SETTLEMENT EGISTRATIOCLAIM ORM

1 01-CA40051877AF1531 1 of 8 SETTLEMENT REGISTRATION/CLAIM FORMAuto Airbag SETTLEMENT for Certain volkswagen and Audi VehiclesA SETTLEMENT FUND HAS BEEN CREATED AND YOU MAY BE ENTITLED TO A CASH PAYMENTTo Register/Submit a Claim for a Payment from the SETTLEMENT Fund (a SETTLEMENT Payment ), YOU MUST:1. Bring or have brought your vehicle (one of the Subject Vehicles listed in Section II, below) to a volkswagen or Audi dealership for the Takata Airbag Recall Remedy, as directed by a recall notice; OR2. Have sold or returned your Subject Vehicle after February 9, 2016 and before November 10, YOU MUST EITHER:1. Register and submit your claim for reimbursement of the reasonable expenses you incurred related to the Takata Airbag Recall;OR2. Register to potentially receive up to $500 from the SETTLEMENT NOTE: Some vehicles included in the SETTLEMENT may be recalled at a later date.

2 Your receipt of a SETTLEMENT Notice does not necessarily mean your vehicle is subject to a recall. Please refer to the National Highway Traffic Safety Administration s website, , to volkswagen s website, , or to Audi s website, , for the latest information about Takata recalls and to determine if your vehicle is subject to a 2 of 8 SETTLEMENT REGISTRATION/CLAIM FORMAuto Airbag SETTLEMENT for Certain volkswagen and Audi VehiclesINSTRUCTIONS FOR REGISTERING/SUBMITTING A CLAIM FOR A SETTLEMENT PAYMENTP lease Read These Instructions Carefully1. Subject to certain limited exclusions, you are eligible to register/submit a claim for a SETTLEMENT Payment if:a. You owned or leased, on November 10, 2021, a Subject Vehicle distributed for sale or lease in the United States or its territories or possessions, AND you bring or have brought your Subject Vehicle to a volkswagen or Audi dealership for the Takata Airbag Recall Remedy; orb.

3 You sold, or returned pursuant to a lease, a Subject Vehicle distributed for sale or lease in the United States or its territories or possessions after February 9, 2016 and before November 10, To register/submit a claim for a SETTLEMENT Payment, you must either:a. Submit an electronic Registration/Claim Form online by visiting (Online registration will result in expedited processing); orb. Submit a paper Registration/Claim Form by completing this form and returning it along with any required documentation by Mail, e-mail, or other delivery method to:Mailing Address:Auto Airbag SETTLEMENT SETTLEMENT Notice Administrator Box 5650 Portland, OR 97208-5650 The deadline for submitting a Registration/Claim Form is as follows:a. If you sold or returned, pursuant to a lease, a recalled Subject Vehicle after February 9, 2016, and before November 10, 2021, you have one year from the date that the SETTLEMENT becomes final (the Effective Date ) to submit a Registration/Claim If you owned or leased a Subject Vehicle on November 10, 2021, the deadline for submitting a Registration/Claim Form is one year after the Effective Date, or one year after the Recall Remedy is performed on your Subject Vehicle, whichever is later, until the Final Registration/Claim Deadline is reached.

4 IMPORTANT: NO REGISTRATION/CLAIM FORMS MAY BE SUBMITTED AFTER THE FINAL/REGISTRATION CLAIM DEADLINE. THE EFFECTIVE DATE AND THE FINAL REGISTRATION/CLAIM DEADLINE ARE NOT YET KNOWN, BUT WILL BE POSTED PROMINENTLY ON THE SETTLEMENT WEBSITE, , WHEN THEY ARE If you are or were the registered owner or lessee of more than one Subject Vehicle, you must submit a separate Registration/Claim Form for each Subject Vehicle to obtain a separate out-of-pocket SETTLEMENT Payment for each Recall Remedy performed on each Subject Vehicle you own(ed) or lease(d). However, claims for unreimbursed expenses cannot be Capitalized terms in this Form have the same meaning as provided in the SETTLEMENT Agreement, which is available at The Long Form Notice, which is also available at or by calling 1-888-735-5596, also explains the key terms of the SETTLEMENT .

5 6. Type or print legibly in blue or black ink. Do not use any highlighters. Provide all requested information, attach any supporting documentation, and sign the Form. 03-CA40051877AF1533 3 of 8 SETTLEMENT REGISTRATION/CLAIM FORMAuto Airbag SETTLEMENT for Certain volkswagen and Audi VehiclesIMPORTANT: KEEP A COPY OF YOUR COMPLETED REGISTRATION FORM AND THE SUPPORTING DOCUMENTS. ANY DOCUMENTS YOU SUBMIT WITH YOUR FORM WILL NOT BE RETURNED. IF YOUR CLAIM IS REJECTED FOR ANY REASON, YOU WILL BE NOTIFIED AND GIVEN AN OPPORTUNITY TO ADDRESS ANY DEFICIENCIES. THE SETTLEMENT SPECIAL ADMINISTRATOR S DECISIONS REGARDING CLAIMS FOR REIMBURSEMENT OF OUT-OF-POCKET EXPENSES SUBMITTED BY CLASS MEMBERS ARE FINAL AND CANNOT BE I: CLASS MEMBER INFORMATIONP lease fill in the below contact information.

6 This information will only be used to contact you regarding the Auto Airbag SETTLEMENT and safety Organization/Trust Name(s) (if applicable):First Name:MI:Last Name:Address 1:Address 2:City:State:ZIP Code:Country:Phone: Email:04-CA40051877AF1534 4 of 8 SETTLEMENT REGISTRATION/CLAIM FORMAuto Airbag SETTLEMENT for Certain volkswagen and Audi VehiclesSECTION II: SUBJECT VEHICLE INFORMATIONP lease enter the Vehicle Identification Number (VIN) of your Subject Vehicle. The VIN can be found on the dashboard of the vehicle, the vehicle s registration, or the vehicle s title, and is 17 characters long. To confirm whether or not your vehicle is eligible for participation in the Auto Airbag SETTLEMENT , please visit Identification Number (VIN): volkswagen SETTLEMENT SUBJECT VEHICLESC heck the box next to your vehicle model and model year.

7 Check only CC200920102011201220132014201520162017 volkswagen Eos2010201120122013201420152016 volkswagen Golf20102011201220132014 volkswagen Passat Sedan2006200720082010 volkswagen Passat Wagon2006200720082010Vo l k s wa ge n Pa s s at2012201320142015 volkswagen Beetle Convertible20122013201420152016201720182 019Vo l k s wa ge n B e e t l e20122013201420152016201720182019 Audi A320062007200820092010201120122013 Audi A4 Avant2005200620072008 Audi A4 Cabriolet200720082009 Audi A4 Sedan2005200620072008 Audi A5 Cabriolet201020112012 Audi A6 Avant20062007200820092010201105-CA400518 77AF1535 5 of 8 SETTLEMENT REGISTRATION/CLAIM FORMAuto Airbag SETTLEMENT for Certain volkswagen and Audi VehiclesAudi A6 Sedan2005200620072008200920102011 Audi Q52009201020112012 Audi R8 Coupe2017 Audi RS 4 Cabriolet2008 Audi RS 4 Sedan20072008 Audi S4 Avant2005200620072008 Audi S4 Cabriolet200720082009 Audi S4 Sedan2005200620072008 Audi S5 Cabriolet201020112012 Audi S6 Sedan20072008200920102011 Audi TT Coupe20162017 Audi R8 Spyder2017 Audi TT Roadster201620171.

8 Did you purchase or lease your Subject Vehicle before November 10, 2021?Ye sNo2. Did you still own or lease your Subject Vehicle on November 10, 2021?Ye sNo3. Did you bring your Subject Vehicle to a volkswagen or Audi dealership for the Takata Airbag Recall Remedy?Ye sNo4. If you answered No to Question 2 in this Section, did you sell, or return pursuant to a lease, your Subject Vehicle after February 9, 2016, and before November 10, 2021?Ye sNo06-CA40051877AF1536 6 of 8 SETTLEMENT REGISTRATION/CLAIM FORMAuto Airbag SETTLEMENT for Certain volkswagen and Audi VehiclesSECTION III: OUT-OF-POCKET EXPENSES1. Did you pay for any expenses, as further defined below, related to the Takata Airbag Inflator Recall for your Subject Vehicle that have not been reimbursed by volkswagen or Audi?Ye sNoIf you answered Yes to Question 1 in this Section, please complete the remainder of this Section and Section IV to submit a claim for reimbursement of the out-of-pocket expenses you incurred, in addition to two potential later payments of up to $250 each from the SETTLEMENT you answered No to Question 1 in this Section, please skip to and complete Section IV below to register for total potential cash payments of up to $500 from the SETTLEMENT SETTLEMENT Special Administrator will process and approve payments from the SETTLEMENT Fund in accordance with the SETTLEMENT Agreement.

9 Payments for reimbursable out-of-pocket expenses will be made first, and if enough money remains in the SETTLEMENT Fund at the end of each program year, that money will be paid to Class Members who: (a) submitted claims for out-of-pocket expenses in that year or prior program years that were previously rejected; or (b) registered for a Residual Distribution payment only. Reimbursements for out-of-pocket expenses will be made on a first-in-first-out basis during years one through three, until the SETTLEMENT Fund is depleted for that year. If there are no more funds to reimburse Class Members in years one through three, those Class Members will be moved to subsequent years for reimbursement. If approved reimbursements to Class Members in year four and until the Final Registration/Claim Deadline exceed the amount available in the SETTLEMENT Fund, reimbursements will be made on a pro rata Payments (excluding reimbursements for out-of-pocket expenses) are capped at $250 per Class Member in the Program year in which the Class Member registers for a payment from the Residual Distribution (or a subsequent year if the Class Member is moved to the subsequent year due to insufficient funds in years one through three).

10 Approved payments to Class Members to reimburse them for reasonable out-of-pocket expenses are not capped, unless pro rata reimbursements are required in year four. After the Final Registration/Claim Deadline, if enough money remains in the SETTLEMENT Fund and it is administratively feasible, the remaining money will be paid to all Class Members who registered/submitted a claim for a SETTLEMENT Payment on a per capita basis, up to a maximum of $250 per Class Member. If there are additional funds remaining after those payments and, if it is administratively feasible, the remaining money will be distributed per capita to all Class Members. Please periodically check the SETTLEMENT website for updates about the SETTLEMENT , including information about the deadlines for filing Registration/Claim Forms. 07-CA40051877AF1537 7 of 8 SETTLEMENT REGISTRATION/CLAIM FORMAuto Airbag SETTLEMENT for Certain volkswagen and Audi Vehicles2.