Step 1 of 8 - Address Update



IMPORTANT: In order to receive a Discretionary Award in this Settlement, you must complete and sign this Claim Form, and it must be received by the Claims Administrator by April 1, 2024. You may submit your claim form in one of three ways: (1) complete and submit this electronic claim form, (2) upload a completed claim form HERE; or (3) mail the claim form to the address below.

CFPB Claims Administrator
c/o Atticus Administration
PO Box 64053
Saint Paul, MN 55164


  • Please verify the accuracy of your Name and Address. If any of the information is incorrect or incomplete, provide the correct information below.
  • Provide as much detail as necessary to fully answer the questions below, including dates.
  • If you are guessing at names or spellings of names, please make that clear in your answer(s) and/or provide as much additional detail as possible to help identify the individual(s) (e.g., "my direct supervisor in 2014").
  • When identifying other individuals who worked at the Bureau, include their title and whether they worked in management. If you do not know their title, describe their relationship to you (e.g., "my supervisor," "my coworker," "my team lead," or "a manager").
  • If you are uncertain of dates of incidents described in your responses, please provide as much detail as possible to help identify the time period (e.g., "late fall 2015," "2014 between Christmas and New Year," "shortly after the 2016 Presidential election," etc.).
  • In order to receive an award for emotional distress, you must complete Section L regarding emotional distress. You may but are not required to submit additional documentation regarding your emotional distress, such as medical records.
  • If you wish for the Neutral to consider losses that you have suffered after your employment with the Bureau ended, you must list your post-CFPB employment history and earnings in Section N and provide evidence of these earnings (e.g., W-2 form, 1099 form, tax return, Social Security Wage Statement, etc.).
  • When completing this Claim Form, state which position you held during each incident you describe. You have been provided a work history listing details about each position you held while working at the Bureau from February 13, 2011 through December 31, 2022, which you can use to help fill out this Claim Form. You may also submit a statement or documentation with respect to any positions you held while working at the Bureau from January 1, 2023 through September 15, 2023. Some of the questions refer to “covered positions” and “non-covered positions.” You can use the work history to determine if a position you held between February 13, 2011 and December 31, 2022, is covered or non-covered, and positions you held from January 1, 2023 through September 15, 2023 may also be covered for purposes of the Discretionary Award. A covered position is a position that is non-supervisory, located in the Office of Consumer Response, in job series 301, and with a pay band of 40-60, except that the following positions are not covered positions: Consumer Response Implementation Manager (associated with position description number 110090), Consumer Response Manager (Quality Control) (associated with position description number 111410), Policy Analyst (associated with position description number 110210), or Consumer Response Analyst (associated with position description number 110770). A non-covered position is a position that does not meet the above criteria.
  • You must sign the Claim Form under penalty of perjury and the Claims Administrator must receive it by April 1, 2024.

The Jones et al. v. Chopra et al. lawsuit alleged that the Consumer Financial Protection Bureau ("CFPB" or the "Bureau") engaged in systemic discrimination against Black/African American and Hispanic employees who worked in certain positions in the Office of Consumer Response. In the lawsuit, Plaintiffs challenged several CFPB policies and practices as discriminatory against such Black/African American and Hispanic employees, including those relating to compensation and movement within the Bureau. Plaintiffs also alleged the Bureau retaliated against employees who complained of racial discrimination or engaged in other protected equal employment opportunity ("EEO") activity. The Bureau denied these allegations. Instead of continuing to litigate this case, the parties settled this lawsuit.

This Claim Form is intended to assist you in providing information about how, if at all, you believe you were subjected to discrimination, a hostile work environment, or harassment by the Bureau because you are Black/African American and/or Hispanic, or were retaliated against by the Bureau for protected EEO activity, and what losses and harm you suffered as a result. You may not have experienced some of the topics addressed below. You need only respond to questions that apply to you. If you believe you experienced discrimination because you are Black/African American and/or Hispanic and/or retaliation for protected EEO activity in ways not specifically addressed below, please include additional information in Section P, using additional pages if needed, in order to fully set forth your claim of discrimination on the basis of your Black/African American and/or Hispanic race and/or ethnicity and/or claim of retaliation for protected EEO activity.

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