Submit Claim | Soap Settlement

The deadline for submitting this proof of claim form is August 1, 2021 at 11:59pm

I. YOUR IDENTITY AND CONTACT INFORMATION:

Contact information of claimant.

Please note that you must provide a legible and accurate email address. All Settlement Payments to Eligible Claimants will be delivered via PayPal using the email address provided in this Claim Form. If you do not have a PayPal account, you will be prompted to open an account using the email address provided in this Claim Form.

First Name *

Middle Name

Last Name *

Address, including apartment, unit or box number *

City *

Province *

Postal Code *

Phone Number *

Email Address *

II. DECLARATION OF PURCHASE(S):

In the box provided here, please declare the number of bottles of Dial Complete that you have purchased up to a maximum of 30 bottles. If you have purchased more than 30 bottles, then simply write “30” in the box provided:

Number of Bottles Purchased *

* Required Fields

III. SIGNATURE:

By submitting this Claim Form, you hereby submit to the jurisdiction of the Superior Court of Quebec for the purpose of this claim.

By signing this Claim Form, you confirm that the information provided herein is true and accurate, to the best of your knowledge.

Signature *

Date

Tegegne v. Henkel Consumer Goods Canada Inc. and The Dial Corporation

Court File No. 500-06-000577-110

Superior Court of Quebec

The deadline for submitting this proof of claim form is August 1, 2021 at 11:59pm

Your Claim Form has been submitted successfully.

Submitted Claim ID:
Confirmation Code:
You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
CLAIM INFORMATION
First Name
Middle Name
Last Name
Street Address
City
Province
Postal Code
Email Address
Phone Number
Number of Bottles