Broiler Chicken Claim Form for Indirect Purchasers
This form is used for commercial and institutional indirect purchasers of broiler chickens in specified states to submit claims for settlements related to alleged price fixing by the defendants. It's necessary to complete and submit the claim form by the specified deadline in order to be eligible for payment. Detailed instructions on how to complete the form are provided.
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How do I fill this out?
To fill out this form, you'll need to provide accurate information about your business's broiler chicken purchases. Ensure that you complete all required sections and sign the form. Detailed instructions and definitions of broiler chicken product categories can be found in the form itself.
How to fill out the Broiler Chicken Claim Form for Indirect Purchasers?
1
Accurately complete all required portions of the Claim Form.
2
Sign the Claim Form and ensure the information is accurate.
3
Submit the claim form by mail or electronically by the specified deadline.
4
Categorize your broiler purchases as specified in the form.
5
Ensure all the provided information is accurate and complete to avoid disputes.
Who needs the Broiler Chicken Claim Form for Indirect Purchasers?
1
Commercial food businesses that indirectly purchased broiler chickens.
2
Institutional purchasers using broiler chickens in food preparation.
3
Businesses in specified states impacted by alleged price fixing.
4
Companies seeking compensation from the settlement funds.
5
Firms aiming to submit valid claims for payment.
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With PrintFriendly, you can easily edit this PDF form by adding text, signatures, and other relevant information. Use our intuitive PDF editor to ensure every section is accurately filled out. Make necessary adjustments before saving and downloading your completed form.
1
Open the PDF form in PrintFriendly's editor.
2
Enter your business and purchase details as required.
3
Navigate to the signature section to add your electronic signature.
4
Review the form for accuracy and completeness.
5
Save and download the completed form for submission.
What are the instructions for submitting this form?
To submit this form, you have two options: i) Mail the completed and signed Claim Form, postmarked no later than March 2, 2022, to: Broilers CIIPP Settlement, c/o A.B. Data, Ltd., P.O. Box 173122, Milwaukee, WI 53217 or ii) Complete and submit the Claim Form using the Settlement Administrator's website, www.chickencommercialsettlement.com. Upon completion of the online Claim Form, you will receive an acknowledgment that your claim has been submitted. If filing electronically, ensure the form is submitted no later than March 2, 2022.
What are the important dates for this form in 2024 and 2025?
The deadline to submit this form is March 2, 2022.
What is the purpose of this form?
The purpose of this form is to allow commercial and institutional indirect purchasers of broiler chickens to submit claims for settlement funds related to alleged price-fixing conspiracies. The settlements aim to compensate businesses in specified states that purchased broiler chickens indirectly from the defendants or their co-conspirators. By submitting this form accurately and on time, eligible businesses can receive payments from the settlement funds. In order to be considered for payment, businesses must provide detailed information about their broiler purchases and sign the certification section.
Tell me about this form and its components and fields line-by-line.
- 1. Business Information: Details about your business, including name, address, and contact information.
- 2. Broiler Purchases: Information about your broiler chicken purchases, categorized by product type and purchase date.
- 3. Signature: Signature of the person completing the form, certifying the accuracy of the information provided.
What happens if I fail to submit this form?
Failure to submit this form by the specified deadline may result in your business not receiving any payment from the settlements.
- Missed Compensation: You will not receive any payment from the settlement funds.
- Invalid Claim: Your claim may be invalid if the form is incomplete or incorrect.
How do I know when to use this form?
- 1. Indirect Purchasers: Businesses that indirectly purchased broiler chickens in specified states.
- 2. Settlement Claims: Submitting claims for compensation from the settlement funds.
Frequently Asked Questions
What is this form for?
This form is used to submit claims for settlement funds related to alleged price fixing of broiler chickens.
Who needs to fill this out?
Commercial and institutional indirect purchasers of broiler chickens in specified states.
How do I submit the form?
You can mail it or submit it online through the settlement administrator's website.
When is the deadline for submission?
The form must be submitted or postmarked by March 2, 2022.
Can I edit the form online?
Yes, you can edit the form using PrintFriendly's PDF editor.
How do I sign the form electronically?
Use PrintFriendly's PDF editor to add your electronic signature.
What information is required?
Details of broiler chicken purchases, broken down by category and date.
What happens if I miss the deadline?
You may not receive any payment from the settlements.
Can I share the completed form?
Yes, you can email it or share a download link via PrintFriendly.
How do I ensure my claim is valid?
Complete all required sections accurately and submit it by the deadline.
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