Claim Form

This claim form relates to the proposed settlement with Pentair Water Pool and Spa, Inc. (“Pentair”). It is substantially the same as the claim form that you may have received in connection with prior settlements in this case involving Hayward Industries, Inc. (“Hayward”) and Zodiac Pool Systems, Inc. (“Zodiac”).

If you have already submitted a claim form in connection with the Hayward and Zodiac Settlements, you do not need to submit a claim form again for it to be considered in the proposed Pentair Settlement. Settlement Class Members who submit a claim by December 11, 2015 (the last date set by the Court to submit claims in the Hayward and Zodiac Settlements), and who have not timely excluded themselves from any of the three settlements, will be eligible to receive a payment from the Pentair Settlement and a payment from the Hayward and Zodiac Settlements.

If you have not submitted a claim form in the Hayward or Zodiac Settlements, and you wish to have a claim considered in the Pentair Settlement, then you need to fill out this claim form and mail it, as instructed below.

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, please fill out the form below and click Submit. 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.

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