If you are a UK-domiciled Publisher of online display ads, you may opt out of the collective proceedings.

First Name*

Last Name*

Company Name

Company Number

Address of business (or individual if not a business)*

Town*

Country*

Postal Code*

Telephone Number*

Email Address*

I believe that I am/my business is a member of the “Publisher” opt-out class in the collective proceedings before the UK’s Competition Appeal Tribunal: Ad Tech Collective Action LLP v (1) Alphabet Inc; (2) Google LLC; (3) Google Ireland limited; and (4) Google UK Limited (Claim Nos 1572/7/7/22 and 1582/7/7/23). I/my business wish/wishes to opt out from (i.e., be excluded from) these proceedings.

I understand that if I opt out/my business opts out of this claim and the claim subsequently results in a damages award or settlement, I/my business will not be entitled to any compensation.

I confirm that the information provided above is true and correct to the best of my knowledge.

Signature*

If you are under 18 years of age you will need to get your parent/guardian to sign this form on your behalf.

Consent

I agree that my electronic signature on this form is the equivalent of my handwritten signature. I further agree that my electronic signature on this form is as valid as my handwritten signature. I hereby confirm that the electronic signature has been produced with my consent.

I confirm I am over the age of 18I am opting out on behalf of the named individual as their parent/guardian