Exclusion Form

Excluding Yourself From The Settlement

To exclude yourself from the class, the Settlement, and you want to keep your right, if any, to sue Ohio National on your own about the claims in this lawsuit. You can submit a request for exclusion to the Settlement Administrator electronically (through the Settlement Website) or by postal mail. Please ensure that your Exclusion includes the following criteria:

●    The case name and number: Veritas Independent Partners, LLC v. The Ohio National Life Insurance Company, et al., S.D. Ohio Case No. 1:18-cv-769;
●    Your full name and the unique identification number assigned by the Settlement Administrator;
●    Your address, telephone number, and email address (optional);
●    A statement that you would like to “opt out”, or be excluded from the Settlement; and
●    Your handwritten signature in ink or signature submitted through the exclusion request portal on the Settlement Website and the date of your signature. Electronic signatures (including DocuSign signatures) will not be considered a personal signature and will be deemed invalid, except those submitted through the exclusion request portal on the Settlement Website. You must personally sign and date your Request for Exclusion; your lawyer (if applicable) may not sign on your behalf. 

Your Request for Exclusion must either be submitted electronically via the exclusion request portal on the Settlement Website no later than June 29, 2026, or be postmarked no later than June 29, 2026, and sent via First-Class U.S. Mail to:

Ohio National Settlement
ATTN: EXCLUSIONS
P.O. Box 173001
Milwaukee, WI 53217
www.ONTrailssSettlement.com

To Submit an Exclusion; please click HERE.