secure.gaprefundsettlement.com Open in urlscan Pro
13.66.231.217  Public Scan

Form analysis
1 forms found in the DOM

POST /en/login

<form method="post" id="loginForm" action="/en/login" novalidate="novalidate">
  <input name="culture" type="hidden" value="en">
  <div class="row">
    <div class="col-sm-6 col-md-6 col-lg-4 col-xs-12 margin-top-15">
      <label class="control-label" for="ClaimDetails_UniqueId">Settlement Administration Claim&nbsp;Number</label>
      <input type="text" class="form-control" readonly="" value="DM6UTXCJ9F" data-val="true" data-val-regex="LocKey_Validation_UniqueId" data-val-regex-pattern="^[A-Za-z0-9]{5}-?[A-Za-z0-9]{5}$" data-val-required="LocKey_Validation_ThisIsRequired"
        id="ClaimDetails_UniqueId" name="ClaimDetails.UniqueId" aria-required="true">
      <span class="text-danger field-validation-valid" data-valmsg-for="ClaimDetails.UniqueId" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="row margin-top-20">
    <div class="col-sm-12">
      <p>Vehicle Information:</p>
    </div>
  </div>
  <div class="row">
    <div class="col-sm-4 col-xs-12">
      <label class="control-label" for="ClaimDetails_Vin">VIN (Last four digits)</label>
      <input type="text" name="displayvin" class="form-control" value="2766" maxlength="4" readonly="">
      <input type="hidden" class="form-control" value="2766" maxlength="4" readonly="" data-val="true" data-val-regex="Invalid Vin" data-val-regex-pattern="^([A-HJ-NPR-Z0-9]{4}|[A-HJ-NPR-Z0-9]{17})$" id="ClaimDetails_Vin" name="ClaimDetails.Vin">
      <span class="text-danger field-validation-valid" data-valmsg-for="ClaimDetails.Vin" data-valmsg-replace="true"></span>
    </div>
    <div class="col-sm-4 col-xs-12">
      <label class="control-label" for="ClaimDetails_Make">Make</label>
      <input type="text" class="form-control" value="NISSAN" readonly="" data-val="true" data-val-maxlength="This field can only contain 200 characters." data-val-maxlength-max="200" id="ClaimDetails_Make" name="ClaimDetails.Make">
      <span class="text-danger field-validation-valid" data-valmsg-for="ClaimDetails.Make" data-valmsg-replace="true"></span>
    </div>
    <div class="col-sm-4 col-xs-12">
      <label class="control-label" for="ClaimDetails_Model">Model</label>
      <input type="text" class="form-control" value="ALTIMA-4 CYL." readonly="" data-val="true" data-val-maxlength="This field can only contain 200 characters." data-val-maxlength-max="200" id="ClaimDetails_Model" name="ClaimDetails.Model">
      <span class="text-danger field-validation-valid" data-valmsg-for="ClaimDetails.Model" data-valmsg-replace="true"></span>
    </div>
  </div>
  <div class="row introduction margin-top-30">
    <div class="col-xs-12">
      <p>Click <a href="/en/claimforminfo">here</a> to complete your Claim Form online for the above referenced vehicle.</p>
      <p>OR</p>
      <p>Click <a href="/claimformupload?culture=en">here</a> to upload your completed Claim Form image for the above referenced vehicle.</p>
    </div>
  </div>
  <div class="row margin-top-10">
    <div class="col-xs-12">
      <p>Please Note: If you received multiple Claim Forms for different Vehicles, each Vehicle will require a separate claim filing.</p>
    </div>
  </div>
  <div class="row margin-top-20 margin-bottom-20">
    <div class="col-sm-12 margin-top-20 margin-bottom-20">
      <div class="col-sm-offset-4 col-sm-4 col-xs-12">
        <button type="button" class="btn-big-gray btn-block" style="border:none;" onclick="location.href = '/en/index'"> Back </button>
      </div>
    </div>
  </div>
  <input name="__RequestVerificationToken" type="hidden" value="CfDJ8DTWhQ56bJtDisSimGN-H5MviMa6jQSDGlUicr6Gi3pm8CF6DImuhzbD2-BIJbuhiZGK-Wu1zV9aZ_O__9URWQCdCXS3oDnGpSRU_2PXxHlB9MSochCRWQXhZ6I1T1L_9XkcJf3xS2gBQ7g7zZCa0J0">
</form>

Text Content

Herrera et al. v. Wells Fargo Bank, N.A. et al.
GAP Refund Settlement
Case No. 8:18-cv-00332-JVS-MRW
Please select one option...HomeKey DatesImportant DocumentsFAQFile a
ClaimContact Us
 * Home
 * Key Dates
 * Important Documents
 * FAQ
 * File a Claim
 * Contact Us

Settlement Administration Claim Number

Vehicle Information:

VIN (Last four digits)
Make
Model

Click here to complete your Claim Form online for the above referenced vehicle.

OR

Click here to upload your completed Claim Form image for the above referenced
vehicle.

Please Note: If you received multiple Claim Forms for different Vehicles, each
Vehicle will require a separate claim filing.

Back


FOR MORE INFORMATION

Visit this website often to get the most up-to-date information.

Call
1‑833‑636‑2118
Email
info@gaprefundsettlement.com
Mail

Herrera v. Wells Fargo
c/o JND Legal Administration
PO Box 91338
Seattle, WA 98111

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