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Round 4 Claim Form

Click here to download a copy of the Round 4 Claim Form if you did not receive a notice and claim form in the mail.

If you received a notice in the mail, there is a claimant id printed on the claim form you received (below the barcode and above your name and address), and also on the grid which details your purchases.  You can enter your claimant id below and file your claim online.

 

Registration Page

Please Enter Your Information (All fields marked with an * are required)

THE CLAIMANT ID NUMBER ASKED FOR BELOW IS LOCATED BENEATH THE BARCODE ON THE NOTICE YOU RECEIVED.


*Claimant Id Number:


*Confirm Claimant Id Number:


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Disclaimer

Please do not contact the Defendants or the Court. Any and all callers will be directed to this website. If you have questions, please refer to the Commonly Asked Questions and the other information posted here.

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