Egyptian Pima Cotton Settlement

Claim Form

Hansen-Mitchell, et al. v. Welspun USA, Inc., et al.,
Circuit Court for St. Clair County, State of Illinois.
Case No. 19-L-0391

You must submit this Claim Form to receive any payment.

Please select benefit payment option:

If Electronic Payment is selected, you will receive an email after Final Approval with a list of available payment options.

Even if you received a prior Refund or reimbursement for any Welspun Subject Product labeled or marketed in any way as “Egyptian Cotton” or “Pima Cotton,” you are still entitled to a Benefit. Did you receive a prior Refund?

For use with Tier 1 Claims

Purchase Information

For use with Tier 2 Claims

1. Did you purchase either Welspun’s towel(s) or pillowcase(s) during the Class Period?

2. If you answered yes to Question 1 above, please identify the Welspun towel(s) or pillowcase(s) that you purchased during the Class Period and the number of units purchased:

3. Did you purchase either Welspun’s sheet(s) and/or comforter(s) during the Class Period?

4. If you answered yes to Question 3 above, please identify the sheet(s) and comforter(s) you purchased during the Class Period and the number of units purchased:

5. Please identify the store(s) at which you purchased the Welspun Subject Product(s):

By signing below, you are submitting to the jurisdiction of the Circuit Court for the 20th Judicial Circuit, Court of St. Clair, State of Illinois.

1. I have read the Settlement Agreement and the Supplemental Agreement and agree to its terms, including the Release(s);
2. The information provided in this Claim Form is accurate and complete to the best of my knowledge, information, and belief;
3. The additional documentation information provided to the Settlement Administrator to support my Claim is original or else a complete and true copy of the original(s);
4. I am a member of the Settlement Class and did not request to Opt-Out from the Settlement Class;
5. I have not already entered into a Settlement for any of the Claims set forth in this Claim Form;
6. I am neither (a) a Person who purchased or acquired the Product for resale or for commercial purposes; (b) an officer, employee, director, principal, legal representative, successor, or assign of Defendants or their affiliated entities; (c) a governmental entity; (d) a judge to whom this Action is assigned, or any member of the judge’s family within the first degree of consanguinity; nor (e) Class Counsel.
7. I have not submitted any other Claim for the same purchases and have not authorized any other Person or entity to do so, and know of no other Person or entity having done so on my behalf;
8. No other Person in my Household has submitted a Claim under this Settlement;
9. I will timely provide any additional information requested by the Settlement Administrator to validate my Claim;
10. I understand that by submitting this Claim Form, the effect is the same as if I have given a complete Release of all settled Claims; and
11. I understand that Claims will be audited for veracity, accuracy, and fraud. Claims Forms that are not valid and/or illegible can be rejected.