Ride Share - Lawsuit
First Name
First Name
Last Name
Last Name
Email
Email
Phone
Phone
Zip Code
Zip Code
Which Rideshare Service?
Uber
Lyft
Were you Physically Assaulted (sexual in nature) while in a Rideshare?
Yes
No
Upload gov.id proof (.png, .jpg, .pdf)
Upload gov.id proof
Upload receipt of ride. (.png, .jpg, .pdf)
Upload gov.id proof
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