Collateral Recovery Update

Your Name

Claimant Name

Email

Claim Number

Have you received any recoveries of your Madoff-related fraud losses other than payments from MVF? Have you received any recoveries of your Madoff-related fraud losses other than payments from MVF? No Yes

Please enter the total amount of all collateral recoveries (not including any payments from MVF).

Please list each amount, date, and source for all collateral recoveries (not including any payments from MVF).

By clicking the “I agree” box you are declaring under penalty of perjury under the laws of the United States of America (and the applicable laws of any other jurisdiction) on information and belief that the information contained herein, the statements made and the answers given are true and correct. By clicking the “I agree” box you are declaring under penalty of perjury under the laws of the United States of America (and the applicable laws of any other jurisdiction) on information and belief that the information contained herein, the statements made and the answers given are true and correct. I agree.