Ubisoft, Inc. — Notice of Dispute

Ubisoft, Inc. (“Ubisoft”) is committed to resolving its customers’ disputes in a fair and efficient manner. If you are unsatisfied with the resolution that a customer service representative offers for a problem that you are experiencing, you may notify us of your dispute by sending this form to Ubisoft’s legal department.

Please complete this form in its entirety (printing legibly). Retain a copy for your records and send the completed form by certified U.S. mail to:. Ubisoft, 625 3rd Street, San Francisco, CA 94107, USA

A Ubisoft representative will respond within 45 days of receiving this form. If the dispute is not resolved to your satisfaction, you may begin arbitration by submitting a Demand for Arbitration to the American Arbitration Association. We provide further details in our website’s Terms of Use, as well as a Demand for Arbitration form.

Name of consumer: _____________________________________

Phone number: _____________________________________

Additional number at which you may be reached during business hours: _____________________________

Your email address: ______________________________________

Your fax number: ______________________________________

Your billing address: ______________________________________

If you are an authorized representative of the customer who is experiencing a problem, please print your name, your relationship to the customer, your address, and a phone number at which you may best be reached during business hours:

Your name: _________________________________________________

Relationship to customer: ________________________________________________

Your address: ________________________________________________

Your phone number: ________________________________________________

Please briefly describe the nature of your dispute and attach any supporting documents that you wish. If necessary, please use the reverse side.
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Please briefly describe the relief that you would like from Ubisoft.
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Date: _____________________ Signature: ___________________________

CH92115.1
216054-10002