ENTER CLAIMANT INFORMATION


Use this form if you want to have your purchase data audited because you disagree with your recorded Broiler purchase information, no known purchase information is available for you, or you want to update the information on your previous claim.

Please complete the Claimant Information form below.




ENTER YOUR PURCHASE INFORMATION


Enter the purchase information for ALL of the qualifying broiler purchases you made in the United States from December 1, 2008, until December 31, 2019, in the form below. You may not seek Settlement Proceeds with respect to any Settlement(s) from which you have opted out.





Must click Add to save your information.



Defendant Year Purchase Amount Action



ATTACH DOCUMENTATION


Please submit documents to support your updated claim and/or audit request (e.g., invoices, purchase information, etc.). Supporting documents must include actual receipts or invoices that include the product name, name of Defendant/producer, date of purchase, and net purchase amount.

If your claim is based upon any full or partial assignment of a claim from another entity, and that assignment was not addressed in the prior claims process, then by the claim deadline of June 1, 2024, you must provide: (1) A signed copy of the assignment agreement executed by all parties, (2) if less than a full assignment of an entity’s claims is made (i.e., a partial assignment of claims), then provide substantiation of the actual amount of purchases assigned by the assignor to the assignee, and (3) all entity names relevant to the assignment of claims for both the assignor and assignee.

Please submit legible copies.




Files To Be Uploaded Size Action


SIGN STATEMENT


By signing below, I/we certify that (1) the above and foregoing information is true and correct; (2) I/we warrant that I am/we are duly authorized and have the legal capacity to sign this purchase Audit Request Form on behalf of the direct purchaser entity; (3) I/we are not officers, directors, or employees of any Defendant; any entity in which any Defendant has a controlling interest; an affiliate, legal representative, heir, or assign of any Defendant; or a federal, state, or local governmental entity; and (4) I/we agree to submit additional information, if requested, in order for the Settlement Administrator to process my/our updated claim and audit request.



SECURITY CHECK