ON THE CLAIMS ADMINISTRATOR’S WEBSITE, YOU MAY MAIL IT BY FIRST CLASS MAIL, POSTMARKED NO LATER THAN DECEMBER 9, 2022, OR EMAIL IT, TO THE CLAIMS ADMINISTRATOR AT THE FOLLOWING ADDRESS:

Jiayin Securities Litigation
c/o Strategic Claims Services
P.O. Box 230
600 N. Jackson St., Suite 205
Media, PA 19063
Toll-Free: (866) 274-4004
Fax: (610) 565-7985
info@strategicclaims.net

YOUR FAILURE TO SUBMIT YOUR CLAIM BY DECEMBER 9, 2022 WILL SUBJECT YOUR CLAIM TO REJECTION AND MAY PRECLUDE YOU FROM RECEIVING ANY MONEY IN CONNECTION WITH THE SETTLEMENT OF THE ACTION. DO NOT MAIL OR DELIVER YOUR CLAIM TO THE COURT OR TO ANY OF THE PARTIES OR THEIR COUNSEL, AS ANY SUCH CLAIM WILL BE DEEMED NOT TO HAVE BEEN SUBMITTED. SUBMIT YOUR CLAIM ONLY TO THE CLAIMS ADMINISTRATOR. IF YOU ARE A SETTLEMENT CLASS MEMBER AND DO NOT SUBMIT A PROPER PROOF OF CLAIM AND RELEASE FORM, YOU WILL NOT SHARE IN THE SETTLEMENT BUT YOU NEVERTHELESS WILL BE BOUND BY THE ORDER AND FINAL JUDGMENT OF THE COURT UNLESS YOU EXCLUDE YOURSELF.

SUBMISSION OF A PROOF OF CLAIM DOES NOT ASSURE THAT YOU WILL SHARE IN THE PROCEEDS OF THE SETTLEMENT.
CLAIMANT'S STATEMENT
1. I (we) purchased Jiayin Group Inc. (“Jiayin”) ADSs between May 10, 2019 and September 2, 2020, inclusive, pursuant and/or traceable to the Jiayin IPO. (Do not submit this Proof of Claim and Release Form if you did not purchase Jiayin ADSs between May 10, 2019 and September 2, 2020, inclusive.)

2. By submitting this Proof of Claim and Release Form, I (we) state that I (we) believe in good faith that I am (we are) a Settlement Class Member(s) as defined above and in the Notice of Proposed Settlement of Class Action (the “Notice”), or am (are) acting for such person(s); that I am (we are) not a Defendant in the Action or anyone excluded from the Settlement Class; that I (we) have read and understand the Notice; that I (we) believe that I am (we are) entitled to receive a share of the Net Settlement Fund, as defined in the Notice; that I (we) elect to participate in the proposed Settlement described in the Notice; and that I (we) have not filed a request for exclusion. (If you are acting in a representative capacity on behalf of a Settlement Class Member [e.g., as an executor, administrator, trustee, or other representative], you must submit evidence of your current authority to act on behalf of that Settlement Class Member. Such evidence would include, for example, letters testamentary, letters of administration, or a copy of the trust documents.)

3. I (we) consent to the jurisdiction of the Court with respect to all questions concerning the validity of this Proof of Claim and Release Form. I (we) understand and agree that my (our) claim may be subject to investigation and discovery under the CPLR, provided that such investigation and discovery shall be limited to my (our) status as a Settlement Class Member(s) and the validity and amount of my (our) claim. No discovery shall be allowed on the merits of the Actions or Settlement in connection with processing of the Proof of Claim and Release Form.

4. I (we) have set forth where requested below all relevant information with respect to each purchase or acquisition of Jiayin ADSs during the timeframe mentioned below, and each sale, if any, of such securities. I (we) agree to furnish additional information to the Claims Administrator to support this claim if requested to do so.

5. I (we) have enclosed photocopies of the stockbroker’s confirmation slips, stockbroker’s statements, or other documents evidencing each purchase and sale of Jiayin ADSs listed below in support of my (our) claim. (IF ANY SUCH DOCUMENTS ARE NOT IN YOUR POSSESSION, PLEASE OBTAIN A COPY OR EQUIVALENT DOCUMENTS FROM YOUR BROKER OR TAX ADVISOR BECAUSE THESE DOCUMENTS ARE NECESSARY TO PROVE AND PROCESS YOUR CLAIM.)

6. I (we) understand that the information contained in this Proof of Claim and Release Form is subject to such verification as the Claims Administrator may request or as the Court may direct, and I (we) agree to cooperate in any such verification. (The information requested herein is designed to provide the minimum amount of information necessary to process most simple claims. The Claims Administrator may request additional information as required to efficiently and reliably calculate your Recognized Loss. In some cases, the Claims Administrator may condition acceptance of the claim based upon the production of additional information, including, where applicable, information concerning transactions in any derivatives securities such as options.)

7. Upon the occurrence of the Court’s approval of the Settlement, as detailed in the Notice, I (we) agree and acknowledge that my (our) signature(s) hereto shall effect and constitute a full and complete release, remise and discharge by me (us) and my (our) heirs, joint tenants, tenants in common, beneficiaries, executors, administrators, predecessors, successors, attorneys, insurers and assigns (or, if I am (we are) submitting this Proof of Claim and Release Form on behalf of a corporation, a partnership, estate or one or more other persons, by it, him, her or them, and by its, his, her or their heirs, executors, administrators, predecessors, successors, and assigns) of each of the “Released Parties” of all “Released Claims,” as those terms are defined in the Stipulation.

8. Upon the occurrence of the Court’s approval of the Settlement, as detailed in the Notice, I (we) agree and acknowledge that my (our) signature(s) hereto shall effect and constitute a covenant by me (us) and my (our) heirs, joint tenants, tenants in common, beneficiaries, executors, administrators, predecessors, successors, attorneys, insurers and assigns (or, if I am (we are) submitting this Proof of Claim and Release Form on behalf of a corporation, a partnership, estate or one or more other persons, by it, him, her or them, and by its, his, her or their heirs, executors, administrators, predecessors, successors, and assigns) to permanently refrain from prosecuting or attempting to prosecute any Released Claims against any of the Released Parties.

9. “Released Parties” has the meaning laid out in the Stipulation.

10. “Released Claims” has the meaning laid out in the Stipulation.

11. “Unknown Claims” has the meaning laid out in the Stipulation.

12. I (We) acknowledge that the inclusion of “Unknown Claims” in the definition of claims released pursuant to the Stipulation was separately bargained for and is a material element of the Settlement of which this release is a part.

CLAIMANT INFORMATION
The Claims Administrator will use this information for all communications regarding this Claim Form. If this information changes, you MUST notify the Claims Administrator in writing. Complete names of all persons and entities must be provided.
Beneficial Owner's Name*

(as you would like it to appear on your check if eligible for payment)
Co-Beneficial Owner's Name

(as you would like it to appear on your check if eligible for payment)
Entity Name

(if Beneficial Owner is not an individual)
Representative or Custodian Name

(if different from Beneficial Owner(s) listed above)
Address*
street name and number apartment, unit or box number City State / Province / Region ZIP / Postal Code Country
Account Number
Last 4 Digits of Social Security Number (for individuals) or T.I.N. (for estates, trusts, corporations, etc.)
Best Phone Number*
Alternate Phone Number
Email*
Enter Email Confirm Email

SCHEDULE OF TRANSACTIONS IN JIAYIN AMERICAN DEPOSITORY SHARES
Purchases/Acquisitions
Separately list each and every purchase or acquisition of Jiayin ADSs from May 10, 2019 to September 2, 2020, both dates inclusive, and provide the following information (must be documented):
Trade Date (List Chronologically) (Month/Day/Year) Number of Shares Purchased/ Acquired Price Per Share Total Cost (excluding taxes, commissions, and fees)
Sales
Separately list each and every sale or disposition of Jiayin ADSs from May 10, 2019 to September 2, 2020, both dates inclusive, and provide the following information (must be documented):
Trade Date (List Chronologically) (Month/Day/Year) Number of Shares Sold Price Per Share Amount Received (excluding taxes, commissions, and fees)
Ending Holdings*
State the total number of shares of Jiayin ADSs held at the close of trading on September 2, 2020 (Must be documented). If none, enter 0. Be sure to attach documentation verifying your holdings, such as an account statement.
BALANCE CHECK
Below is a summary of the transactions you entered. Your Purchases/Acquisitions minus Sales and Ending Holdings should equal zero. Please correct any errors below to ensure that all transactions are accounted for.
TOTAL Purchases/Acquisitions
TOTAL Sales
Ending Holdings
BALANCE CONFIRMATION
Outstanding Shares
This field shows the number of shares that are outstanding based on what you have entered in the Purchases/Acquisitions, Sales, and Ending Holdings fields. When all shares are accounted for, the balance in this field will be zero.
Balance Check Error*

You are required to attach proof as part of the online filing process. Please attach your files below.
Documentation*
Drop files here or

Max. file size: 32 MB.
Please attach your proof in PDF format. If you have a large number of files, please consider uploading a ZIP file. The total maximum file size limit is 32MB.
Confirmation*
- I have reviewed all of my answers to the fields on this form and confirm that everything is accurate to the best of my abilities.

CERTIFICATION
I (We) submit this Proof of Claim and Release Form under the terms of the Stipulation described in the Notice. I (We) also submit to the jurisdiction of the Supreme Court, New York County, with respect to my (our) claim as a Settlement Class Member(s) and for purposes of enforcing the release and covenant not to sue set forth herein. I (We) further acknowledge that I am (we are) bound by and subject to the terms of any judgment that may be entered in this Action. I (We) have not submitted any other claim covering the same purchases or sales of Jiayin ADSs from May 10, 2019 through and including September 2, 2020 and know of no other Person having done so on my (our) behalf.

I (We) certify that I am (we are) NOT subject to backup withholding under the provisions of Section 3406 (a)(1)(c) of the Internal Revenue Code because: (a) I am (We are) exempt from backup withholding; or (b) I (We) have not been notified by the I.R.S. that I am (we are) subject to backup withholding as a result of a failure to report all interest or dividends; or (c) the I.R.S. has notified me (us) that I am (we are) no longer subject to backup withholding.

UNDER THE PENALTIES OF PERJURY UNDER THE LAWS OF THE UNITED STATES, I (WE) CERTIFY THAT ALL OF THE INFORMATION I (WE) PROVIDED ON THIS PROOF OF CLAIM AND RELEASE FORM IS TRUE, CORRECT AND COMPLETE.
Signature of Claimant*

Please type the name of the Claimant. (If this claim is being made on behalf of Joint Claimants, then each must sign)
Signature of Joint Claimant

Please type the name of the Joint Claimant.
Capacity of person(s) signing

(Capacity of person(s) signing, e.g. beneficial purchaser(s), executor, administrator, trustee, etc. Proof of Authority is to be filed with this Proof of Claim and Release Form (See Item 2 under Claimant’s Statement).)
Date*
MM slash DD slash YYYY
Hidden
FormID

Trade Date (List Chronologically) (Month/Day/Year)	Number of Shares Purchased/ Acquired	Price Per Share	Total Cost (excluding taxes, commissions, and fees)

Trade Date (List Chronologically) (Month/Day/Year)	Number of Shares Sold	Price Per Share	Amount Received (excluding taxes, commissions, and fees)

Jiayin Securities Litigation Proof of Claim and Release Form

Step 1 of 6 - Help

GENERAL INSTRUCTIONS

CLAIMANT'S STATEMENT

CLAIMANT INFORMATION

SCHEDULE OF TRANSACTIONS IN JIAYIN AMERICAN DEPOSITORY SHARES

BALANCE CHECK

BALANCE CONFIRMATION

CERTIFICATION