Class Questionnaire Download Page

These documents listed below can be downloaded. These documents may appear in your Explorer or Navigator windows. You can print them at that point or save them to disk for later printing. These documents will be in .doc format (Word 95 or later), .wpd  format (WordPerfect 6 or later), .wps  format (MS Works 6.0 or later), or .pdf (Acrobat Reader) format.  

If you received a class notice for the Cyncar v. Potter class action from the USPS dated August 1, 2007, and you believe that your serious/health condition (Health Impairment) can be qualified as a disability, and you were employed in the Western Area between January 1, 1998 and December 31, 2002, please complete this questionnaire and forward it, with supporting documents, as required, to the Class Attorneys of Record.  The Class Attorneys contact information can be found at this contact link.    These forms are required by the Class Attorneys to assist them in assessing your health situation and providing these forms to the EEOC, and USPS Counsel, during the discovery process and any future proceedings of the class action. 

Note:  If you did not receive the notice of class approval from the USPS, but you feel you fit the situations presented above, please follow the instructions stated above and forward the completed questionnaire, with supporting documents, as required, to Class Counsel at the address provided in the contact link above.