Claim Form

Download a claim form here.

To make a claim, you must submit a valid claim form so that it is received by the Claims Administrator on or before March 30, 2017. You must provide the information requested on the claim form to support and verify your claim, and mail it to the Claims Administrator so that it is received no later than March 30, 2017. The address of the Claims Administrator is:

The Notice Company
Spartanburg Hep-A Class Action
P.O. Box 455
Hingham, MA 02043

You must complete and submit a separate claim form for each person who obtained an IG shot or Hepatitis-A vaccination or HAV blood test.

Failure to submit a valid and timely claim form so that it is received by March 30, 2017, will bar you from receiving a portion of the settlement and bar you from proceeding on any claim arising out of the circumstances described in the Detailed Notice.