If you received a personalized notice in the mail or via email with a Notice ID and Confirmation Code, please enter the codes you were provided below.

Please remember to enter the full Notice ID exactly as it appears on your personalized Notice, (i.e. 12345678).

If you did not receive a personalized Notice in the mail or via email, click below to complete a Claim Form.

The deadline for submitting this proof of claim form is

Contact Information

* Required Fields

Product Purchase Verification

Provide the following information regarding purchases you made during the Class Period of Products, and indicate the purchases for which you are attaching Proof of Purchase documentation. Proof of Purchase means a receipt establishing that you purchased a specific quantity of Products at a specific price, on a specific date, from a specific location, during the Class Period. You may submit claims for up to 10 products without Proof of Purchase, and up to 40 products with Proof of Purchase. Your claims will be cumulative, meaning, any claims for products with Proof of Purchase will not be counted towards your limit on claims without Proof of Purchase.

Products WITHOUT Proof of Purchase
Approximate Date Of Purchase Name Of Retail Establishment Or Online Retailer If At Retail Establishment (City And State) Name(s) Of The Product(s) Purchased Approximate Amount Paid
Products WITH Proof of Purchase
Supporting Documentation

Accepted file types are: DOCX, DOC, XLS, XLSX, PDF, TIF, JPG, GIF, PNG. Other file types will be rejected.

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    Payment Method

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    Fill Out and Sign the Following Attestation

    I declare under penalty of perjury under the laws of the United States that I am a Class Member (as defined in the Class Notice), and that the information in this Claim Form and any documentation attached to it are true and correct to the best of my knowledge. If I did not provide required documents, it is because I do not have them.

    Your Claim Form has been submitted successfully.

    Please print this page for your records.

    Your Claim Details
    Submitted Claim ID:
    Confirmation Code:
    You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
    CLAIM INFORMATION
    First Name
    Last Name
    Street Address
    Street Address 2
    City
    State
    Zip Code
    Email Address
    Phone Number
    Signature
    Date

    If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at Info@SouthofFranceSettlement.com

    Click here to edit your Claim.