PROOF OF CLAIM AND RELEASE FORM
1. The only way to receive a distribution from the Net Settlement Fund created in connection with the proposed Settlement of the action
entitled In re Dentsply Sirona, Inc. Securities Litigation., Case No. 1:18-cv-07253-NG-PK (the “Action”), is to complete, sign, and timely
submit this Proof of Claim and Release form (“Proof of Claim and Release Form”) as directed below. If you fail to submit a properly
addressed (as set forth in paragraph 3 below) Proof of Claim and Release Form, postmarked or received by the date shown below, your claim
may be rejected and you may be precluded from any recovery from the Net Settlement Fund created in connection with the proposed Settlement
of the Action.
2. Submission of this Proof of Claim and Release Form, however, does not ensure that you will share in the proceeds of the Settlement. You will only be entitled to receive a distribution from the Net Settlement Fund if: (i) you are an Authorized Claimant (as described in the Plan of Allocation, paragraphs 76-96 of the Notice of (I) Pendency of Class Action and Proposed Settlement; (II) Settlement Hearing; and (III) Motion for Attorneys’ Fees and Litigation Expenses (“Notice”), which accompanies this Proof of Claim and Release Form); and (ii) you complete and sign this Proof of Claim and Release Form and timely submit it to the Claims Administrator at the address below.
3. THIS PROOF OF CLAIM AND RELEASE FORM MUST BE SUBMITTED EITHER (1) ONLINE AT WWW.DENTSPLYSIRONASECURITIESLITIGATION.COM NO LATER THAN OCTOBER 7, 2025, OR WITHIN 30 DAYS AFTER FINAL APPROVAL IS GRANTED TO THE SETTLEMENT, WHICHEVER IS LATER, OR (2) BY MAIL, POSTMARKED NO LATER THAN OCTOBER 7, 2025, OR WITHIN 30 DAYS AFTER FINAL APPROVAL IS GRANTED TO THE SETTLEMENT, WHICHEVER IS LATER, ADDRESSED AS FOLLOWS:
4. If you are a member of the Class and you have not timely requested exclusion in response to the Notice, you are bound by the terms of any judgment entered in the Action, including the releases provided therein, WHETHER OR NOT YOU SUBMIT A PROOF OF CLAIM AND RELEASE FORM OR RECEIVE A PAYMENT.
5. PLEASE NOTE: As set forth in the Plan of Allocation, each Authorized Claimant shall receive his, her, or its pro rata share of the Net Settlement Fund. If the prorated payment to any Authorized Claimant calculates to less than $10.00, it will not be included in the calculation, and no distribution will be made to that Authorized Claimant.
1. If you purchased or otherwise acquired Dentsply Intl. or Dentsply Sirona common stock in your name, you are the beneficial purchaser or other acquirer as well as the record purchaser or other acquirer. If, however, you purchased or otherwise acquired the Dentsply Intl. or Dentsply Sirona common stock through a third party, such as a brokerage firm, you are the beneficial purchaser or other acquirer and the third party is the record purchaser or other acquirer.
2. Use Part I of this form entitled “Claimant Information” to identify each beneficial purchaser or other acquirer of Dentsply Intl. or Dentsply Sirona common stock that forms the basis of this claim. THIS CLAIM MUST BE FILED BY THE ACTUAL BENEFICIAL PURCHASER(S) OR OTHER ACQUIRER(S) OR THE LEGAL REPRESENTATIVE OF SUCH PURCHASER(S) OR OTHER ACQUIRER(S) UPON WHICH THIS CLAIM IS BASED.
NOTE: Separate Proof of Claim and Release Forms should be submitted for each separate legal entity (for example, a claim from joint owners should not include separate transactions of just one of the joint owners, and an individual should not combine his or her IRA transactions with transactions made solely in the individual’s name). Conversely, a single Proof of Claim should be submitted on behalf of one legal entity including all transactions made by that entity, no matter how many separate accounts that entity has (for example, a corporation with multiple brokerage accounts should include all transactions made in Dentsply Intl. or Dentsply Sirona common stock during the Class Period on one Proof of Claim, no matter how many accounts the transactions were made in). All joint purchasers or other acquirers must sign this claim. Executors, administrators, guardians, conservators and trustees must complete and sign this claim on behalf of Persons represented by them and proof of their authority must accompany this claim and their titles or capacities must be stated. The Social Security (or Taxpayer Identification) Number and telephone number of the beneficial owner may be used in verifying the claim. Failure to provide the foregoing information could delay verification of your claim or result in rejection of the claim.
1. Use Part II of this form entitled “Schedule of Transactions in Common Stock” to supply all required details of your transaction(s). If you need more space or additional schedules, attach separate sheets giving all of the required information in substantially the same form. Sign and print or type your name on each additional sheet.
2. On the schedules, provide all of the requested information with respect to all of your purchases or other acquisitions and all of your sales or other dispositions of Dentsply Intl. or Dentsply Sirona common stock from December 8, 2015 through November 2, 2018, inclusive, whether such transactions resulted in a profit or a loss. Failure to report all such transactions may result in the rejection of your claim.
3. The date of covering a “short sale” is deemed to be the date of purchase or other acquisition of Dentsply Intl. or Dentsply Sirona common stock. The date of a “short sale” is deemed to be the date of sale of Dentsply Intl. or Dentsply Sirona common stock.
4. You must attach copies of broker confirmations or other documentation of your transactions in Dentsply Intl. or Dentsply Sirona common stock to your claim. Failure to provide this documentation could delay verification of your claim or result in rejection of your claim. Lead Plaintiff does not have information about your transactions in Dentsply Intl. or Dentsply Sirona common stock.
5. You are required to submit genuine and sufficient documentation for all of your transactions in and holdings of Dentsply Intl. and Dentsply Sirona common stock set forth in the Schedule of Transactions in Common Stock in Part II. Documentation may consist of copies of brokerage confirmation slips or monthly brokerage account statements, or an authorized statement from your broker containing the transactional and holding information found in a broker confirmation slip or account statement. The Parties and the Claims Administrator do not have information about your investments in Dentsply Intl. or Dentsply Sirona common stock. IF SUCH DOCUMENTS ARE NOT IN YOUR POSSESSION, PLEASE OBTAIN COPIES OF THE DOCUMENTS OR EQUIVALENT DOCUMENTS FROM YOUR BROKER. FAILURE TO SUPPLY THIS DOCUMENTATION MAY RESULT IN THE REJECTION OF YOUR CLAIM. DO NOT SEND ORIGINAL DOCUMENTS.
NOTICE REGARDING ELECTRONIC FILES: Claimants with large numbers of transactions may request, or may be requested, to submit their transaction information in electronic files. All Claimants MUST submit a signed Proof of Claim and Release Form whether or not they submit electronic files. If you wish to file your claim electronically, you must contact the Claims Administrator at (866) 217–4456 to obtain the required file layout. No electronic files will be considered to have been properly submitted unless the Claims Administrator issues to the claimant a written acknowledgment of receipt and acceptance of electronically submitted data.
2. Submission of this Proof of Claim and Release Form, however, does not ensure that you will share in the proceeds of the Settlement. You will only be entitled to receive a distribution from the Net Settlement Fund if: (i) you are an Authorized Claimant (as described in the Plan of Allocation, paragraphs 76-96 of the Notice of (I) Pendency of Class Action and Proposed Settlement; (II) Settlement Hearing; and (III) Motion for Attorneys’ Fees and Litigation Expenses (“Notice”), which accompanies this Proof of Claim and Release Form); and (ii) you complete and sign this Proof of Claim and Release Form and timely submit it to the Claims Administrator at the address below.
3. THIS PROOF OF CLAIM AND RELEASE FORM MUST BE SUBMITTED EITHER (1) ONLINE AT WWW.DENTSPLYSIRONASECURITIESLITIGATION.COM NO LATER THAN OCTOBER 7, 2025, OR WITHIN 30 DAYS AFTER FINAL APPROVAL IS GRANTED TO THE SETTLEMENT, WHICHEVER IS LATER, OR (2) BY MAIL, POSTMARKED NO LATER THAN OCTOBER 7, 2025, OR WITHIN 30 DAYS AFTER FINAL APPROVAL IS GRANTED TO THE SETTLEMENT, WHICHEVER IS LATER, ADDRESSED AS FOLLOWS:
Dentsply Sirona Securities Litigation
c/o A.B. Data, Ltd.
P.O. Box 173027
Milwaukee, WI 53217
4. If you are a member of the Class and you have not timely requested exclusion in response to the Notice, you are bound by the terms of any judgment entered in the Action, including the releases provided therein, WHETHER OR NOT YOU SUBMIT A PROOF OF CLAIM AND RELEASE FORM OR RECEIVE A PAYMENT.
5. PLEASE NOTE: As set forth in the Plan of Allocation, each Authorized Claimant shall receive his, her, or its pro rata share of the Net Settlement Fund. If the prorated payment to any Authorized Claimant calculates to less than $10.00, it will not be included in the calculation, and no distribution will be made to that Authorized Claimant.
B. INSTRUCTIONS FOR COMPLETING PART I – CLAIMANT INFORMATION
1. If you purchased or otherwise acquired Dentsply Intl. or Dentsply Sirona common stock in your name, you are the beneficial purchaser or other acquirer as well as the record purchaser or other acquirer. If, however, you purchased or otherwise acquired the Dentsply Intl. or Dentsply Sirona common stock through a third party, such as a brokerage firm, you are the beneficial purchaser or other acquirer and the third party is the record purchaser or other acquirer.
2. Use Part I of this form entitled “Claimant Information” to identify each beneficial purchaser or other acquirer of Dentsply Intl. or Dentsply Sirona common stock that forms the basis of this claim. THIS CLAIM MUST BE FILED BY THE ACTUAL BENEFICIAL PURCHASER(S) OR OTHER ACQUIRER(S) OR THE LEGAL REPRESENTATIVE OF SUCH PURCHASER(S) OR OTHER ACQUIRER(S) UPON WHICH THIS CLAIM IS BASED.
NOTE: Separate Proof of Claim and Release Forms should be submitted for each separate legal entity (for example, a claim from joint owners should not include separate transactions of just one of the joint owners, and an individual should not combine his or her IRA transactions with transactions made solely in the individual’s name). Conversely, a single Proof of Claim should be submitted on behalf of one legal entity including all transactions made by that entity, no matter how many separate accounts that entity has (for example, a corporation with multiple brokerage accounts should include all transactions made in Dentsply Intl. or Dentsply Sirona common stock during the Class Period on one Proof of Claim, no matter how many accounts the transactions were made in). All joint purchasers or other acquirers must sign this claim. Executors, administrators, guardians, conservators and trustees must complete and sign this claim on behalf of Persons represented by them and proof of their authority must accompany this claim and their titles or capacities must be stated. The Social Security (or Taxpayer Identification) Number and telephone number of the beneficial owner may be used in verifying the claim. Failure to provide the foregoing information could delay verification of your claim or result in rejection of the claim.
C. INSTRUCTIONS FOR COMPLETING PART II – SCHEDULE OF TRANSACTIONS IN COMMON STOCK
1. Use Part II of this form entitled “Schedule of Transactions in Common Stock” to supply all required details of your transaction(s). If you need more space or additional schedules, attach separate sheets giving all of the required information in substantially the same form. Sign and print or type your name on each additional sheet.
2. On the schedules, provide all of the requested information with respect to all of your purchases or other acquisitions and all of your sales or other dispositions of Dentsply Intl. or Dentsply Sirona common stock from December 8, 2015 through November 2, 2018, inclusive, whether such transactions resulted in a profit or a loss. Failure to report all such transactions may result in the rejection of your claim.
3. The date of covering a “short sale” is deemed to be the date of purchase or other acquisition of Dentsply Intl. or Dentsply Sirona common stock. The date of a “short sale” is deemed to be the date of sale of Dentsply Intl. or Dentsply Sirona common stock.
4. You must attach copies of broker confirmations or other documentation of your transactions in Dentsply Intl. or Dentsply Sirona common stock to your claim. Failure to provide this documentation could delay verification of your claim or result in rejection of your claim. Lead Plaintiff does not have information about your transactions in Dentsply Intl. or Dentsply Sirona common stock.
5. You are required to submit genuine and sufficient documentation for all of your transactions in and holdings of Dentsply Intl. and Dentsply Sirona common stock set forth in the Schedule of Transactions in Common Stock in Part II. Documentation may consist of copies of brokerage confirmation slips or monthly brokerage account statements, or an authorized statement from your broker containing the transactional and holding information found in a broker confirmation slip or account statement. The Parties and the Claims Administrator do not have information about your investments in Dentsply Intl. or Dentsply Sirona common stock. IF SUCH DOCUMENTS ARE NOT IN YOUR POSSESSION, PLEASE OBTAIN COPIES OF THE DOCUMENTS OR EQUIVALENT DOCUMENTS FROM YOUR BROKER. FAILURE TO SUPPLY THIS DOCUMENTATION MAY RESULT IN THE REJECTION OF YOUR CLAIM. DO NOT SEND ORIGINAL DOCUMENTS.
NOTICE REGARDING ELECTRONIC FILES: Claimants with large numbers of transactions may request, or may be requested, to submit their transaction information in electronic files. All Claimants MUST submit a signed Proof of Claim and Release Form whether or not they submit electronic files. If you wish to file your claim electronically, you must contact the Claims Administrator at (866) 217–4456 to obtain the required file layout. No electronic files will be considered to have been properly submitted unless the Claims Administrator issues to the claimant a written acknowledgment of receipt and acceptance of electronically submitted data.