DIPF Indirect Purchaser Antitrust Litigation
www.DIPFIndirectSettlement.com

Claim Form

In order to prepare the Claim Form so that you can download and print it with the bar code needed for us to process it, you must complete your name and address information in the form below and click Print Claim Form. This will generate a personalized claim form with your name and address information on it. This is a large file and might take a few minutes.

Once your personalized Claim Form has been generated and you have printed it out, you must mail the completed form to the address listed on the printed Claim Form.

IMPORTANT! Your claim form will not be considered filed until you have mailed it.

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