CLAIMANT INFORMATION



* Denotes required field


PURCHASE INFORMATION


For some but not all potential Class Members and for some but not all purchases, the Settlement Administrator has received Capacitors Class Period purchase information from certain distributors. It is important to note that the Settlement Administrator did not receive data from all distributors regarding purchases made by the class of Capacitors for the entire Class Period. If you received a Settlement Notice Packet, and a Notice ID and Purchase Amounts were populated in the Purchase Information section of the Claim Form, you have the option to elect for those Purchase Amounts to be your full amounts claimed, with no requirement for providing further proof of your purchase(s).








UPLOAD SUPPORTING DOCUMENTATION


Please use the browse option, by clicking on “Select Files” in the box below to upload your supporting documentation.



Files To Be Uploaded Size Action

CERTIFICATION



By signing this claim submission, I certify, under penalty of perjury, 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 behalf of the individual or entity. I am, or the individual or entity on whose behalf I am submitting this claim submission is, a member of the Class, and have not submitted a request to exclude myself, or “opt-out of”, the Settlement. I agree to furnish additional information regarding this claim submission if so requested to do so by the Settlement Administrator.


* Denotes required field