NYFS Uber class action application form

NYFS – Authority to Act, Exclusivity, Funding & Consent Form

1. Authority to Act: I appoint NYFS and its appointed due and sole representatives to act for me in all matters relating to my employment status and minimum entitlement claims against Uber in New Zealand. This includes assessing my claim, obtaining information from Uber, preparing and filing proceedings, negotiating settlement, and taking all strategic or procedural steps necessary to advance the claim.

2. Exclusivity of Representation: I appoint NYFS as my exclusive representative for all claims relating to my work with Uber, including employment status, minimum wage, holiday pay, public holiday pay, unlawful deductions, reimbursements and related legal entitlements. I will not engage any other lawyer, union, advocate, or claims organisation for these matters while this agreement is in place.

3. Withdrawal and Continuing Fee Obligation: If I withdraw from the NYFS group claim at any time, or if I engage another representative for the same or related claim against Uber, I acknowledge and agree that:

• NYFS remains entitled to be paid the full fees, costs or success-based charges that would have been payable had NYFS continued to act for me;

• These fees become immediately payable in full upon withdrawal, without set-off or deduction;

• NYFS may enforce this obligation as a contractual debt;

• Withdrawal does not affect NYFS’s right to rely on any data, documents or work it has completed up to the date of withdrawal.

4. Funding and Fees: I agree to participate under NYFS’s funding model, which may include a success fee, NYFS membership fee or disbursements. I authorise NYFS to deduct all agreed fees and costs from any settlement or award. I understand no outcome is guaranteed.

Success fee: 20% of awarded employee entitlements.

Membership fee: $0.

Disbursements: As incurred by NYFS and it's representatives. These are pooled and weighted across the successful employee entitlements.

NYFS will not be responsible for any inability of payment due to Employer entering into liquidation, or administration or other form of dissolution. In such case, the agreement between you and NYFS will be terminated with no right of claim by you against NYFS.

5. Privacy and Data Consent: I consent to NYFS collecting, using, storing and sharing my personal information—including Uber account data, identity documents, trip and log-in records, earnings, bank records, and work-related expenses—for the purposes of assessing and advancing my claim. I authorise NYFS to obtain this information directly from Uber or third parties. My information may be shared only with NYFS’s legal advisers, experts and funders for the purposes of pursuing the claim.

6. Declaration and Acknowledgement: I confirm all information I provide is true and complete. I understand that any estimates provided by NYFS, including online calculators, are indicative only and not legal advice. I acknowledge that NYFS may use aggregated, anonymised data for reporting and strategic purposes.

7. Full and correct disclosure: You must provide NYFS, and it's representatives, full and correct disclosure to the best of your knowledge.

NYFS – Authority Request Information From Uber (Privacy Act Authority )

I authorise NYFS (Not Your Fault Services Limited) and its appointed representatives to request, receive and use all information held about me by Uber and Rasier New Zealand Limited (together “Uber”), including but not limited to:

• Trip history

• Log-in and log-off times

• Ratings, cancellations and account activity

• Payment records, earnings, deductions and fees

• Any account notes, correspondence or decisions relating to my driver account

• Any other personal information relevant to my work as an Uber driver

This authority is given for the purpose of:

1. Assessing and advancing my employment and minimum entitlement claims against Uber;

2. Enabling NYFS to obtain accurate information needed for my legal claim; and

3. Allowing NYFS to communicate with Uber on my behalf.

Legal Basis

This authority is provided under:

• Privacy Act 2020, including Information Privacy Principle 6 (access to personal information) and Principle 11 (authorised disclosure);

• Any other laws permit me to authorise a representative to obtain my personal information.

I confirm that NYFS is my authorised representative for this purpose, and Uber is permitted to release my information directly to NYFS without further confirmation from me.

Duration

This authority remains valid:

• until my claim is fully resolved, or

• until I revoke it in writing.

Revocation does not affect Uber’s obligation to release information already requested while this authority was in force.

Declaration

I confirm that the above details are true and correct, and I am the person linked to the Uber driver account described above.