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�TAl��D I SH <br />LEGAL PROCESSING <br />* COURT APPOINTED NOTICE ADMINISTRATOR * <br />DIRECTIONS <br />Part A: Fill in the contact information <br />Part B: Attach only ONE of the following: <br />1. Copy of tax bill or tax exempt status stating property address <br />2. Copy of insurance declaration stating property address <br />3. Copy of deed to building stating property address <br />Part C: Pursuant to the court-ordereddiscovery, we have a database of <br />buildings where proof of phenolic has been conf'irmed. An exhibit of <br />proof which states that the building at 1200 Woodhill Drive contains <br />Beazer Phenolic Foam Roof Insulation {Koppers Exelfherm, Rx, <br />APRB� or Extra) is on file. In some instances an exhibit of "Proof of <br />Metal Deck" is required and may be attached for your completion. <br />Part D: Please estimate the approximate square footage of the roof. <br />Part E: The attached exhibit will also serve as the proof of installation date. <br />Part H: An appropriate person needs to sign and date the claim form (It does <br />not have to be signed by the largest shareholder, Board Chairman, etc. <br />etc. ... just an appropriate person authorized to do so.) <br />NOTICE: Send aEL Claim forms to the following Address: <br />Standish Legal Processing <br />* Court Appointed Notice Administrator * <br />Beazer Phenolic Foam Settlement <br />999 Broadway, Suite 500 <br />Saugus, MA 01906 <br />Arr�v: Ben Rotker <br />FAX A COPY TO 781-231-5261 <br />