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Claim Forms must be postmarked or submitted online no later than March 15, 2013.
If you received an email or postcard notice, a "Claimant ID Number" is located on
the email or postcard you received. Please enter and confirm that information below.
If you did not receive an email or postcard or do not have the Claimant ID Number,
please proceed to Section I.
SECTION I: INSTRUCTIONS
If you were a Quixtar Independent Business Owner ("IBO") after January 1, 2003,
but you resigned as an IBO by February 21, 2012, you may be eligible to receive:
- A bundle of free Quixtar products (currently estimated to have a $150 retail value,
although the value may be greater or lesser depending on the number of new claims
filed) (see SECTION II: PRODUCT CREDIT).
- A partial refund (currently estimated at 20%, may be more or less depending on number
of new claims filed) (maximum $2,000) of your expenditures on business support materials
(see SECTION III: CASH REFUND FOR BSM EXPENDITURES).
- No new hardship claims may be filed at this time. Hardship claims previously filed
will be determined by the Special Master appointed by the Court. If you filed a
hardship claim and you receive a letter from the Claims Administrator requesting
additional documentation of you claim, you must provide the requested documentation
or your claim will be denied.
To determine your eligibility for these benefits, complete the applicable section(s)
of this Claim Form no later than March 15, 2013.
It is important that all of the information you provide in this Claim Form is true,
accurate, and complete. Persons who submit false or fraudulent claims will not be
eligible for compensation.
NOTE: If you were not a Quixtar Independent Business Owner ("IBO") during the period
outlined above, or if you are currently a Quixtar IBO, you are not entitled to compensation
under the Settlement Agreement.
SECTION II: PRODUCT CREDIT
Complete this Section if you paid an initial registration fee to become a Quixtar
SECTION III: CASH REFUND FOR BSM EXPENDITURES
Complete this Section ONLY if you have receipts, credit card statements,
or other forms of proof (your own signed statement may be acceptable) that you spent
at least $100 more on business support materials (books, tapes, and function tickets)
than you received from re-selling business support materials.
SECTION IV: SIGN
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