Settlement Class Members who seek payment from the Settlement must complete this Claim Form. Claim Forms must be SUBMITTED NO LATER THAN 11:59 pm, Eastern Time on May 15, 2020.
Before you complete and submit this Claim Form, you should read and be familiar with the Notice of Proposed Class Action Settlement (the “Notice”) available here. Defined terms (with initial capitals) used in these General Instructions have the same meaning as set forth in the Settlement Agreement. By submitting this Claim Form, you acknowledge that you have read and understand the Notice, and you agree to the Release(s) included as a material term of the Settlement Agreement.
If you fail to submit a timely Claim Form, your Claim may be rejected and you may be precluded from any recovery from the Settlement fund. If you are a member of the Settlement Class and you do not timely and validly request to Opt-Out from the Settlement Class, you will be bound by any judgment entered by the Court approving the Settlement regardless of whether you submit a Claim Form. You can elect one Benefit per Household.
Phone numbers and are requested solely for purposes of claim verification, or to resolve questions about submitted claim forms, and will not be shared with third parties.
If you select to receive payment electronically, you will receive an additional $1.00 in compensation.
Please choose how you would like to receive your settlement payment:
*A valid Proof of Purchase, at a minimum, includes the purchase of a Black Pepper Product, the purchase price, purchase date, and place of purchase. Proof of Purchase must be attached and submitted with your Claim. Examples of proofs of purchase may include a receipt, a record of retailer loyalty-club purchases, or a photo of the container and UPC code.
No Proof benefits are available for Settlement Class Members who purchased the Black Pepper Products during the Class Period and do not have valid Proof of Purchase. You may recover a maximum of $4.00 per Black Pepper Product, for up to 2 containers, for a maximum of $8.00 per Household, or less, depending on a number of factors.
Proof-of-Purchase benefits are available for Settlement Class Members who purchased the Black Pepper Products during the Class Period and who elect to provide a valid Proof of Purchase showing, at a minimum, the purchase of a Black Pepper Product, the purchase price, purchase date, and place of purchase. You may recover the greater of $4.00 per container or the actual cost per container for each container purchased, and recovery may vary depending upon a number of factors. Proof of Purchase must be attached and submitted with this Claim.
Attach Proof of Purchase. Examples of proofs of purchase may include a receipt, a record of retailer loyalty-club purchases, or a photo of the container and UPC code.
By signing below, you are submitting to the jurisdiction of the United States District Court for the District of Columbia.
I hereby certify under penalty of perjury that:
1. I have read the Settlement 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 information provided to the Settlement Administrator to support my Claim is an original or a complete and true copy of the original document;
4. I am a member of the Settlement Class and did not request to Opt-Out from the Settlement Class;
5. I have not 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; (b) an employee, principal, legal representative, successor, or and assign of Defendant or its affiliated entities; (c) a government entity; nor (d) a judge to whom this Action is assigned, or any member of the judge’s immediate family or staff;
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. I will timely provide any additional information requested by the Settlement Administrator to validate my Claim;
9. I understand that by submitting this Claim Form, I am deemed to have given a complete Release of all settled claims; and
10. I understand that Claims will be audited for veracity, accuracy and fraud. Illegible Claims Forms can be rejected. If a Claim Form is determined not to be a Valid Claim, it will be rejected.
Please read for a full explanation of the settlement and your options and all applicable timelines.
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