PASSENGER AUTHORIZATION FORM

I, ________________________________[Passenger’s English name/탑승자의 영문 성함],

certify and attest that I am the passenger or the parent or legal guardian of the passenger who
flew on Korean Air (KE) or Asiana Airlines (OZ) using Ticket Number(s) (the “Ticket
Number(s)”): __________________________________ [Please print your ticket number
clearly/티켓번호].

I hereby transfer and assign any and all rights arising out of the settlements in the Air Passenger
Antitrust Litigation Class Action, MDL No. 07-01891 (the “Settlements”) to seek redemption
using a Coupon Code for the aforementioned Ticket Number to:
__________________________________________________ [Coupon Owner’s English
name/쿠폰 소유자의 성함을 영문으로 적어주십시오] (the “Coupon Code Owner”).

I understand the Ticket Number may be used by Coupon Code Owner for the sole purpose of
redemption of the Coupon Code and hereby give my authorization for such use. By transferring,
and assigning the above Ticket Number to the Coupon Code Owner, I understand that I
relinquish any and all rights under the Settlements to submit the Ticket Number(s) identified
above for redemption using Coupon Codes. Any rights I may have to other Coupon Codes or
Ticket Numbers are reserved and not relinquished.

I understand that when the Coupon Code Owner submits his/her/its Coupon Code for redemption
to CCC, the Ticket Number and my personal information (or the personal information of my
minor child(ren) or other lawful ward(s)) may be stored, transmitted and processed in connection
with the redemption of the Coupon Code in and between the United States and South Korea.
Personal information will be disclosed by CCC to Korean Air Co., Ltd. and Asiana Airlines, Inc.
only for the purpose of Coupon Code redemption. Additionally, I understand the Airlines will
need to transfer my personal information to CCC and/or the Coupon Code Owner. The items of
personal information transferred may include, but not be limited to, the name of the passenger on
the ticket associated with a submitted Ticket Number, the price of the ticket associated with the
Ticket Number, and the redemption eligibility status of the Ticket Number. The purpose of this
transfer of information is to assist with the redemption of Coupon Codes.

Information exchanged between CCC and the Airlines may be retained by any of them until six
months after the earlier of (a) the expiration date for all Coupon Codes, including the cy pres
distribution of Coupon Codes, or (B) the date when all Coupon Codes have been redeemed. The
subject transfer of personal information involves the cross-border transfer of personal
information from South Korea to the United States
404 South Wells Street, Suite 600 – Chicago, IL 60607 –
(312) 204-69690 – Fax: (312) 204-6980 – Email: Admin@kpacoupons.com
I understand that I have the right to refuse to provide consent to the use, storage, and transfer of
my personal information, in which case the Coupon Code may not be redeemed. I give my
consent to the use, storage, and transfer of my personal information as stated herein.
I declare under penalty of perjury that the information contained in this form is true and accurate.

Signature of Passenger/항공권을 이용하신 승객분의 싸인___________________________

Print Name/영문성함 __________________________________
If applicable, name of minor child(ren) or ward(s)/자녀 혹은 피보호자의 항공권을 상환하실
경우, 그분들의 성함을 적어주십시오________________________________________
Address __________________________________________
City/State/Zip Code_________________________________
Country _________________________________________
Phone ___________________________________________
Email address _____________________________________

Please fill out the information above and send this document by:

• email to coupons@kpacoupons.com
• fax to (312) 204-6980
• or mail to:
Chicago Clearing Corporation
404 South Wells Street
Suite 600
Chicago, IL

All rebates are subject to investigation, including requesting further documentation, if deemed
necessary.

404 South Wells Street, Suite 600 – Chicago, IL 60607 –

(312) 204-69690 – Fax: (312) 204-6980 – Email: Admin@kpacoupons.com