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Alcazar v. Fashion Nova, Inc.

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CONTACT INFORMATION

CLAIM INFORMATION

1. Are you legally blind?

Yes
No

2. Have you visited the Fashion Nova website (https://www.fashionnova.com) with the intention of visiting a Fashion Nova physical store?

Yes
No

3. During your visit to the Fashion Nova website (https://www.fashionnova.com), did you attempt to find a physical store location on Fashion Nova’s website but were unable to do so after reasonable diligence?

Yes
No

4. In what state were you living when you visited the Fashion Nova website?


5. What were the approximate dates of your visit to the Fashion Nova website?


Payment Method

Attestation and Signature

I declare under penalty of perjury that I am legally blind and that the information provided in this Claim Form, to the best of my knowledge, is true and correct.