CLAIMAINT INFORMATION











    PURCHASING INFORMATION

    If your business purchased beef directly from Defendants during the claims period, you must complete the purchase information table below. This form must reflect ALL of your purchases from the Defendants that you are claiming during the relevant time periods. You may not seek Settlement Proceeds if you previously opted out of the JBS Settlement.

    Please provide additional documentation to support your claim (e.g., invoices, purchase information, etc.). Documentation must include examples of receipts or invoices that include the product name, name of Defendant manufacturer, date of purchase, and net purchase amount. Please submit legible copies.

    Please upload a file(s) in one of the following formats: .bmp, .gif, .jpg, .jpeg, .pdf, .png, .tiff, .tif, .doc, .docx, .xls, .xlsx, .csv, .rtf. Upload files (max file is 10) (10MB limit)

    DEFENDANT

    2015

    2016

    2017

    2018

    2019

    2020

    2021

    2022

    Cargill

    JBS

    National Beef

    Tyson

    ACKNOWLEDGEMENT AND VERIFICATION

    YesI (WE) DECLARE, UNDER THE PENALTY OF PERJURY UNDER THE LAWS OF THE UNITED STATES, THAT THE INFORMATION PROVIDED HEREIN IS TRUE AND CORRECT.

    YesI (WE) READ, UNDERSTOOD, AND AGREED TO THE TERMS AND CONDITIONS.

     

    Type Your Full Name:

    Type Your Title:

    Your Signature:

    Date: