Canadian Settlement Claim Form

IMPORTANT INFORMATION AND INSTRUCTIONS

1. Only the following group of persons are eligible to submit a Canadian Claim Form:

   Any individual who (i) was a customer of the Debtors at any time between May 1, 2023 through October 1, 2023 (the “Cyber Security Incident Period”); (ii) resided in Canada during the Cyber Security Incident Period; and (iii) received a notice from 23andMe notifying the customer that their personal information was compromised in the Cyber Security Incident;

   (“Canadian Data Breach Class” or “Canadian Data Breach Class Members”).

2. In order to be eligible for compensation, any Canadian Data Breach Class Member must complete and submit the Canadian Settlement Claim Form, and provide supporting documentation if a claim is made with respect to Eligible Extraordinary Claims, by no later than 11:59 pm Pacific Time on June 25, 2026 (“Canadian Eligible Claimants”).

3. Canadian Eligible Claimants may submit the Canadian Settlement Claim Form in order to apply for compensation in relation to two types of claims:

   1. Eligible Extraordinary Claims:

      Each Canadian Eligible Claimant may make a claim for reimbursement of up to CAD$2,500 in relation to documented, unreimbursed, out-of-pocket expenses incurred between October 1, 2023 and March 31, 2024 as a direct result of the Cyber Security Incident for:

      1. unreimbursed costs associated with the purchase of a physical security or monitoring system;
      2. unreimbursed costs associated with seeking professional mental health counseling or treatment; and/or
      3. any other documented, unreimbursed, out-of-pocket expense that the Canadian Eligible Claimant establishes was incurred as a direct result of, and in response to, the Cyber Security Incident.

      In order to be an Eligible Extraordinary Claim, the Canadian Eligible Claimant must provide documentation proving that the expenses were incurred, and that they were incurred during the period from October 1, 2023 to and including March 31, 2024.

   2. Eligible Ordinary Claims: Each Canadian Eligible Claimant may make a claim for compensation other than the Eligible Extraordinary Claims without the need to provide further information or documentation. Each Canadian Eligible Claimant who completes and submits a valid Canadian Claim Form will be automatically considered for receiving compensation.
4. All payments will be issued in Canadian currency.