Claim Form - MagnaChip Fair Fund - Strategic Claims Services

MagnaChip Fair Fund Claim Form for Preliminary Claimants

Step 1 of 5 - General Instructions

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 the Claim Form for those who have not filed previously link found in the Important Documents section of the case page.

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 – 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 2 – Schedule of Transactions
Please read the instructions carefully and enter your relevant transactions. You need to ensure that your number of shares in beginning holdings plus 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 3 – 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 4 – 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.

CLAIMANT IDENTIFICATION
The Fund Administrator will use the contact information for all correspondence relevant to this Claim (including the issuance of the distribution check, if the Claim is ultimately determined to be eligible for payment). If the contact information changes, then you must notify the Fund Administrator in writing.
Beneficial Owner's Name*

(as you would like it to appear on your check if eligible for payment)
Co-Beneficial Owner’s Name
Address*
Street Address Address Line 2 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 MAGNACHIP COMMON STOCK
Holdings at Start of Recovery Period*
List all shares of MagnaChip Semiconductor Corp. held as of the close of trading on January 31, 2012 (must be documented). If none, enter 0. Be sure to attach documentation verifying your holdings such as an account statement.
Purchases
List all purchases of MagnaChip common stock between February 1, 2012 and May 13, 2015* , inclusive (must be documented). Be sure to attach documentation verifying your transactions. *The purchases during the Relevant Period (February 1, 2012 through and including February 12, 2015) are eligible; however, purchase and sale transactions from February 13, 2015 through and including May 13, 2015 are required in order to reconcile the Claim Form.
Trade Date (List Chronologically) (mm/dd/yyyy) Number of Shares Price Per Share Total Purchase Price (Excluding Commissions)
Sales
List all sales of MagnaChip common stock between February 1, 2012 and May 13, 2015, inclusive (must be documented). Be sure to attach documentation verifying your transactions.
Trade Date (List Chronologically) (mm/dd/yyyy) Number of Shares Price Per Share Total Sales Proceeds (Excluding Commissions)
Unsold Holdings*
List the number of shares of MagnaChip common stock held as of the close of trading on May 13, 2015 (must be documented). If none, enter 0. Be sure to attach documentation verifying your holdings such as a current account statement.
BALANCE CHECK
Below is a summary of the transactions you entered. Your Holdings at Start of Recovery Period plus Purchases minus Sales and Unsold Holdings should equal zero. Please correct any errors below to ensure that all transactions are accounted for.
Holdings at Start of Recovery Period
Total Purchases
Total Sales
Unsold Holdings
BALANCE CONFIRMATION
Outstanding Shares
This field shows the number of shares that are outstanding based on what you have entered in the Holdings at Start of Recovery Period, Purchases, Sales, and Unsold Holdings fields. When all shares are accounted for, the balance in this field will be zero.
Balance Check Error*

Claim Form – MagnaChip Fair Fund

MagnaChip Fair Fund Claim Form for Preliminary Claimants

Step 1 of 5 - General Instructions

CLAIMANT IDENTIFICATION

SCHEDULE OF TRANSACTIONS IN MAGNACHIP COMMON STOCK

BALANCE CHECK

BALANCE CONFIRMATION

CERTIFICATION

Trade Date (List Chronologically) (mm/dd/yyyy)	Number of Shares	Price Per Share	Total Purchase Price (Excluding Commissions)