IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

KENNETH BEATTY and DONNET 

JAMES, on behalf of themselves and all 

others similarly situated,

Plaintiffs,

v.

CAPITAL ONE FINANCIAL 

CORPORATION, CAPITAL ONE BANK 

(USA), NATIONAL ASSOCIATION, 

CAPITAL ONE, NATIONAL 

ASSOCIATION,

Defendants.

Case No. 1:12-cv-00434

Magistrate Judge Michael T. Mason

INDEX OF EXHIBITS

TO JOINT MEMORANDUM OF LAW IS SUPPORT OF JOINT MOTION

FOR APPROVAL OF SETTLEMENT

Joint Stipulation of Settlement.........................................................................................................1

Notice of Settlement ...............................................................................................A

Consent to Join Settlement and Release Form........................................................B

IRS Form W-9.........................................................................................................C

All potential Settlement Class Members.................................................................D

Proposed Final Judgment and Order Approving Settlement and Dismissing Action......................2

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EXHIBIT 1

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UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

KENNETH BEATTY and DONNET JAMES, 

et al.,

Plaintiffs,

vs.

CAPITAL ONE FINANCIAL 

CORPORATION, et al.,

Defendants.

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CASE NO. 1:12-CV-00434

Magistrate Judge Michael T. Mason

JOINT STIPULATION OF SETTLEMENT

This Joint Stipulation of Settlement (“Joint Stipulation”) was made and entered into by, 

between, and among Kenneth Beatty and Donnet James (the “Named Plaintiffs”), on behalf of 

themselves and other Opt-In Plaintiffs, and Defendants Capital One Financial Corporation, 

Capital One Bank (USA), National Association, and Capital One, National Association

(“Defendants” or “Capital One”) and is conditioned upon the Court’s approval. 

1. DEFINITIONS

The following terms, when used in this Joint Stipulation, have the meanings set 

forth below, except when they are otherwise or more precisely defined in another Section.

(a) Plaintiffs and Defendants herein are collectively referred to as “the Parties.”

(b) “Action” means the civil action filed in the United States District Court, Northern

District of Illinois titled Kenneth Beatty and Donnet James, et al. v. Capital One Financial 

Corporation, et al., Civil Action Number 1:12-cv-00434.

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(c) “Plaintiffs’ Counsel” or “Class Counsel” means Thomas & Solomon LLP and 

Werman Law Office P.C.

(d) “Court” means the United States District Court, Northern District of Illinois.

(e) “Plaintiffs” means the individuals who have filed consent forms to participate in 

this Action pursuant to Section 216(b) of the Fair Labor Standards Act, including the Named 

Plaintiffs.

1

(f) “Named Plaintiffs” means Kenneth Beatty and Donnet James, the Named 

Plaintiffs in the Action

(g) The “FLSA Notice” refers to: (1) Notice of Settlement (Exhibit A); (2) Consent 

to Join Settlement and Release Form (Exhibit B); and (3) an IRS Form W-9 (Exhibit C) which 

will be sent by first class mail to all Settlement Class Members and, with regard to Settlement 

Class Members employed by Capital One at the time of mailing, also by electronic mail and 

hand-delivery, in the form attached hereto as Exhibit A, and (2) a “Notice Reminder,” which is 

the FLSA Notice and which will be sent no later than thirty (30) days prior to the end of the 

Notice Period by first class mail to all Settlement Class Members, and with regard to Settlement 

Class Members then currently employed by Capital One, also by email, who have not otherwise

responded to the first FLSA Notice. 

(h) The “Settlement Class” and “Settlement Class Members” means all individuals 

who (a) were employed by Capital One as a Relationship Manager, Senior Relationship 

Manager, and/or Underwriter between (1) January 19, 2009 (for Plaintiffs outside of New York) 

or January 19, 2006 (for Plaintiffs in New York), and (2) the earlier of (i) the date the position 

was reclassified as non-exempt or (ii) the effective date of the Plaintiff’s opt-in and (b) for whom 

 

1

To the extent any Plaintiffs or Class Members are deceased, the parties will stipulate to 

substitute their successor in interest or other appropriate party in their place.

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data has been provided to Plaintiffs’ Counsel; provided, however, that such data may be 

supplemented by Capital One to include additional individuals, so long as such supplemental 

data does not result in an increase of more than 280 work weeks, and (c) who return a Consent to 

Join Settlement and Release Form by the deadline provided in the Agreement. All potential 

Settlement Class Members are identified in Exhibit D hereto, which identifies each and every 

member of the potential Settlement Class and shall control to identify all potential Settlement 

Class Members.

2. BACKGROUND 

On or about January 1, 2012, Capital One reclassified as non-exempt the position of 

Relationship Manager in the Capital One Auto Finance Business. The Action was filed on 

January 19, 2012 by Kenneth Beatty, who was previously employed by Capital One as a 

Relationship Manager, and who alleged that Defendants failed to pay him and others similarly 

situated overtime wages when they worked more than forty hours in a workweek, in violation of 

the Fair Labor Standards Act, 29 U.S.C. § 201, et seq. (“FLSA”) and the Illinois Minimum Wage 

Law, 810 ILCS 105/1 et seq. (the “IMWL”). 

On February 3, 2012, Plaintiffs filed a Motion for Class Certification of their Illinois 

Minimum Wage Law Claim and Request for Discovery on Class Certification Issues. No 

briefing schedule was set because Plaintiffs and Defendants agreed to stay briefing while they 

engaged in settlement discussions. On or about March 15, 2012, Capital One made

reclassification payments to certain individuals who were employed as Relationship Managers 

and who had executed an acknowledgement form indicating that they were being paid overtime 

compensation in connection with the reclassification of the Relationship Manager position.

On April 17, 2012, a First Amended Complaint was filed with the Court adding Donnet 

James as a named plaintiff and alleging, in addition to the previous FLSA and IMWL claims, 

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that Defendants had violated their obligations pursuant to New York Labor Law §§ 190 et seq.

and 650 et seq., and the supporting New York State Department of Labor regulations, 12 

N.Y.C.R.R. § 142 (the “NYLL”), with respect to Ms. James, who was previously employed by 

Capital One as an Underwriter, and other Plaintiffs similarly situated.

The Parties disagree on many procedural and substantive issues. Plaintiffs believe that 

class and collective action certification are appropriate and that they would prevail on all claims

if the Action proceeded. Defendants believe they could defeat class and collective action

certification. Defendants further believe that they would prevail on all claims if this litigation 

proceeded, because the classification of Plaintiffs as exempt was proper and at all times in 

compliance with the law.

For settlement purposes only, the Parties submit this Joint Stipulation. If for any reason 

this Joint Stipulation is not approved by the Court, this Joint Stipulation (and the related 

Settlement Term Sheet, signed September 6, 2012) will be void and of no force and effect, and 

the Parties expressly reserve their rights with respect to the prosecution and defense of the 

Action as if this Joint Stipulation never existed.

3. REASONS FOR SETTLEMENT

(a) Plaintiffs’ Counsel have diligently and thoroughly investigated the facts of this 

Action and researched the legal issues involved. Based on their own independent investigation 

and evaluation, Plaintiffs’ Counsel believe that settlement for the consideration and other terms 

set forth in this Joint Stipulation is fair, reasonable and adequate, and in the best interests of 

Plaintiffs. While Plaintiffs’ Counsel believe the claims asserted in the Action have merit and that 

class certification was likely, they recognize and acknowledge that it would be expensive, time 

consuming, and burdensome to fully prosecute this Action. Plaintiffs’ Counsel also have taken 

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into account the uncertainty and risks inherent in any litigation, especially in complex collective

and class actions like this one.

(b) Defendants deny liability or wrongdoing of any kind associated with Plaintiffs’ 

claims, and Defendants further deny that this Action is appropriate for collective or class

treatment for any purpose other than settlement. 

Although the Parties do not abandon the positions they took in this Action, they believe 

that continued litigation would be protracted, expensive, uncertain, and contrary to their best 

interests. In light of these realities, the Parties believe that this Joint Stipulation is fair, 

reasonable and the best way to resolve the disputes between and among them.

4. STATEMENT OF NO ADMISSION

(a) This Joint Stipulation does not constitute and is not to be deemed, construed, or 

used as an admission by Defendants as to the truth of the factual allegations or the merits of the 

claims made against them in this Action.

(b) This Joint Stipulation does not constitute and is not to be deemed, construed, or 

used as an admission of liability or wrongdoing on the part of Defendants with respect to this 

Action. 

(c) This Joint Stipulation is a confidential settlement document and may not be 

admitted into evidence or used in any proceeding, except an action, motion, or proceeding to 

approve, interpret, or enforce the terms of the Joint Stipulation.

5. CONFIDENTIALITY

(a) Neither Plaintiffs nor their counsel will ever make a press release regarding the 

terms of this Joint Stipulation. 

(b) Plaintiffs and their counsel agree that neither the existence nor the terms of this 

Joint Stipulation shall be publicized in any manner for the period from September 6, 2012, until 

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one year after the date on which the court approves this settlement, unless otherwise required by 

law; provided, however, that direct communications with class members by counsel shall not be 

prohibited.

(c) The Named Plaintiffs agree that they will not disclose the terms of this Joint 

Stipulation to anyone other than their immediate family members and their tax and/or legal 

advisors, in any manner, unless otherwise required by law. 

(d) Plaintiffs’ Counsel agrees never to take any steps with respect to the settlement of 

this case resulting in reputational or financial harm to Defendants.

6. MONETARY TERMS OF SETTLEMENT

(a) Defendants will make a “Total Settlement Payment” in the amount of $3,200,000. 

From this amount, the following will be deducted:

(i) “Attorneys’ Fees,” in the total amount of $1,066,666.67;

2

(ii) “Litigation Expenses and Costs,” in the total amount of $30,000;

3

(iii) “Settlement Administrator Costs” of $15,000; and

(iv) “Named Plaintiff Stipends” in the amount of $10,000 for Kenneth Beatty 

and $5,000 for Donnet James, for a total of $15,000;

(b) The settlement proceeds that remain after the deductions described in paragraph 

6(a) will be divided among the remaining potential Settlement Class Members pro rata based on 

individual estimates of lost wages. The individual estimates of lost wages will be calculated 

using the following factors: (1) each potential Settlement Class Member’s number of weeks in a 

 

2

The payment of legal fees to Plaintiffs’ Counsel is consistent with legal services agreements 

executed between Plaintiffs’ Counsel and the Plaintiffs, and represents one-third of the total 

Settlement Amount.

3

The reimbursement of costs to Plaintiffs’ Counsel is consistent with the Plaintiffs’ legal 

services agreements executed between Plaintiffs’ Counsel and the Plaintiffs.

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relevant position (excluding leaves of absence); (2) each potential Settlement Class Member’s 

regular rate of pay during the relevant weeks in a relevant position; and (3) an assumed number 

of overtime hours worked (6 hours for Senior Relationship Managers, and 4 hours for 

Relationship Managers and Underwriters); provided, however, that the estimate of lost wages for 

each individual who acknowledged receipt of a payment of overtime from Capital One following 

the reclassification of the Relationship Manager position shall have his or her estimate reduced 

by 33%. The pro rata allocations to the potential Settlement Class, totaling $2,073,333.33 are 

set forth on Exhibit D of this Joint Stipulation.

(c) The amounts paid pursuant to this Joint Stipulation will not be taken into account 

in determining the rights or benefits of any Settlement Class Member under any benefit plan.

7. CLASS CERTIFICATION

For settlement purposes only the Parties stipulate to the certification of the Action as a 

collective action pursuant to 29 U.S.C. § 216(b). In making this stipulation the Parties 

acknowledge for settlement purposes only that the Named Plaintiffs are similarly situated to the 

members of the Settlement Class and that Plaintiffs’ Counsel is adequate Class Counsel.

8. SETTLEMENT TIMELINE

The parties agree to follow the following timeline for the completion of the settlement 

process and the dismissal of this Action:

(a) Settlement Approval: By November 19, 2012, Plaintiffs shall file a Joint Motion 

for Settlement Approval requesting that the Court: (1) grant approval of the parties’ Settlement; 

(2) conditionally certify the Settlement Class pursuant to 29 U.S.C. § 216(b); (3) appoint Thomas 

& Solomon LLP and Werman Law Office P.C. as Class Counsel for the Settlement Class; (4) 

approve the Parties’ proposed Notice of Settlement; and (5) approve the proposed settlement 

procedure. 

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(b) Notice Period: Within fourteen (14) days following the Court’s Order granting 

Settlement Approval, the Settlement Administrator will mail, and Capital One will otherwise 

distribute, the settlement materials described below in Paragraph 9 to potential members of the 

Settlement Class, who will have sixty (60) days to consider the terms of the Settlement and to 

return the required documentation. 

9. SETTLEMENT ADMINISTRATION

(a) Through a Settlement Administrator, jointly selected by the Parties, the members 

of the Settlement Class will receive the following documentation explaining the settlement and 

their rights: (1) Notice of Settlement; (2) Consent to Join Settlement and Release Form; and (3) 

an IRS Form W-9. The Notice of Settlement will explain how each potential Settlement Class 

Member’s share of the settlement was calculated, will identify their specific settlement amount 

(before taxes) and will provide instructions for how to consent to and accept a settlement 

payment. The Consent to Join Settlement and Release Form will identify the scope of the 

release. In order to join and receive their portion of the Settlement, each potential Settlement 

Class Member must sign the Consent to Join Settlement and Release Form and IRS Form W-9 

and return both to the Settlement Administrator within sixty (60) days of the date of mailing. 

(b) Plaintiffs’ Counsel also shall provide an IRS Form W-9 to the Settlement 

Administrator prior to receiving any payments pursuant to this Joint Stipulation. The payment of 

the fees and costs award to Plaintiffs’ Counsel shall constitute full satisfaction of the obligation 

to pay any amounts to any person, attorney or law firm for attorneys’ fees, expenses or costs in 

the Action incurred by any attorney on behalf of the Named Plaintiffs and the Settlement Class, 

and shall relieve Defendants and Defendants’ Counsel of any other claims or liability to any 

other attorney or law firm for any attorneys’ fees, expenses and/or costs to which any of them 

may claim to be entitled on behalf of the Named Plaintiffs and the Settlement Class.

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(c) Upon request, the Settlement Administrator shall during the 60-day opt-in period 

periodically provide to Defendants’ Counsel and Plaintiffs’ Counsel the names of members of 

the Settlement Class who chose to opt into the Action. Promptly after the 30th day of the 60-day 

opt-in period, the Settlement Administrator shall issue a reminder Notice of Settlement to all 

members of the Settlement Class who by that date have not signed and returned to the Settlement 

Administrator the Consent to Join Settlement and Release Form and IRS Form W-9.

(d) Following the end of the 60-day opt-in period, the Settlement Administrator shall 

notify Counsel for the Parties of the number of Settlement Class Members who have opted in to 

the Settlement, and of the total amount claimed by those Settlement Class Members. In the event 

that (i) 85% or more of the members of the Settlement Class who as of the date of this Joint 

Stipulation are currently employed by Capital One opt into the Settlement, and (ii) less than 70% 

of the Total Settlement Payment Amount (net of attorneys’ fees, costs, administration and 

enhancements) is claimed by the opt-ins, Capital One shall be permitted, at its option and with no 

penalty, to withdraw from the settlement by notifying Plaintiffs’ Counsel of its withdrawal by 

5:00 p.m. Central Time within ten (10) business days following Defendants’ receipt of the 

information from the Settlement Administrator.

(e) The Settlement Administrator will be responsible for the issuance of all checks, 

Forms W-2, and Forms 1099. Half of each Named Plaintiff’s total settlement amount, excluding 

any Named Plaintiff Stipend, shall constitute settlement of each Named Plaintiff’s wage claims, 

for which the Settlement Administrator will issue a Form W-2. The other half of each Named 

Plaintiff’s settlement amount plus any Named Plaintiff Stipend shall constitute settlement of each 

Plaintiff’s claims for liquidated damages and/or interest and penalties, for which the Settlement 

Administrator will issue an IRS Form 1099. The Settlement Administrator will be responsible 

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for calculating the amounts of withholdings and payroll taxes for the wages portion of the 

settlement. Federal income tax will be withheld at a 25% withholding rate for all Plaintiffs who 

are as of the date of this Joint Stipulation not employed by Capital One. Federal income tax will 

be withheld for all Plaintiffs who are as of the date of this Joint Stipulation employed by Capital 

One according to the elections on file with Capital One. State income tax will be withheld 

according to applicable state withholding requirements. Each Plaintiff shall agree to indemnify 

Defendants if the tax allocation and treatment of these payments is later challenged by the IRS or 

any state tax authority. The Settlement Administrator shall be responsible for all tax filings.

(f) The Settlement Administrator will be responsible for distribution of the checks to 

Plaintiffs. Defendants will deliver or cause to be delivered the Total Settlement Payment (net of 

all settlement amounts allocated to Class Members who have not opted in to the settlement) to 

the Settlement Administrator no later than fifteen (15) business days after the Settlement 

Administrator notifies counsel for the Parties pursuant to Paragraph 9(d) of the total amount 

claimed by the opt-in Settlement Class Members. The Settlement Administrator shall release the 

settlement funds to Plaintiffs and Plaintiffs’ Counsel seven (7) days after Defendants have

delivered the Total Settlement Payment to the Settlement Administrator at which time Plaintiffs’ 

Counsel’s attorneys’ fees and costs will be paid. Plaintiffs’ Counsel will cooperate with 

Defendants to the extent that Defendants are required to provide accurate addresses, a Form W-9, 

and, if necessary, any additional Form W-4 information to facilitate payroll withholding and tax 

reporting. The Settlement Administrator will report payments to Plaintiffs’ Counsel on IRS 

Form 1099.

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(g) If requested by Plaintiffs’ Counsel on behalf of any Named Plaintiff or Settlement 

Class Member, the Settlement Administrator will issue replacement settlement checks for checks 

that are lost, misplaced, delayed or inadvertently destroyed. 

10. RELEASE OF CLAIMS

Following the Court’s approval of the Settlement, Named Plaintiffs and Settlement Class 

Members will release and discharge Defendants and their former and present parents, 

subsidiaries, and affiliated corporations, and their officers, directors, employees, partners, 

shareholders and agents, and any other successors, assigns, or legal representatives (“Released 

Parties”) from any and all claims, causes of action, or liabilities based on or arising out of the 

allegations in the Action or which could arise out of the allegations in the Amended Complaint,

under any federal, state, or local statutory or common law (“Released Claims”). The Released 

Claims include, but are not limited to, any and all claims arising from or dependent on Illinois

wage and hour laws for overtime pay (including, but not limited to, the Illinois Minimum Wage

Law), the NYLL, the FLSA, and all of their implementing regulations. In addition, the Named 

Plaintiffs will, to the fullest extent permitted by law, release the Released Parties from any and 

all claims, causes of action, or liabilities, known or unknown, of whatever nature, arising from 

events taking place at any time prior to the effective date of the release. A Settlement Class 

Member who fails to accept the relevant release has no right to receive a payment pursuant to 

this Joint Stipulation.

11. DISMISSAL

The parties agree to cooperate and take all steps necessary and appropriate to dismiss this 

Action with prejudice, and any Plaintiff and Settlement Class Member who opts into the Action 

pursuant to this Joint Stipulation agrees to withdraw with prejudice any action or claims that may 

have been asserted against Defendants that are covered by the Release of claims in Paragraph 10. 

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The parties agree that upon entry of an Order by this Court finding this Settlement to be fair and 

reasonable, this Action will be dismissed in its entirety, without prejudice, and such dismissal 

without prejudice shall convert to a dismissal with prejudice ninety (90) days after the Notice 

Period expires. 

12. CONSTRUCTION

The terms and conditions of this Joint Stipulation are the result of lengthy, intensive, 

arm’s-length negotiations between and among the Parties. Accordingly, this Joint Stipulation is 

not to be construed in favor of or against any party by reason of the extent to which any party or 

its counsel participated in the drafting of the Joint Stipulation.

13. INTEGRATION

This Joint Stipulation contains the entire agreement between the parties relating to the 

settlement and transactions contemplated hereby, and all prior or contemporaneous agreements, 

understandings, representations, and statements, whether oral or written and whether by a party 

or such party’s legal counsel, are merged herein. No rights hereunder may be waived except in 

writing.

14. BINDING ON SUCCESSORS AND ASSIGNS 

This Joint Stipulation shall be binding upon and inure to the benefit of the Parties and 

their respective heirs, trustees, executors, administrators, successors, and assigns.

15. PARTIES’ AUTHORITY

The signatories hereto represent that they are fully authorized to enter into this Joint 

Stipulation and bind the respective Parties to its terms and conditions.

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Signed this ___ day of _____________, 2012.

By: /s/

J. Nelson Thomas

Michael J. Lingle

THOMAS & SOLOMON LLP

693 East Avenue

Rochester, NY 14607

Telephone: (585) 272-0540

WERMAN LAW OFFICE

Douglas M. Werman

Werman Law Office

77 West Washington, Suite 1402

Chicago, Illinois 60602

Telephone: (312) 419-1008

Attorneys for Plaintiffs, others similarly situated, 

and the Putative Class

By: /s/

Kenneth W. Gage, IL Bar No. 6291335

PAUL HASTINGS LLP

191 North Wacker Drive, 30th Floor

Chicago, Illinois 60606

COUNSEL FOR DEFENDANTS

CAPITAL ONE FINANCIAL CORPORATION 

ET AL.

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EXHIBIT A

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[Settlement Administrator Letterhead]

[______, 2012]

[Employee]

Re: Collective Action Settlement

Dear [Employee]:

You are receiving this correspondence because you are eligible to join in a settlement with 

Defendants Capital One Financial Corporation, Capital One Bank (USA), National Association, 

and Capital One, National Association (“Defendants” or “Capital One”). Under the terms of 

the settlement, you are entitled to receive $________. To participate in the settlement and 

receive a settlement payment, you must sign the enclosed consent form and return it no later than 

[INSERT 60 DAYS FROM MAILING]. 

In January, 2012, a lawsuit was filed in federal court in Illinois alleging that individuals who 

were employed by Capital One as a Relationship Manager, Senior Relationship Manager, and/or 

Underwriter since January 19, 2009 (for persons employed outside of New York) or January 19, 

2006 (for persons employed in New York), were not properly paid overtime for time they 

worked over 40 hours in individual work weeks. Capital One denied and continues to deny, all 

allegations in this lawsuit; however, the parties ultimately agreed to a settlement and you are 

entitled to participate in the settlement in exchange for a release of all federal, state and local 

wage and hour claims for overtime pay you may have arising from your employment as a 

Relationship Manager, Senior Relationship Manager, and/or Underwriter. 

The settlement amount is based on an equitable formula that takes into account (1) the number of 

weeks you worked in the relevant job position (excluding leaves of absence); (2) your regular 

rate of pay during the relevant weeks in the relevant position; (3) an assumed number of 

overtime hours worked (6 hours for Senior Relationship Managers, and 4 hours for Relationship 

Managers and Underwriters); and (4) if you already received a back payment for overtime from 

Capital One following the reclassification of the Relationship Manager position, a reduction of 

33%.

If you wish to participate in the settlement and receive a settlement payment, you must sign and 

return the enclosed consent form no later than [60 days from mailing]. If you choose to 

participate in this settlement, you will receive a payment of approximately $_____, less 

applicable tax and payroll deductions.

One half of this payment is considered wages and shall be subject to the withholding of all 

applicable local, state, and federal taxes, and shall appear on a Form W-2. The remaining oneCase: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 17 of 37 PageID #:318
half payment is not considered wages, and you will be responsible for paying the appropriate 

taxes on the amount. This amount will appear on a Form 1099. Please consult with your 

accountant or other tax advisor regarding the tax consequences of the settlement amount paid to 

you.

Please understand that the Court has approved this settlement. By signing and returning the 

consent form you agree to opt-in to this litigation and agree not to sue Capital One or any of the 

“Released Parties” (as that term is defined in the parties’ settlement agreement). You also will 

release all federal, state and local wage and hour claims arising from your employment as a

Relationship Manager, Senior Relationship Manager, and/or Underwriter through the earlier of 

(a) the date your job position was reclassified as non-exempt or (b) the effective date of your optin to this litigation.

Failure to return this consent on or before the deadline will prevent you from receiving your 

check. You should keep a record of mailing to verify the date it was mailed.

Alternatively, you can choose to do nothing. If you do not sign and return the enclosed consent 

form, you will be unable to participate in the settlement and you will not be subject to the 

judgment in this case. The lawsuit and the settlement will have no effect on you. Because of the 

operative statute of limitations applicable to this case, if you do not join this settlement you may 

lose any right, if such a right exists, to recover these claims in the future.

If you currently work at Capital One, no one at Capital One will retaliate against you for 

accepting this offer. If you no longer work at Capital One, acceptance will not in any way affect 

your eligibility for rehire. 

If you want to ask questions when deciding whether to accept this offer or need to change your 

address, you may contact [Settlement Administrator], a third party that has been retained to 

administer this process at INSERT 1-800 NUMBER OR EMAIL ADDRESS or Class Counsel at 

INSERT 1-800 NUMBER OR EMAIL ADDRESS. Please do not contact the Court. 

Sincerely,

[Insert Name] 

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EXHIBIT B

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IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

KENNETH BEATTY and DONNET 

JAMES, on behalf of themselves and all 

others similarly situated, 

Plaintiffs,

v.

CAPITAL ONE FINANCIAL 

CORPORATION, et al.

 Defendants.

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No. 12-cv-434

Magistrate Judge Mason 

CONSENT TO JOIN ACTION AND PARTICIPATE IN SETTLEMENT, INCLUDING

RELEASE OF CLAIMS

I consent to join the above-captioned lawsuit and to participate in the settlement of this 

action. In exchange for a payment in the amount of $________, pursuant to the court-approved 

settlement in this action, I acknowledge and agree to release and waive claims against the named 

Defendants and other parties released by the court-approved settlement in this action, including 

without limitation Defendants’ former and present parents, subsidiaries, and affiliated 

corporations, and their officers, directors, employees, partners, shareholders and agents, and any 

other successors, assigns, or legal representatives (“Released Parties”) from any and all claims, 

causes of action, or liabilities based on or arising out of the allegations in the Action or which 

could arise out of the allegations in the Amended Complaint, under any federal, state, or local 

statutory or common law (“Released Claims”). Released Claims include, but are not limited to, 

any and all claims arising from or dependent on Illinois wage and hour laws for overtime pay 

(including, but not limited to, the Illinois Minimum Wage Law), the New York Labor Law, the 

Fair Labor Standards Act, and all of their implementing regulations. 

DATE: 

SIGNATURE

PRINTED NAME

14475453v.2

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EXHIBIT C

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Form W-9

(Rev. December 2011)

Department of the Treasury 

Internal Revenue Service 

Request for Taxpayer 

Identification Number and Certification

Give Form to the 

requester. Do not 

send to the IRS.

Print or type 

See Specific Instructions on page 2.

Name (as shown on your income tax return)

Business name/disregarded entity name, if different from above

Check appropriate box for federal tax classification: 

Individual/sole proprietor C Corporation S Corporation Partnership Trust/estate

Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=partnership) ▶

Other (see instructions) ▶

Exempt payee

Address (number, street, and apt. or suite no.)

City, state, and ZIP code

Requester’s name and address (optional)

List account number(s) here (optional)

Part I Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. The TIN provided must match the name given on the “Name” line 

to avoid backup withholding. For individuals, this is your social security number (SSN). However, for a 

resident alien, sole proprietor, or disregarded entity, see the Part I instructions on page 3. For other 

entities, it is your employer identification number (EIN). If you do not have a number, see How to get a 

TIN on page 3.

Note. If the account is in more than one name, see the chart on page 4 for guidelines on whose 

number to enter.

Social security number

– –

Employer identification number

–

Part II Certification

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me), and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue 

Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am 

no longer subject to backup withholding, and

3. I am a U.S. citizen or other U.S. person (defined below).

Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding 

because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage 

interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and 

generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the 

instructions on page 4.

Sign 

Here Signature of 

U.S. person ▶ Date ▶

General Instructions

Section references are to the Internal Revenue Code unless otherwise 

noted.

Purpose of Form

A person who is required to file an information return with the IRS must 

obtain your correct taxpayer identification number (TIN) to report, for 

example, income paid to you, real estate transactions, mortgage interest 

you paid, acquisition or abandonment of secured property, cancellation 

of debt, or contributions you made to an IRA.

Use Form W-9 only if you are a U.S. person (including a resident 

alien), to provide your correct TIN to the person requesting it (the 

requester) and, when applicable, to:

1. Certify that the TIN you are giving is correct (or you are waiting for a 

number to be issued),

2. Certify that you are not subject to backup withholding, or

3. Claim exemption from backup withholding if you are a U.S. exempt 

payee. If applicable, you are also certifying that as a U.S. person, your 

allocable share of any partnership income from a U.S. trade or business 

is not subject to the withholding tax on foreign partners’ share of 

effectively connected income.

Note. If a requester gives you a form other than Form W-9 to request 

your TIN, you must use the requester’s form if it is substantially similar 

to this Form W-9.

Definition of a U.S. person. For federal tax purposes, you are

considered a U.S. person if you are:

• An individual who is a U.S. citizen or U.S. resident alien,

• A partnership, corporation, company, or association created or 

organized in the United States or under the laws of the United States,

• An estate (other than a foreign estate), or

• A domestic trust (as defined in Regulations section 301.7701-7).

Special rules for partnerships. Partnerships that conduct a trade or 

business in the United States are generally required to pay a withholding 

tax on any foreign partners’ share of income from such business. 

Further, in certain cases where a Form W-9 has not been received, a 

partnership is required to presume that a partner is a foreign person, 

and pay the withholding tax. Therefore, if you are a U.S. person that is a 

partner in a partnership conducting a trade or business in the United 

States, provide Form W-9 to the partnership to establish your U.S.

status and avoid withholding on your share of partnership income.

Cat. No. 10231X Form W-9 (Rev. 12-2011)

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 22 of 37 PageID #:323
Form W-9 (Rev. 12-2011) Page 2 

The person who gives Form W-9 to the partnership for purposes of 

establishing its U.S. status and avoiding withholding on its allocable 

share of net income from the partnership conducting a trade or business 

in the United States is in the following cases:

• The U.S. owner of a disregarded entity and not the entity,

• The U.S. grantor or other owner of a grantor trust and not the trust, 

and

• The U.S. trust (other than a grantor trust) and not the beneficiaries of 

the trust.

Foreign person. If you are a foreign person, do not use Form W-9. 

Instead, use the appropriate Form W-8 (see Publication 515, 

Withholding of Tax on Nonresident Aliens and Foreign Entities).

Nonresident alien who becomes a resident alien. Generally, only a 

nonresident alien individual may use the terms of a tax treaty to reduce 

or eliminate U.S. tax on certain types of income. However, most tax 

treaties contain a provision known as a “saving clause.” Exceptions 

specified in the saving clause may permit an exemption from tax to 

continue for certain types of income even after the payee has otherwise 

become a U.S. resident alien for tax purposes.

If you are a U.S. resident alien who is relying on an exception 

contained in the saving clause of a tax treaty to claim an exemption 

from U.S. tax on certain types of income, you must attach a statement 

to Form W-9 that specifies the following five items:

1. The treaty country. Generally, this must be the same treaty under 

which you claimed exemption from tax as a nonresident alien.

2. The treaty article addressing the income.

3. The article number (or location) in the tax treaty that contains the 

saving clause and its exceptions.

4. The type and amount of income that qualifies for the exemption 

from tax.

5. Sufficient facts to justify the exemption from tax under the terms of 

the treaty article.

Example. Article 20 of the U.S.-China income tax treaty allows an 

exemption from tax for scholarship income received by a Chinese 

student temporarily present in the United States. Under U.S. law, this 

student will become a resident alien for tax purposes if his or her stay in 

the United States exceeds 5 calendar years. However, paragraph 2 of 

the first Protocol to the U.S.-China treaty (dated April 30, 1984) allows 

the provisions of Article 20 to continue to apply even after the Chinese 

student becomes a resident alien of the United States. A Chinese

student who qualifies for this exception (under paragraph 2 of the first 

protocol) and is relying on this exception to claim an exemption from tax 

on his or her scholarship or fellowship income would attach to Form 

W-9 a statement that includes the information described above to 

support that exemption.

If you are a nonresident alien or a foreign entity not subject to backup 

withholding, give the requester the appropriate completed Form W-8.

What is backup withholding? Persons making certain payments to you 

must under certain conditions withhold and pay to the IRS a percentage 

of such payments. This is called “backup withholding.” Payments that 

may be subject to backup withholding include interest, tax-exempt 

interest, dividends, broker and barter exchange transactions, rents, 

royalties, nonemployee pay, and certain payments from fishing boat 

operators. Real estate transactions are not subject to backup 

withholding.

You will not be subject to backup withholding on payments you 

receive if you give the requester your correct TIN, make the proper 

certifications, and report all your taxable interest and dividends on your 

tax return.

Payments you receive will be subject to backup 

withholding if:

1. You do not furnish your TIN to the requester,

2. You do not certify your TIN when required (see the Part II 

instructions on page 3 for details),

3. The IRS tells the requester that you furnished an incorrect TIN,

4. The IRS tells you that you are subject to backup withholding 

because you did not report all your interest and dividends on your tax 

return (for reportable interest and dividends only), or

5. You do not certify to the requester that you are not subject to 

backup withholding under 4 above (for reportable interest and dividend 

accounts opened after 1983 only).

Certain payees and payments are exempt from backup withholding. 

See the instructions below and the separate Instructions for the 

Requester of Form W-9.

Also see Special rules for partnerships on page 1.

Updating Your Information

You must provide updated information to any person to whom you 

claimed to be an exempt payee if you are no longer an exempt payee 

and anticipate receiving reportable payments in the future from this 

person. For example, you may need to provide updated information if 

you are a C corporation that elects to be an S corporation, or if you no 

longer are tax exempt. In addition, you must furnish a new Form W-9 if 

the name or TIN changes for the account, for example, if the grantor of a 

grantor trust dies.

Penalties

Failure to furnish TIN. If you fail to furnish your correct TIN to a

requester, you are subject to a penalty of $50 for each such failure 

unless your failure is due to reasonable cause and not to willful neglect.

Civil penalty for false information with respect to withholding. If you 

make a false statement with no reasonable basis that results in no 

backup withholding, you are subject to a $500 penalty.

Criminal penalty for falsifying information. Willfully falsifying

certifications or affirmations may subject you to criminal penalties 

including fines and/or imprisonment.

Misuse of TINs. If the requester discloses or uses TINs in violation of 

federal law, the requester may be subject to civil and criminal penalties.

Specific Instructions

Name

If you are an individual, you must generally enter the name shown on 

your income tax return. However, if you have changed your last name, 

for instance, due to marriage without informing the Social Security 

Administration of the name change, enter your first name, the last name 

shown on your social security card, and your new last name.

If the account is in joint names, list first, and then circle, the name of 

the person or entity whose number you entered in Part I of the form.

Sole proprietor. Enter your individual name as shown on your income 

tax return on the “Name” line. You may enter your business, trade, or 

“doing business as (DBA)” name on the “Business name/disregarded 

entity name” line.

Partnership, C Corporation, or S Corporation. Enter the entity's name 

on the “Name” line and any business, trade, or “doing business as 

(DBA) name” on the “Business name/disregarded entity name” line.

Disregarded entity. Enter the owner's name on the “Name” line. The 

name of the entity entered on the “Name” line should never be a 

disregarded entity. The name on the “Name” line must be the name 

shown on the income tax return on which the income will be reported. 

For example, if a foreign LLC that is treated as a disregarded entity for 

U.S. federal tax purposes has a domestic owner, the domestic owner's 

name is required to be provided on the “Name” line. If the direct owner 

of the entity is also a disregarded entity, enter the first owner that is not 

disregarded for federal tax purposes. Enter the disregarded entity's 

name on the “Business name/disregarded entity name” line. If the owner 

of the disregarded entity is a foreign person, you must complete an 

appropriate Form W-8. 

Note. Check the appropriate box for the federal tax classification of the 

person whose name is entered on the “Name” line (Individual/sole 

proprietor, Partnership, C Corporation, S Corporation, Trust/estate).

Limited Liability Company (LLC). If the person identified on the 

“Name” line is an LLC, check the “Limited liability company” box only 

and enter the appropriate code for the tax classification in the space 

provided. If you are an LLC that is treated as a partnership for federal 

tax purposes, enter “P” for partnership. If you are an LLC that has filed a 

Form 8832 or a Form 2553 to be taxed as a corporation, enter “C” for 

C corporation or “S” for S corporation. If you are an LLC that is 

disregarded as an entity separate from its owner under Regulation 

section 301.7701-3 (except for employment and excise tax), do not 

check the LLC box unless the owner of the LLC (required to be 

identified on the “Name” line) is another LLC that is not disregarded for 

federal tax purposes. If the LLC is disregarded as an entity separate 

from its owner, enter the appropriate tax classification of the owner 

identified on the “Name” line.

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 23 of 37 PageID #:324
Form W-9 (Rev. 12-2011) Page 3 

Other entities. Enter your business name as shown on required federal 

tax documents on the “Name” line. This name should match the name 

shown on the charter or other legal document creating the entity. You 

may enter any business, trade, or DBA name on the “Business name/

disregarded entity name” line.

Exempt Payee 

If you are exempt from backup withholding, enter your name as 

described above and check the appropriate box for your status, then 

check the “Exempt payee” box in the line following the “Business name/

disregarded entity name,” sign and date the form.

Generally, individuals (including sole proprietors) are not exempt from 

backup withholding. Corporations are exempt from backup withholding 

for certain payments, such as interest and dividends.

Note. If you are exempt from backup withholding, you should still 

complete this form to avoid possible erroneous backup withholding.

The following payees are exempt from backup withholding:

1. An organization exempt from tax under section 501(a), any IRA, or a 

custodial account under section 403(b)(7) if the account satisfies the 

requirements of section 401(f)(2),

2. The United States or any of its agencies or instrumentalities,

3. A state, the District of Columbia, a possession of the United States, 

or any of their political subdivisions or instrumentalities,

4. A foreign government or any of its political subdivisions, agencies, 

or instrumentalities, or

5. An international organization or any of its agencies or 

instrumentalities.

Other payees that may be exempt from backup withholding include:

6. A corporation,

7. A foreign central bank of issue,

8. A dealer in securities or commodities required to register in the 

United States, the District of Columbia, or a possession of the United 

States,

9. A futures commission merchant registered with the Commodity 

Futures Trading Commission,

10. A real estate investment trust,

11. An entity registered at all times during the tax year under the 

Investment Company Act of 1940,

12. A common trust fund operated by a bank under section 584(a),

13. A financial institution,

14. A middleman known in the investment community as a nominee or 

custodian, or

15. A trust exempt from tax under section 664 or described in section 

4947.

The following chart shows types of payments that may be exempt 

from backup withholding. The chart applies to the exempt payees listed 

above, 1 through 15.

IF the payment is for . . . THEN the payment is exempt 

for . . .

Interest and dividend payments All exempt payees except 

for 9

Broker transactions Exempt payees 1 through 5 and 7 

through 13. Also, C corporations.

Barter exchange transactions and 

patronage dividends

Exempt payees 1 through 5

Payments over $600 required to be 

reported and direct sales over 

$5,000 1

Generally, exempt payees 

1 through 7 2

1 See Form 1099-MISC, Miscellaneous Income, and its instructions.

2 However, the following payments made to a corporation and reportable on Form 

1099-MISC are not exempt from backup withholding: medical and health care 

payments, attorneys' fees, gross proceeds paid to an attorney, and payments for 

services paid by a federal executive agency.

Part I. Taxpayer Identification Number (TIN)

Enter your TIN in the appropriate box. If you are a resident alien and 

you do not have and are not eligible to get an SSN, your TIN is your IRS 

individual taxpayer identification number (ITIN). Enter it in the social 

security number box. If you do not have an ITIN, see How to get a TIN 

below.

If you are a sole proprietor and you have an EIN, you may enter either 

your SSN or EIN. However, the IRS prefers that you use your SSN.

If you are a single-member LLC that is disregarded as an entity 

separate from its owner (see Limited Liability Company (LLC) on page 2), 

enter the owner’s SSN (or EIN, if the owner has one). Do not enter the 

disregarded entity’s EIN. If the LLC is classified as a corporation or 

partnership, enter the entity’s EIN.

Note. See the chart on page 4 for further clarification of name and TIN 

combinations.

How to get a TIN. If you do not have a TIN, apply for one immediately. 

To apply for an SSN, get Form SS-5, Application for a Social Security 

Card, from your local Social Security Administration office or get this 

form online at www.ssa.gov. You may also get this form by calling 

1-800-772-1213. Use Form W-7, Application for IRS Individual Taxpayer 

Identification Number, to apply for an ITIN, or Form SS-4, Application for

Employer Identification Number, to apply for an EIN. You can apply for 

an EIN online by accessing the IRS website at www.irs.gov/businesses

and clicking on Employer Identification Number (EIN) under Starting a 

Business. You can get Forms W-7 and SS-4 from the IRS by visiting 

IRS.gov or by calling 1-800-TAX-FORM (1-800-829-3676).

If you are asked to complete Form W-9 but do not have a TIN, write 

“Applied For” in the space for the TIN, sign and date the form, and give 

it to the requester. For interest and dividend payments, and certain 

payments made with respect to readily tradable instruments, generally 

you will have 60 days to get a TIN and give it to the requester before you 

are subject to backup withholding on payments. The 60-day rule does 

not apply to other types of payments. You will be subject to backup 

withholding on all such payments until you provide your TIN to the 

requester.

Note. Entering “Applied For” means that you have already applied for a 

TIN or that you intend to apply for one soon.

Caution: A disregarded domestic entity that has a foreign owner must 

use the appropriate Form W-8.

Part II. Certification

To establish to the withholding agent that you are a U.S. person, or 

resident alien, sign Form W-9. You may be requested to sign by the 

withholding agent even if item 1, below, and items 4 and 5 on page 4 

indicate otherwise.

For a joint account, only the person whose TIN is shown in Part I 

should sign (when required). In the case of a disregarded entity, the 

person identified on the “Name” line must sign. Exempt payees, see 

Exempt Payee on page 3.

Signature requirements. Complete the certification as indicated in 

items 1 through 3, below, and items 4 and 5 on page 4.

1. Interest, dividend, and barter exchange accounts opened 

before 1984 and broker accounts considered active during 1983. 

You must give your correct TIN, but you do not have to sign the 

certification.

2. Interest, dividend, broker, and barter exchange accounts 

opened after 1983 and broker accounts considered inactive during 

1983. You must sign the certification or backup withholding will apply. If 

you are subject to backup withholding and you are merely providing 

your correct TIN to the requester, you must cross out item 2 in the 

certification before signing the form.

3. Real estate transactions. You must sign the certification. You may 

cross out item 2 of the certification.

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 24 of 37 PageID #:325
Form W-9 (Rev. 12-2011) Page 4

4. Other payments. You must give your correct TIN, but you do not 

have to sign the certification unless you have been notified that you 

have previously given an incorrect TIN. “Other payments” include 

payments made in the course of the requester’s trade or business for 

rents, royalties, goods (other than bills for merchandise), medical and 

health care services (including payments to corporations), payments to 

a nonemployee for services, payments to certain fishing boat crew

members and fishermen, and gross proceeds paid to attorneys

(including payments to corporations).

5. Mortgage interest paid by you, acquisition or abandonment of 

secured property, cancellation of debt, qualified tuition program 

payments (under section 529), IRA, Coverdell ESA, Archer MSA or 

HSA contributions or distributions, and pension distributions. You 

must give your correct TIN, but you do not have to sign the certification.

What Name and Number To Give the Requester

For this type of account: Give name and SSN of:

1. Individual The individual

2. Two or more individuals (joint 

account)

The actual owner of the account or, 

if combined funds, the first 

individual on the account 1

3. Custodian account of a minor 

 (Uniform Gift to Minors Act)

The minor 2

4. a. The usual revocable savings 

trust (grantor is also trustee) 

b. So-called trust account that is 

not a legal or valid trust under 

state law

The grantor-trustee 1

The actual owner 1

5. Sole proprietorship or disregarded 

entity owned by an individual

The owner 3

6. Grantor trust filing under Optional 

Form 1099 Filing Method 1 (see 

Regulation section 1.671-4(b)(2)(i)(A))

The grantor*

For this type of account: Give name and EIN of:

7. Disregarded entity not owned by an 

individual

The owner

8. A valid trust, estate, or pension trust Legal entity 4

9. Corporation or LLC electing 

corporate status on Form 8832 or 

Form 2553

The corporation

10. Association, club, religious, 

charitable, educational, or other 

tax-exempt organization

The organization

11. Partnership or multi-member LLC The partnership

12. A broker or registered nominee The broker or nominee

13. Account with the Department of 

Agriculture in the name of a public 

entity (such as a state or local 

government, school district, or 

prison) that receives agricultural 

program payments

The public entity

14. Grantor trust filing under the Form 

1041 Filing Method or the Optional 

Form 1099 Filing Method 2 (see 

Regulation section 1.671-4(b)(2)(i)(B))

The trust

1

List first and circle the name of the person whose number you furnish. If only one person on a 

joint account has an SSN, that person’s number must be furnished.

2

Circle the minor’s name and furnish the minor’s SSN.

3

You must show your individual name and you may also enter your business or “DBA” name on 

the “Business name/disregarded entity” name line. You may use either your SSN or EIN (if you 

have one), but the IRS encourages you to use your SSN. 4

List first and circle the name of the trust, estate, or pension trust. (Do not furnish the TIN of the 

personal representative or trustee unless the legal entity itself is not designated in the account 

title.) Also see Special rules for partnerships on page 1.

*Note. Grantor also must provide a Form W-9 to trustee of trust.

Note. If no name is circled when more than one name is listed, the 

number will be considered to be that of the first name listed.

Secure Your Tax Records from Identity Theft

Identity theft occurs when someone uses your personal information 

such as your name, social security number (SSN), or other identifying 

information, without your permission, to commit fraud or other crimes. 

An identity thief may use your SSN to get a job or may file a tax return 

using your SSN to receive a refund.

To reduce your risk:

• Protect your SSN,

• Ensure your employer is protecting your SSN, and

• Be careful when choosing a tax preparer.

If your tax records are affected by identity theft and you receive a 

notice from the IRS, respond right away to the name and phone number 

printed on the IRS notice or letter.

If your tax records are not currently affected by identity theft but you 

think you are at risk due to a lost or stolen purse or wallet, questionable 

credit card activity or credit report, contact the IRS Identity Theft Hotline 

at 1-800-908-4490 or submit Form 14039.

For more information, see Publication 4535, Identity Theft Prevention 

and Victim Assistance.

Victims of identity theft who are experiencing economic harm or a 

system problem, or are seeking help in resolving tax problems that have 

not been resolved through normal channels, may be eligible for 

Taxpayer Advocate Service (TAS) assistance. You can reach TAS by 

calling the TAS toll-free case intake line at 1-877-777-4778 or TTY/TDD 

1-800-829-4059.

Protect yourself from suspicious emails or phishing schemes. 

Phishing is the creation and use of email and websites designed to 

mimic legitimate business emails and websites. The most common act 

is sending an email to a user falsely claiming to be an established 

legitimate enterprise in an attempt to scam the user into surrendering 

private information that will be used for identity theft.

The IRS does not initiate contacts with taxpayers via emails. Also, the 

IRS does not request personal detailed information through email or ask 

taxpayers for the PIN numbers, passwords, or similar secret access 

information for their credit card, bank, or other financial accounts.

If you receive an unsolicited email claiming to be from the IRS, 

forward this message to phishing@irs.gov. You may also report misuse 

of the IRS name, logo, or other IRS property to the Treasury Inspector 

General for Tax Administration at 1-800-366-4484. You can forward 

suspicious emails to the Federal Trade Commission at: spam@uce.gov

or contact them at www.ftc.gov/idtheft or 1-877-IDTHEFT 

(1-877-438-4338).

Visit IRS.gov to learn more about identity theft and how to reduce 

your risk.

Privacy Act Notice

Section 6109 of the Internal Revenue Code requires you to provide your correct TIN to persons (including federal agencies) who are required to file information returns with 

the IRS to report interest, dividends, or certain other income paid to you; mortgage interest you paid; the acquisition or abandonment of secured property; the cancellation 

of debt; or contributions you made to an IRA, Archer MSA, or HSA. The person collecting this form uses the information on the form to file information returns with the IRS, 

reporting the above information. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation and to cities, states, the District 

of Columbia, and U.S. possessions for use in administering their laws. The information also may be disclosed to other countries under a treaty, to federal and state agencies 

to enforce civil and criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You must provide your TIN whether or not you are required to 

file a tax return. Under section 3406, payers must generally withhold a percentage of taxable interest, dividend, and certain other payments to a payee who does not give a 

TIN to the payer. Certain penalties may also apply for providing false or fraudulent information.

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 25 of 37 PageID #:326
EXHIBIT D

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 26 of 37 PageID #:327
Kenneth Beatty, et al. v. Capital One Financial Corporation, et al.

Exhibit D

Emplid Owed Wages Liquidated 

Damages

Settlement 

Payment

101009 $ 1,885.01 $ 1,885.01 $ 3,770.03

104177 $ 1,227.93 $ 1,227.93 $ 2,455.86

104539 $ 1,901.82 $ 1,901.82 $ 3,803.65

104774 $ 2,031.61 $ 2,031.61 $ 4,063.22

104808 $ 2,147.04 $ 2,147.04 $ 4,294.08

104819 $ 2,488.35 $ 2,488.35 $ 4,976.69

105926 $ 3,132.17 $ 3,132.17 $ 6,264.34

106898 $ 286.77 $ 286.77 $ 573.54

108100 $ 1,354.24 $ 1,354.24 $ 2,708.48

108647 $ 4,266.94 $ 4,266.94 $ 8,533.89

108837 $ 2,779.03 $ 2,779.03 $ 5,558.07

108867 $ 280.59 $ 280.59 $ 561.19

111853 $ 15,307.98 $ 15,307.98 $ 30,615.96

111995 $ 2,535.97 $ 2,535.97 $ 5,071.94

112306 $ 2,859.52 $ 2,859.52 $ 5,719.05

115183 $ 2,636.27 $ 2,636.27 $ 5,272.54

116686 $ 13,702.88 $ 13,702.88 $ 27,405.76

117604 $ 516.96 $ 516.96 $ 1,033.92

118436 $ 2,811.21 $ 2,811.21 $ 5,622.43

123438 $ 3,055.12 $ 3,055.12 $ 6,110.24

124167 $ 1,145.39 $ 1,145.39 $ 2,290.77

124224 $ 2,779.03 $ 2,779.03 $ 5,558.07

125430 $ 3,127.10 $ 3,127.10 $ 6,254.20

125496 $ 2,779.03 $ 2,779.03 $ 5,558.07

125706 $ 2,077.74 $ 2,077.74 $ 4,155.49

128872 $ 422.45 $ 422.45 $ 844.90

129865 $ 2,321.50 $ 2,321.50 $ 4,643.00

129957 $ 1,144.19 $ 1,144.19 $ 2,288.39

130518 $ 1,224.98 $ 1,224.98 $ 2,449.97

131051 $ 2,779.03 $ 2,779.03 $ 5,558.07

131118 $ 4,966.32 $ 4,966.32 $ 9,932.63

131208 $ 13,062.57 $ 13,062.57 $ 26,125.14

152282 $ 230.19 $ 230.19 $ 460.38

152464 $ 1,569.68 $ 1,569.68 $ 3,139.36

152846 $ 15,054.78 $ 15,054.78 $ 30,109.57

152943 $ 1,609.42 $ 1,609.42 $ 3,218.84

153236 $ 14,945.39 $ 14,945.39 $ 29,890.78

153445 $ 2,744.63 $ 2,744.63 $ 5,489.27

154540 $ 3,580.30 $ 3,580.30 $ 7,160.60

155610 $ 3,823.52 $ 3,823.52 $ 7,647.04

157106 $ 635.90 $ 635.90 $ 1,271.81

157585 $ 2,311.35 $ 2,311.35 $ 4,622.69

157781 $ 5,722.41 $ 5,722.41 $ 11,444.83

158085 $ 460.02 $ 460.02 $ 920.04

158086 $ 1,471.26 $ 1,471.26 $ 2,942.51

158242 $ 2,779.03 $ 2,779.03 $ 5,558.07

158243 $ 2,194.77 $ 2,194.77 $ 4,389.55

158248 $ 2,825.84 $ 2,825.84 $ 5,651.67

158598 $ 12,759.24 $ 12,759.24 $ 25,518.49

158716 $ 2,742.58 $ 2,742.58 $ 5,485.16

1 of 8

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 27 of 37 PageID #:328
Kenneth Beatty, et al. v. Capital One Financial Corporation, et al.

Exhibit D

Emplid Owed Wages Liquidated 

Damages

Settlement 

Payment

161000 $ 14,482.69 $ 14,482.69 $ 28,965.37

161037 $ 766.97 $ 766.97 $ 1,533.94

161496 $ 11,056.50 $ 11,056.50 $ 22,113.00

161599 $ 2,448.68 $ 2,448.68 $ 4,897.37

161760 $ 2,844.78 $ 2,844.78 $ 5,689.57

162256 $ 3,081.97 $ 3,081.97 $ 6,163.93

162305 $ 896.53 $ 896.53 $ 1,793.06

163121 $ 9,710.81 $ 9,710.81 $ 19,421.63

163126 $ 1,162.65 $ 1,162.65 $ 2,325.29

163464 $ 893.14 $ 893.14 $ 1,786.28

163467 $ 3,339.86 $ 3,339.86 $ 6,679.72

163674 $ 2,796.23 $ 2,796.23 $ 5,592.47

163734 $ 537.15 $ 537.15 $ 1,074.30

163752 $ 5,303.95 $ 5,303.95 $ 10,607.89

163755 $ 3,328.75 $ 3,328.75 $ 6,657.50

163758 $ 4,729.85 $ 4,729.85 $ 9,459.69

163761 $ 12,212.08 $ 12,212.08 $ 24,424.15

163763 $ 11,201.65 $ 11,201.65 $ 22,403.30

163767 $ 7,207.83 $ 7,207.83 $ 14,415.67

163768 $ 138.83 $ 138.83 $ 277.67

163771 $ 12,616.18 $ 12,616.18 $ 25,232.37

163799 $ 537.15 $ 537.15 $ 1,074.30

163915 $ 11,435.44 $ 11,435.44 $ 22,870.88

163922 $ 3,158.16 $ 3,158.16 $ 6,316.32

163923 $ 13,316.41 $ 13,316.41 $ 26,632.81

163926 $ 1,410.74 $ 1,410.74 $ 2,821.48

163929 $ 3,616.44 $ 3,616.44 $ 7,232.88

163931 $ 9,016.23 $ 9,016.23 $ 18,032.47

164137 $ 290.31 $ 290.31 $ 580.62

164158 $ 930.82 $ 930.82 $ 1,861.64

164167 $ 857.28 $ 857.28 $ 1,714.56

164191 $ 13,914.85 $ 13,914.85 $ 27,829.70

164196 $ 3,580.30 $ 3,580.30 $ 7,160.60

164202 $ 736.64 $ 736.64 $ 1,473.28

164212 $ 387.34 $ 387.34 $ 774.68

164245 $ 637.14 $ 637.14 $ 1,274.29

164255 $ 484.72 $ 484.72 $ 969.43

164259 $ 1,262.68 $ 1,262.68 $ 2,525.35

164275 $ 304.19 $ 304.19 $ 608.38

164298 $ 3,555.88 $ 3,555.88 $ 7,111.75

164301 $ 477.08 $ 477.08 $ 954.16

164385 $ 4,164.56 $ 4,164.56 $ 8,329.13

164390 $ 635.66 $ 635.66 $ 1,271.31

164415 $ 21,434.26 $ 21,434.26 $ 42,868.52

164425 $ 5,723.09 $ 5,723.09 $ 11,446.18

164452 $ 228.33 $ 228.33 $ 456.66

164477 $ 473.88 $ 473.88 $ 947.76

164502 $ 230.56 $ 230.56 $ 461.12

164535 $ 226.84 $ 226.84 $ 453.69

164564 $ 304.94 $ 304.94 $ 609.87

2 of 8

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 28 of 37 PageID #:329
Kenneth Beatty, et al. v. Capital One Financial Corporation, et al.

Exhibit D

Emplid Owed Wages Liquidated 

Damages

Settlement 

Payment

164576 $ 483.44 $ 483.44 $ 966.87

164602 $ 12,538.52 $ 12,538.52 $ 25,077.04

164603 $ 13,469.41 $ 13,469.41 $ 26,938.83

164604 $ 4,655.70 $ 4,655.70 $ 9,311.39

164610 $ 436.45 $ 436.45 $ 872.90

164631 $ 304.19 $ 304.19 $ 608.38

164665 $ 1,179.20 $ 1,179.20 $ 2,358.40

164698 $ 5,269.85 $ 5,269.85 $ 10,539.70

164736 $ 9,946.98 $ 9,946.98 $ 19,893.96

164740 $ 2,779.03 $ 2,779.03 $ 5,558.07

164787 $ 2,565.86 $ 2,565.86 $ 5,131.71

164890 $ 7,931.10 $ 7,931.10 $ 15,862.20

166362 $ 5,984.56 $ 5,984.56 $ 11,969.12

166437 $ 3,244.21 $ 3,244.21 $ 6,488.41

166570 $ 2,800.74 $ 2,800.74 $ 5,601.48

168283 $ 9,752.58 $ 9,752.58 $ 19,505.17

168298 $ 540.46 $ 540.46 $ 1,080.91

168905 $ 4,049.75 $ 4,049.75 $ 8,099.49

169581 $ 345.59 $ 345.59 $ 691.19

170104 $ 1,409.34 $ 1,409.34 $ 2,818.68

170566 $ 3,378.92 $ 3,378.92 $ 6,757.83

172065 $ 107.09 $ 107.09 $ 214.17

172640 $ 15,883.91 $ 15,883.91 $ 31,767.82

173894 $ 108.84 $ 108.84 $ 217.69

174072 $ 218.30 $ 218.30 $ 436.61

174515 $ 596.10 $ 596.10 $ 1,192.19

174770 $ 2,837.22 $ 2,837.22 $ 5,674.45

175394 $ 3,666.05 $ 3,666.05 $ 7,332.09

176143 $ 3,560.07 $ 3,560.07 $ 7,120.14

176479 $ 1,447.83 $ 1,447.83 $ 2,895.65

176551 $ 3,560.07 $ 3,560.07 $ 7,120.14

177367 $ 2,779.03 $ 2,779.03 $ 5,558.07

178043 $ 183.75 $ 183.75 $ 367.50

178349 $ 1,810.25 $ 1,810.25 $ 3,620.49

178726 $ 506.02 $ 506.02 $ 1,012.05

178860 $ 5,036.65 $ 5,036.65 $ 10,073.31

179644 $ 531.18 $ 531.18 $ 1,062.36

180182 $ 4,294.68 $ 4,294.68 $ 8,589.36

180510 $ 1,486.90 $ 1,486.90 $ 2,973.79

180521 $ 1,191.28 $ 1,191.28 $ 2,382.57

180590 $ 2,779.03 $ 2,779.03 $ 5,558.07

181722 $ 483.44 $ 483.44 $ 966.87

181941 $ 3,560.07 $ 3,560.07 $ 7,120.14

182061 $ 5,751.71 $ 5,751.71 $ 11,503.42

182081 $ 401.15 $ 401.15 $ 802.29

182484 $ 2,086.53 $ 2,086.53 $ 4,173.06

182872 $ 1,612.08 $ 1,612.08 $ 3,224.16

184294 $ 3,356.92 $ 3,356.92 $ 6,713.84

185769 $ 1,033.68 $ 1,033.68 $ 2,067.37

185771 $ 1,407.99 $ 1,407.99 $ 2,815.97

3 of 8

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 29 of 37 PageID #:330
Kenneth Beatty, et al. v. Capital One Financial Corporation, et al.

Exhibit D

Emplid Owed Wages Liquidated 

Damages

Settlement 

Payment

191735 $ 669.46 $ 669.46 $ 1,338.92

193663 $ 1,269.77 $ 1,269.77 $ 2,539.55

194963 $ 2,861.39 $ 2,861.39 $ 5,722.78

200787 $ 1,061.08 $ 1,061.08 $ 2,122.16

200842 $ 1,346.63 $ 1,346.63 $ 2,693.26

201346 $ 1,395.23 $ 1,395.23 $ 2,790.45

201539 $ 397.48 $ 397.48 $ 794.96

201543 $ 2,819.42 $ 2,819.42 $ 5,638.84

201752 $ 54.21 $ 54.21 $ 108.42

201871 $ 2,588.24 $ 2,588.24 $ 5,176.48

202595 $ 17,208.06 $ 17,208.06 $ 34,416.11

202690 $ 676.32 $ 676.32 $ 1,352.63

202909 $ 2,233.83 $ 2,233.83 $ 4,467.65

202922 $ 2,445.42 $ 2,445.42 $ 4,890.85

202988 $ 4,434.17 $ 4,434.17 $ 8,868.33

203021 $ 4,384.21 $ 4,384.21 $ 8,768.42

203332 $ 8,430.78 $ 8,430.78 $ 16,861.56

203420 $ 5,041.99 $ 5,041.99 $ 10,083.98

203432 $ 476.64 $ 476.64 $ 953.29

203641 $ 1,806.47 $ 1,806.47 $ 3,612.93

204691 $ 290.06 $ 290.06 $ 580.12

206563 $ 547.79 $ 547.79 $ 1,095.57

206835 $ 3,980.99 $ 3,980.99 $ 7,961.98

208033 $ 16,876.05 $ 16,876.05 $ 33,752.10

208586 $ 7,258.42 $ 7,258.42 $ 14,516.83

208808 $ 6,076.50 $ 6,076.50 $ 12,153.01

217061 $ 2,078.77 $ 2,078.77 $ 4,157.54

218638 $ 1,917.58 $ 1,917.58 $ 3,835.16

221375 $ 228.33 $ 228.33 $ 456.66

221379 $ 771.18 $ 771.18 $ 1,542.37

221581 $ 228.33 $ 228.33 $ 456.66

221604 $ 441.29 $ 441.29 $ 882.58

222845 $ 345.59 $ 345.59 $ 691.19

223239 $ 599.46 $ 599.46 $ 1,198.92

223507 $ 960.08 $ 960.08 $ 1,920.16

223527 $ 3,222.47 $ 3,222.47 $ 6,444.94

223531 $ 4,204.35 $ 4,204.35 $ 8,408.69

223649 $ 12,054.86 $ 12,054.86 $ 24,109.72

223658 $ 1,273.31 $ 1,273.31 $ 2,546.61

224032 $ 18,577.37 $ 18,577.37 $ 37,154.75

224033 $ 2,878.63 $ 2,878.63 $ 5,757.27

224036 $ 6,485.32 $ 6,485.32 $ 12,970.64

224039 $ 1,000.34 $ 1,000.34 $ 2,000.68

224040 $ 7,017.28 $ 7,017.28 $ 14,034.56

224047 $ 14,617.19 $ 14,617.19 $ 29,234.39

224142 $ 3,614.38 $ 3,614.38 $ 7,228.75

224266 $ 4,271.57 $ 4,271.57 $ 8,543.15

224502 $ 228.33 $ 228.33 $ 456.66

224503 $ 2,779.03 $ 2,779.03 $ 5,558.07

224505 $ 2,324.01 $ 2,324.01 $ 4,648.01

4 of 8

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 30 of 37 PageID #:331
Kenneth Beatty, et al. v. Capital One Financial Corporation, et al.

Exhibit D

Emplid Owed Wages Liquidated 

Damages

Settlement 

Payment

224507 $ 2,726.54 $ 2,726.54 $ 5,453.07

224509 $ 1,624.83 $ 1,624.83 $ 3,249.66

224624 $ 2,779.03 $ 2,779.03 $ 5,558.07

224690 $ 2,283.90 $ 2,283.90 $ 4,567.80

224791 $ 1,528.40 $ 1,528.40 $ 3,056.80

224798 $ 1,134.21 $ 1,134.21 $ 2,268.43

224893 $ 5,307.30 $ 5,307.30 $ 10,614.61

225230 $ 566.42 $ 566.42 $ 1,132.83

225390 $ 1,509.81 $ 1,509.81 $ 3,019.61

225391 $ 4,028.02 $ 4,028.02 $ 8,056.05

225394 $ 4,074.77 $ 4,074.77 $ 8,149.53

225933 $ 4,174.72 $ 4,174.72 $ 8,349.43

226022 $ 4,589.11 $ 4,589.11 $ 9,178.23

226111 $ 2,670.70 $ 2,670.70 $ 5,341.40

226118 $ 2,636.27 $ 2,636.27 $ 5,272.54

226174 $ 3,857.72 $ 3,857.72 $ 7,715.43

226470 $ 2,695.29 $ 2,695.29 $ 5,390.58

226881 $ 1,982.26 $ 1,982.26 $ 3,964.52

227076 $ 1,475.55 $ 1,475.55 $ 2,951.09

227589 $ 2,969.38 $ 2,969.38 $ 5,938.76

228891 $ 2,779.03 $ 2,779.03 $ 5,558.07

239726 $ 1,024.64 $ 1,024.64 $ 2,049.27

241707 $ 483.27 $ 483.27 $ 966.54

242765 $ 797.96 $ 797.96 $ 1,595.92

243275 $ 3,916.26 $ 3,916.26 $ 7,832.52

244210 $ 1,981.71 $ 1,981.71 $ 3,963.42

244793 $ 801.13 $ 801.13 $ 1,602.25

248254 $ 1,361.06 $ 1,361.06 $ 2,722.11

249329 $ 4,006.22 $ 4,006.22 $ 8,012.43

250188 $ 16,490.14 $ 16,490.14 $ 32,980.27

251463 $ 1,230.74 $ 1,230.74 $ 2,461.48

254953 $ 13,502.84 $ 13,502.84 $ 27,005.69

255947 $ 189.66 $ 189.66 $ 379.31

256095 $ 12,906.92 $ 12,906.92 $ 25,813.83

257372 $ 386.12 $ 386.12 $ 772.23

257732 $ 3,059.53 $ 3,059.53 $ 6,119.06

282026 $ 31.74 $ 31.74 $ 63.47

282985 $ 3,284.73 $ 3,284.73 $ 6,569.47

287200 $ 500.79 $ 500.79 $ 1,001.58

287539 $ 3,679.49 $ 3,679.49 $ 7,358.98

287996 $ 3,097.99 $ 3,097.99 $ 6,195.99

288670 $ 661.98 $ 661.98 $ 1,323.95

289694 $ 2,330.26 $ 2,330.26 $ 4,660.51

294959 $ 2,160.75 $ 2,160.75 $ 4,321.49

295121 $ 1,004.50 $ 1,004.50 $ 2,009.01

304317 $ 1,980.03 $ 1,980.03 $ 3,960.07

313351 $ 3,244.33 $ 3,244.33 $ 6,488.66

315709 $ 3,347.13 $ 3,347.13 $ 6,694.26

315876 $ 2,681.58 $ 2,681.58 $ 5,363.16

316503 $ 2,453.31 $ 2,453.31 $ 4,906.63

5 of 8

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 31 of 37 PageID #:332
Kenneth Beatty, et al. v. Capital One Financial Corporation, et al.

Exhibit D

Emplid Owed Wages Liquidated 

Damages

Settlement 

Payment

317565 $ 2,902.84 $ 2,902.84 $ 5,805.69

319327 $ 3,335.49 $ 3,335.49 $ 6,670.97

321847 $ 1,563.49 $ 1,563.49 $ 3,126.97

321957 $ 2,249.48 $ 2,249.48 $ 4,498.96

322236 $ 958.16 $ 958.16 $ 1,916.32

322309 $ 2,970.88 $ 2,970.88 $ 5,941.76

322427 $ 2,611.91 $ 2,611.91 $ 5,223.83

324543 $ 2,960.36 $ 2,960.36 $ 5,920.73

326637 $ 3,449.53 $ 3,449.53 $ 6,899.07

327764 $ 3,225.24 $ 3,225.24 $ 6,450.48

329414 $ 2,409.93 $ 2,409.93 $ 4,819.86

330486 $ 2,976.11 $ 2,976.11 $ 5,952.22

331591 $ 1,434.94 $ 1,434.94 $ 2,869.87

331828 $ 5,540.30 $ 5,540.30 $ 11,080.61

331935 $ 2,571.02 $ 2,571.02 $ 5,142.04

331984 $ 1,482.78 $ 1,482.78 $ 2,965.57

332021 $ 1,869.73 $ 1,869.73 $ 3,739.46

332027 $ 1,738.39 $ 1,738.39 $ 3,476.77

332251 $ 1,454.23 $ 1,454.23 $ 2,908.45

332446 $ 1,351.82 $ 1,351.82 $ 2,703.63

332625 $ 2,300.63 $ 2,300.63 $ 4,601.26

333368 $ 1,563.91 $ 1,563.91 $ 3,127.82

338748 $ 2,328.30 $ 2,328.30 $ 4,656.59

340602 $ 145.44 $ 145.44 $ 290.89

344589 $ 645.46 $ 645.46 $ 1,290.92

346774 $ 992.80 $ 992.80 $ 1,985.60

346775 $ 1,107.03 $ 1,107.03 $ 2,214.05

346899 $ 1,112.07 $ 1,112.07 $ 2,224.14

347038 $ 1,195.10 $ 1,195.10 $ 2,390.20

350236 $ 2,482.11 $ 2,482.11 $ 4,964.21

350494 $ 517.15 $ 517.15 $ 1,034.30

350786 $ 615.66 $ 615.66 $ 1,231.31

352747 $ 391.71 $ 391.71 $ 783.41

352751 $ 4,012.21 $ 4,012.21 $ 8,024.41

353565 $ 1,034.44 $ 1,034.44 $ 2,068.88

353570 $ 664.22 $ 664.22 $ 1,328.43

353873 $ 1,698.95 $ 1,698.95 $ 3,397.90

356745 $ 1,380.15 $ 1,380.15 $ 2,760.31

357468 $ 356.23 $ 356.23 $ 712.45

358095 $ 1,619.51 $ 1,619.51 $ 3,239.03

358637 $ 493.35 $ 493.35 $ 986.70

359304 $ 18.59 $ 18.59 $ 37.19

361997 $ 263.98 $ 263.98 $ 527.96

362008 $ 1,314.79 $ 1,314.79 $ 2,629.59

364005 $ 1,206.49 $ 1,206.49 $ 2,412.98

364147 $ 1,184.80 $ 1,184.80 $ 2,369.61

365919 $ 1,273.03 $ 1,273.03 $ 2,546.07

366656 $ 1,296.88 $ 1,296.88 $ 2,593.76

366945 $ 1,049.26 $ 1,049.26 $ 2,098.51

366946 $ 1,367.40 $ 1,367.40 $ 2,734.80

6 of 8

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 32 of 37 PageID #:333
Kenneth Beatty, et al. v. Capital One Financial Corporation, et al.

Exhibit D

Emplid Owed Wages Liquidated 

Damages

Settlement 

Payment

367207 $ 1,024.34 $ 1,024.34 $ 2,048.69

367378 $ 76.55 $ 76.55 $ 153.11

367720 $ 1,122.01 $ 1,122.01 $ 2,244.02

368182 $ 1,098.24 $ 1,098.24 $ 2,196.49

368299 $ 1,038.33 $ 1,038.33 $ 2,076.66

368836 $ 953.18 $ 953.18 $ 1,906.36

370872 $ 114.04 $ 114.04 $ 228.08

372142 $ 830.52 $ 830.52 $ 1,661.03

375188 $ 4,150.15 $ 4,150.15 $ 8,300.30

375501 $ 756.31 $ 756.31 $ 1,512.62

375676 $ 756.31 $ 756.31 $ 1,512.62

376489 $ 674.33 $ 674.33 $ 1,348.66

377168 $ 700.77 $ 700.77 $ 1,401.55

377248 $ 868.45 $ 868.45 $ 1,736.90

377621 $ 682.26 $ 682.26 $ 1,364.53

377623 $ 596.98 $ 596.98 $ 1,193.96

377874 $ 639.62 $ 639.62 $ 1,279.24

378693 $ 774.49 $ 774.49 $ 1,548.98

379293 $ 633.56 $ 633.56 $ 1,267.12

381282 $ 483.44 $ 483.44 $ 966.87

381411 $ 571.53 $ 571.53 $ 1,143.06

381412 $ 78.51 $ 78.51 $ 157.01

381413 $ 537.15 $ 537.15 $ 1,074.30

381414 $ 537.15 $ 537.15 $ 1,074.30

381415 $ 617.72 $ 617.72 $ 1,235.45

381504 $ 3,076.90 $ 3,076.90 $ 6,153.80

381505 $ 2,076.80 $ 2,076.80 $ 4,153.60

381523 $ 537.15 $ 537.15 $ 1,074.30

381524 $ 483.44 $ 483.44 $ 966.87

381525 $ 515.66 $ 515.66 $ 1,031.33

381526 $ 617.72 $ 617.72 $ 1,235.45

381527 $ 1,097.98 $ 1,097.98 $ 2,195.96

381731 $ 483.44 $ 483.44 $ 966.87

381732 $ 479.30 $ 479.30 $ 958.61

381770 $ 483.44 $ 483.44 $ 966.87

382052 $ 483.44 $ 483.44 $ 966.87

382053 $ 483.44 $ 483.44 $ 966.87

382506 $ 483.44 $ 483.44 $ 966.87

383672 $ 2,765.35 $ 2,765.35 $ 5,530.71

384109 $ 473.82 $ 473.82 $ 947.64

384608 $ 478.42 $ 478.42 $ 956.84

384609 $ 423.22 $ 423.22 $ 846.44

384610 $ 478.42 $ 478.42 $ 956.84

384611 $ 415.12 $ 415.12 $ 830.24

384722 $ 414.02 $ 414.02 $ 828.04

384723 $ 2,677.60 $ 2,677.60 $ 5,355.21

386168 $ 420.46 $ 420.46 $ 840.93

386561 $ 2,428.24 $ 2,428.24 $ 4,856.47

386851 $ 382.89 $ 382.89 $ 765.78

386852 $ 344.60 $ 344.60 $ 689.21

7 of 8

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 33 of 37 PageID #:334
Kenneth Beatty, et al. v. Capital One Financial Corporation, et al.

Exhibit D

Emplid Owed Wages Liquidated 

Damages

Settlement 

Payment

387354 $ 344.60 $ 344.60 $ 689.21

388837 $ 336.06 $ 336.06 $ 672.13

388985 $ 2,415.21 $ 2,415.21 $ 4,830.42

391552 $ 266.65 $ 266.65 $ 533.29

394092 $ 156.35 $ 156.35 $ 312.70

396306 $ 93.66 $ 93.66 $ 187.31

396595 $ 84.29 $ 84.29 $ 168.58

398875 $ 1,333.30 $ 1,333.30 $ 2,666.60

404103 $ 839.46 $ 839.46 $ 1,678.93

404112 $ 909.42 $ 909.42 $ 1,818.84

405874 $ 718.82 $ 718.82 $ 1,437.64

413318 $ 490.87 $ 490.87 $ 981.75

8 of 8

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 34 of 37 PageID #:335
EXHIBIT 2

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 35 of 37 PageID #:336
IN THE UNITED STATES DISTRICT COURT

FOR THE NORTHERN DISTRICT OF ILLINOIS

EASTERN DIVISION

KENNETH BEATTY and DONNET 

JAMES, on behalf of themselves and all 

others similarly situated, 

Plaintiffs,

v.

CAPITAL ONE FINANCIAL 

CORPORATION, et al.

 Defendants.

)

)

)

)

)

)

)

)

)

)

)

)

No. 12-cv-434

Magistrate Judge Mason

[proposed] FINAL JUDGMENT AND ORDER APPROVING SETTLEMENT 

AND DISMISSING ACTION 

After having fully and carefully reviewed Plaintiffs’ Unopposed Motion for Settlement 

Approval and the Parties’ Settlement Agreement (Dkt. Entry #70-1), the Court hereby ENTERS 

FINAL JUDGMENT and ORDERS that:

1. The Settlement Agreement is APPROVED as a fair, equitable, and reasonable 

resolution of a bona fide dispute in this contested litigation, and is incorporated herein by this 

reference and made a part hereof as though set forth in full. 

2. The formula for allocation of settlement payments set forth in the Settlement 

Agreement is APPROVED as a fair, equitable, and reasonable measure for distributing the 

settlement payment to Class Members;

3. All individuals who have filed consents to join this action as party plaintiffs are 

hereby deemed to fully and unconditionally waive and release any and all Released Claims (as 

that term is defined in the Settlement Agreement) against any and all Released Parties (as that 

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 36 of 37 PageID #:337
term is defined in the Settlement Agreement), as more fully set forth in the Settlement 

Agreement. 

4. The attorneys’ fees representing One-Third (1/3) of the settlement fund, costs, and 

the service payments as set forth in the Settlement Agreement, are APPROVED; and Defendants 

are hereby ORDERED to make payments in accordance with and subject to the terms of the 

Settlement Agreement. 

Accordingly, this Court enters JUDGMENT in accordance with this Order and in 

accordance with the terms of the Settlement Agreement. This case is DISMISSED WITHOUT

PREJUDICE which shall convert to a dismissal with prejudice ninety (90) days after the Notice 

Period expires.

SO ORDERED this _________ day of ____________, 2012

____________________________

Magistrate Judge Mason

Case: 1:12-cv-00434 Document #: 70-1 Filed: 11/19/12 Page 37 of 37 PageID #:338