In re: Dial Complete Marketing and
Sales Litigation

United States District Court
for District of New Hampshire

MDL Docket No.: 11-md-2263-SM

You must accurately complete all required portions of this Claim Form and submit the Claim Form under penalty of perjury.

YOU MUST SUBMIT YOUR CLAIM FORM NO LATER THAN APRIL 12, 2019.


PERSONAL INFORMATION


Provide your name and contact information below.

This information will be used to deliver your Settlement Benefit and communicate with you if any problems arise with your claim. It is your responsibility to notify the Settlement Notice & Claims Administrator of any changes to your contact information after the submission of your Claim Form.



CONFIRMATION OF CLASS MEMBERSHIP


(Claims of more than 30 products require submission of actual purchase receipts in support of your Claim.)


ACKNOWLEDGEMENT


I have received notice of the class action Settlement in this case and I am a class member as described in the notice. I agree to furnish additional information to support this claim if required to do so.



02/23/2019

(Type your name here to electronically sign your Claim Form)