Voting Procedures
VOTING INFORMATION AND INSTRUCTIONS FOR COMPLETING THE CLASS 4 BALLOT
Please follow these instructions to complete your Class 4 Ballot:
1. Read the Plan, the Disclosure Statement, Voting Procedures, and these instructions.
You may need to consult your attorney. If you have questions regarding the Class 4 Ballot, or if you did not receive a copy of the Plan, Disclosure Statement, or Voting Procedures, or if you need additional copies of the Class 4 Ballot or other enclosed materials, please contact the Balloting Agent. The Balloting Agent cannot give legal advice. You should consult your attorney regarding all legal matters. Please note that the Plan, Disclosure Statement, and Voting Procedures are available at the website maintained by the Balloting Agent at [___________].
2. (Item 1) Identifying Information.
Please fill in the identification and address information requested. List the name of the Injured Party and the last 4 digits of the Injured Party’s Social Security Number. If the Injured Party is the Holder of the Class 4 Claim, please list the Injured Party’s street address, city, state, Zip Code, and telephone number.
If the Injured Party is deceased, please list in addition to the Injured Party’s name and last 4 digits of the Injured Party’s Social Security number, the Claimant’s name and the Claimant’s street address, city, state, Zip Code, and telephone number.
If this Ballot is being voted by an authorized agent for the Injured Party or Claimant, as applicable, any such authorized agent must provide his/her address and contact information, in addition to the information requested above.
3. (Item 2) Designation of Disease Category and Amount of Class 4 Current GST Asbestos Claim for Voting Purposes Only.
Please indicate the disease category that is the basis for the Class 4 Claim by marking an
“X” in the box that corresponds to the Injured Party’s diagnosis. Pursuant to the Plan and Confirmation Procedures, Current GST Asbestos Claims will be temporarily allowed for voting purposes only. The Debtors reserve the right to object to any Class 4 Claim, and temporary allowance of any Class 4 Claim for voting purposes does not in any way constitute an admission of liability by the Debtors, or an admission of the value of any Class 4 Claim.
4. (Item 3) Vote.
Please indicate whether the Holder of the Class 4 Claim votes to ACCEPT or to REJECT the Plan by marking an “X” in the box that corresponds to the Holder’s choice.
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If this Ballot is being voted by an authorized agent of the Holder of the Class 4 GST Asbestos Claim, such authorized agent must sign and date the Certification of Authorized Agent Voting Authority, which certification is made under penalty of perjury.
5. (Item 4) Certifications.
Item 4 requires the Injured Party, the Claimant, or an authorized agent, as applicable, to certify under penalty of perjury to the following:
a. Medical Diagnosis.
In order for the Ballot to be tabulated, the Holder must certify that the Injured Party was diagnosed with the asbestos-related disease identified in Item 2. PLEASE DO NOT SUBMIT MEDICAL RECORDS WITH THIS BALLOT. MEDICAL RECORDS CANNOT BE RETURNED BY THE BALLOTING AGENT. FURTHER, THE BALLOTING AGENT WILL MAKE THIS BALLOT AND ANY SUPPORTING DOCUMENTS AVAILABLE TO ALL PARTIES IN INTEREST IN THE BANKRUPTCY CASE, AS WELL AS TO THE PUBLIC AT LARGE.
b. GST Product Contact.
In order for the Ballot to be tabulated, the Holder must certify that the Injured Party had exposure to asbestos from a Garlock product that such Holder contends contributed to causing the Injured Party’s asbestos-related disease. In addition, the Holder must submit one of the following documents demonstrating such exposure:
(i) an affidavit or other sworn statement on personal knowledge of the Injured Party;
(ii) an affidavit or other sworn statement on personal knowledge of the Injured Party’s co-worker or other competent witness; or
(iii) deposition or trial testimony by the Injured Party or other competent witness with personal knowledge of the Injured Party’s exposure to asbestos from a Garlock product.
Documents submitted to demonstrate the Injured Party’s exposure to asbestos from a Garlock product must provide, at a minimum:
(i) identification (by name, address or other description) of the residence(s), plant(s), or commercial building site(s), and the city and state where exposure to asbestos from a Garlock asbestos-containing product allegedly occurred;
(ii) identification of the Garlock asbestos-containing product with which the Injured Party had contact; and
(iii) the manner in which the Injured Party experienced exposure to asbestos from the Garlock asbestos-containing product.
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Testimony or sworn statements that Garlock asbestos-containing products were used at the plant, facility, or other worksite is not sufficient to identify exposure to asbestos from a Garlock asbestos-containing product unless the Injured Party or other witness affirms the Injured Party’s exposure to asbestos from a Garlock asbestos-containing product.
c. Causation.
Finally, the Holder must certify that the Injured Party’s exposure to asbestos from a Garlock asbestos-containing product contributed to causing his or her asbestos-related condition.
6. (Item 5) Evidence of GST Product Contact.
Please indicate which categories of documents have been submitted by marking an “X”
in each box that corresponds to the documents submitted.
7. Return the Ballot in the envelope provided. Do not fold the Ballot. The Ballot must be received by the Balloting Agent by the date specified in the instructions or it will not be counted. Facsimiles and electronic submissions will not be accepted.
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BALLOT FOR CLASS 4 CURRENT GST ASBESTOS CLAIMS