Claim Form
This official website is maintained by the Claims Administrator and supervised by Lead Counsel. Please use the links below for a copy of the Claim Form or file a claim online.
THIS CLAIM FORM CONTAINS FOUR (4) SECTIONS, ALL OF WHICH MUST BE COMPLETED BEFORE THE FORM IS SUBMITTED, INCLUDING THE VERIFICATION ON THE LAST PAGE. YOUR CLAIM WILL NOT BE SUBMITTED UNTIL AFTER YOU COMPLETE THE VERIFICATION AND PRESS THE [GREEN “SUBMIT” BUTTON].Please print the verification for your records.
To complete the online Claim Form and Release click here
To file your claim by mail, download a copy of the Claim Form below
Note: These documents are in PDF format. To view the
documents, you will need Adobe Acrobat Reader
on your computer or other internet-enabled device.
