To make a claim under the Settlement, you must complete this form. All information will be kept private. The Claim filing deadline could be as soon as August 22, 2020. It will not be disclosed to anyone other than the Court, the Claim Administrator, and the Parties in this case, and their counsel, and will be used only for purposes of administering this Settlement. Importantly, your submission, whether online or by mail, will be submitted to a federal court and subject to the penalty of perjury carrying penalties under U.S. laws including criminal, civil and financial penalties for fraudulent submissions.
This Settlement involves Charmin Freshmates Flushable Wipes and any other pre-moistened wipes sold under the Charmin brand name bearing the word “flushable” on the package label (the “Product”). If your claim is validated and the Court approves the Settlement, you will receive a refund of (i) seventy cents ($0.70) for every package of the Product you purchased in New York between April 6, 2011 and March 6, 2020,if you do not have Proof of Purchase; or one dollar and twenty cents ($1.20) for the first package purchased (and $1.00 for any additional packages purchased) if you submit Proof of Purchase. If you do not submit Proof of Purchase, your total refund will be limited to $6.30 per Household. Proof of Purchase means the actual label or bar code portion of the package of the Product (not a photocopy or digital image), or the original or photocopy or digital image of an itemized sales receipt originally generated by a retail seller showing the date and place of purchase, name of the product purchased, and the amount paid. Even if you submit Proof of Purchase, your total refund will be limited to $50.20 per Household.
Packages of the Product between May 23, 2011 and March 6, 2020.
Please list the retailer(s) and in which state(s) you purchased the Product:
Please attach your Proof of Purchase, and review the explanation of qualifying Proofs of Purchases.
If you are submitting the label or barcode portion of the package of the Product as your Proof of Purchase, you must complete the Paper Claim Form and attach the actual original label or barcode of the package of the Product. The Paper Claim Form must be mailed to the Claim Administrator at: Belfiore v. P&G, c/o Claim Administrator, PO Box 34880, Philadelphia, PA. 19101-4880. Claim Forms must be submitted online or received, not just postmarked, by August 22, 2020, the deadline may be extended. Photocopies or digital images of the label or barcode are not acceptable forms of Proof of Purchase.
* These purchases were not made in a state other than New York, and were not for purpose of resale to others. I certify under penalty of perjury under the laws of the United States that all of the foregoing is true and correct.
Please read for a full explanation of the settlement and your options and all applicable timelines.
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