Broiler Chicken Antitrust Litigation (End-User Consumer)

BROILER CHICKEN CONSUMER LITIGATION

INSTRUCTIONS

This class action alleges Defendants and their co-conspirators conspired and combined to fix, raise, maintain, and stabilize the price and supply of chicken products, as of January 1, 2009, with the intent and expected result of increasing prices of chicken products in the United States, in violation of federal and state consumer and antitrust laws. Defendants deny these allegations.

Please fill out the following before answering the questions starting on the second page:.

Claimant Name (Individual Or Business Name): *

Contact Name (If Different Than Claimant Name):

Care Of (If Applicable):

Address: *

City: *

State: *

Zip: *

Mobile Phone: *

Select Day Of Week For Filing: *

Email Address: *

Verify Email Address: *

Please ensure you provide a current, valid email address and mobile phone number with your claim submission. If the email address or mobile phone number you include with your submission becomes invalid for any reason, it is your responsibility to provide accurate contact information to the Claims Administrator to receive a payment. When you receive the email and/or mobile phone text notifying you of your Settlement payment, you will be provided with a number of digital payment options to immediately receive your Settlement payment. You will also at that time have the option to request a paper check.

You can find more information at www.overchargedforchicken.com or by calling toll-free 1-877-888-5428.

QUESTIONNAIRE

1. Did you purchase one of the following chicken products for personal use in the United States from January 1, 2009, through December 31, 2020: fresh or frozen raw chicken defined as whole birds (with or without giblets), whole cut-up birds purchased within a package, or “white meat” parts including breasts and wings (or cuts containing a combination of these)?

Yes No

Please list the state or states where you were a resident and the months and years lived in each state:

State: *

Month From: *

Year From: *

Month To: *

Year To *

Must click Add to save your information.

State

Month From

Year From

Month From

Year From

Action

For the following questions, please limit your responses to only purchases of the chicken products listed in Question 1 above that you made while a resident of one of the states listed in Question 2 above.

3. Are you filing this claim for yourself or for a business that you represent?

Individual Business

4. In general, from Jan. 1, 2009 to December 31, 2020, did you purchase the chicken products monthly during this entire period?

Yes No

5. For the months you purchased chicken products, what is your best estimate of how much that you spent per month?:

CERTIFICATION

By signing this claim submission, I certify, that the information included with this claim submission is accurate and complete to the best of my knowledge, information, and belief. If I am submitting this claim submission on behalf of a claimant, I certify that I am authorized to submit this claim submission on the claimant’s behalf. I am, or the claimant on whose behalf I am submitting this claim submission is, a member of the Settlement Class, and am not subject to any of the exceptions to being included in the Settlement Class, such as being an employee of one of the Defendants. I agree and consent to be communicated with electronically via email and/or mobile phone text (message & data rates may apply). I agree to furnish additional information regarding this claim submission if so requested to do so by the Claims Administrator.

If you understand and agree to these terms, please type "Understand" in the box below: *

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