File A Claim


Settlement Claim Form


Iglesias v. Ferrara Candy Co., Case No. 3:17-cv-00849-VC
UNITED STATES DISTRICT COURT
FOR THE NORTHERN DISTRICT OF CALIFORNIA

If you purchased a cardboard box of Jujyfruits®, Jujubes®, Now & Later®, Lemonhead®, Applehead®, Cherryhead®, Grapehead®, RedHots®, Trolli®, Chuckles®, Black Forest®, Jawbuster®, Jawbreaker®, Brach’s®, Boston Baked Beans®, Super Bubble®, Rainblo®, or Atomic Fireball® candy, in any flavor or variety (the “Class Products”), you may be eligible to participate in the benefits of the proposed settlement in Iglesias, et al. v. Ferrara Candy Co. To participate, you must fill this claim form out completely and either (i) mail it to the address given below, or (ii) submit it online through the Settlement website below. This Claim form must be postmarked or electronically filed no later than September 20, 2018. If you provide incomplete or inaccurate information, your claim may be denied.

  • Please read the full notice of this settlement (available here) carefully before filling out this Claim Form.
  • To be eligible to receive any benefits from the settlement obtained in this class action lawsuit, you must complete or submit your claim form online or by mail:
    ONLINE: Fill out and submit your claim below; or
    MAIL: Ferrara Candy Settlement Claims Administrator, 8001 Broadway, Suite 200, Merrillville, IN 46410.
  • Keep a copy of your completed Claim Form for your records. Any documents you submit with your Claim Form cannot be returned.
  • If your claim is rejected for any reason, the Claims Administrator will notify you of the rejection and the reasons for such rejection.

Part A: Claimant Information

Indicates Required Field


Part B: Purchase Information

  • To be eligible for a payment you must not have previously received a refund for your purchase of the Class Product.
  • To qualify for a cash award, you must have purchased one or more Class Products.
    a. If you provide a copy of a receipt or receipts memorializing the purchase of the Class Products (“Proof of Purchase”), you will receive a refund of 50 cents per box for each Class Product purchased up to the total amount of units purchased that are submitted with Proof of Purchase.
    b. If you do not provide a valid receipt memorializing the purchase of the Class Products, but complete this Claim Form under penalty of perjury, you will receive a refund of 50 cents per box up to 15 boxes for a total refund of up to $7.50.
    c. If there is still money left over in the Claim Fund, your refund will be increased on a pro rata basis with the refunds of other Settlement Class Members until the Claim Fund is spent. If there is not enough money in the Claim Fund to pay the amounts listed above to all Settlement Class Members, your refund will be decreased on a pro rata basis with the refunds of other Settlement Class Members.
  • Please fill out the chart below identifying the purchase transaction(s) for which you are making a claim:

TOTAL NUMBER OF CLASS PRODUCTS

Write the total number of Class Products you purchased in the United States between February 21, 2013 and June 21, 2018 in the chart below:

NUMBER OF PRODUCTS PURCHASED* APPROXIMATE DATE OF PURCHASE*