Ride Share | Lawsuit

First Name

Last Name

Email Address

Phone Number

Zip Code

Were you Physically Assaulted (sexual in nature) while in a Rideshare?

Yes

Which Rideshare Service?

Uber

Lift

Upload gov.id proof (.png, .jpg, .pdf)

Upload gov.id proof (.png, .jpg, .pdf)PNG, JPEG, JPG, PDF (Max 2MB)

Upload receipt of ride. (.png, .jpg, .pdf)

Upload receipt of ride. (.png, .jpg, .pdf)PNG, JPEG, JPG, PDF (Max 2MB)

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