Claim Form

Claimant Information

The Settlement Administrator will use this information for all communications regarding your submission. If this information changes before the Settlement benefits are issued, you must notify the Settlement Administrator.

Supporting Documentation

Using the uploader below, you must upload documentation supporting your claim that you purchased one or more Raw Farm, LLC f/k/a Organic Pastures Dairy Company, LLC’s Cream Top–whole Raw Milk products in California between May 1, 2020 through July 1, 2020. and that the purchase was a retail, not wholesale, purchase. Examples of documentation that can be used to support your claim include receipts, account statements, etc. “Self-prepared” documents such as handwritten receipts are, by themselves, insufficient to receive reimbursement, but can be considered to add clarity to or support other submitted documentation.

Please provide only copies of your supporting documents and keep all originals for your personal files. The Settlement Administrator will have no obligation to return any supporting documentation to you.

IMPORTANT NOTES:

• The document uploader will only accept the following file types: .pdf, png, and jpeg.

• If you have questions or concerns, please contact the Settlement Administrator at info@NilchianVSOrganicPasturesDairy.com.

If you cannot provide documentation at this time, you may file a paper claim, by downloading a copy here.

Certification & Signature

By signing below, I declare under penalty of perjury under the laws of the State of California that all information I have provided on or with this Claim Form is true and correct.