CLAIM FORM For XYZ COMPANY RESTITUTION
Please print legibly and keep a copy for your records.
Our records show that you made payment(s) to George Edward (Ed) Hall II and/or his affiliated businesses in the amount of $4,500.00.
I certify that I am a consumer eligible to receive a restitution payment as part of the NC Attorney General’s judgment obtained against George Edward Hall, II, owner/operator of Carolina Structures, Inc., Titan Concrete, Inc., Carolina Buildings, LLC, Titan Outdoor Impressions, Inc., Kahuna Concrete, and Affordable Contractors.
Your signature on this form is your sworn statement that you are entitled to restitution.