If you purchased LME U.S. Zinc from a primary zinc producer or Glencore Ltd. from September 14, 2010 to February 11, 2016 and paid the Platts Zinc Midwest Special High Grade premium or similar price premium in the United States, you may be eligible to receive a payment from the Settlement (as defined in the Notice) reached in In re: Zinc Antitrust Litigation , No. 14-cv-03728 (PAE) (S.D.N.Y.) (the “Action”).
The Notice of Class Action Settlement (“Notice”) that accompanies this Proof of Claim and Release (“Claim Form”) contains the definitions of the defined terms (which are indicated by initial capital letters) used in this Claim Form. The Notice also sets forth the details of the Settlement and the Plan of Allocation by which the settlement proceeds will be distributed to eligible claimants.
In order to become an eligible claimant, you must be a member of the Settlement Class (as defined in Question 6 of the Notice) and you must complete and submit this Claim Form. An electronic version of the Claim Form is available at www.SHGzincAntitrustSettlement.com which is maintained by the Claims Administrator, Angeion Group. Your Claim Form and supporting documentation must be submitted to the Claims Administrator so that it is postmarked by January 28, 2022 or submitted online by 11:59 Eastern time on January 28, 2022. Submission of this Claim Form does not ensure that you will receive any payment from the Settlement; you will only receive a payment if you are entitled to one under the Plan of Allocation described in the Notice and the Court finally approves the Settlement and Plan of Allocation.
Only include on this claim form your purchases of LME U.S. Zinc from a primary zinc producer or Glencore during the period from September 14, 2010 to February 11, 2016 in which you paid the Platts Zinc Midwest Special High Grade premium or similar price premium in the United States. Indirect purchases are not eligible.
TABLE OF CONTENTS
SECTION A – CLAIMANT INFORMATION
SECTION B – GENERAL INFORMATION
SECTION C – INSTRUCTIONS FOR COMPLETING THE PROOF OF CLAIM TABLE AND FOR PROVIDING SUPPORTING DOCUMENTATION
SECTION D – CERTIFICATION AND SIGNATURE
SECTION E – CLAIM FORM CHECKLIST
SECTION A – CLAIMANT INFORMATION
The Claims Administrator will use this information for all communications relevant to this Claim Form. If this information changes, please notify the Claims Administrator in writing. If you are a trustee, executor, administrator, custodian, or other nominee and are completing and signing this Claim Form on behalf of the Claimant, you must attach documentation showing your authority to act on behalf of the Claimant (see Section B.7 of the Claim Form, below).
Section 1 – Claimant Information
Claimant Name *
Street Address *
City *
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces - Africa, Canada, Europe, Middle East
Armed Forces - Americas
Armed Forces - Pacific
American Samoa
Guam
Marshall Islands
Northern Mariana Islands
Puerto Rico
US Virgin Islands
State *
Zip Code *
Last 4 Digits of Tax ID: * (Tax ID is the last 4 digits of the social security number, employer identification number, or taxpayer identification number)
Telephone Number *
Email Address * (If you provide an email address, you authorize the Claims Administrator to use it in providing you with information relevant to this claim.)
Section 2 – Authorized Representative Information
Name of the Person You Would Like the Claims Administrator to Contact Regarding this Claim (if different from the Claimant Name listed above)
Telephone Number
Email Address (If you provide an email address, you authorize the Claims Administrator to use it in providing you with information relevant to this claim.)
* Required Fields
SECTION C – INSTRUCTIONS FOR COMPLETING THE PROOF OF CLAIM TABLE AND FOR PROVIDING SUPPORTING DOCUMENTATION
You must complete the Table below in order to be eligible to share in the Settlement proceeds. You must also provide supporting documentation so that the Claims Administrator can verify your entries. You may provide your supporting documentation in electronic form by following the instructions in Section B.2 above.
The supporting documentation you provide must consist of business records sufficient to support each of your purchases in the Table below, including whether the volumes purchased are in pounds or tons. For purchases from a primary zinc producer other than Glencore Ltd., please provide the full name and address of each producer.
It is preferred, but not required, that this supporting documentation be provided in an Excel spreadsheet or other generally accepted formats such as a comma separated value (CSV) text format. The information should be provided in a clear and self-explanatory manner, including descriptions for each column or field.
PROOF OF CLAIM TABLE
SCHEDULE OF PURCHASES: GENERAL WORKSHEET
Please fill out the chart below listing the amounts purchased (please report the number in pounds) and the purchase totals for Defendant Glencore (if applicable) and/or any other primary zinc producer and the year of the Class Period (September 14, 2010 through February 10, 2016) in which you directly purchased SHG zinc and paid the Platts Zinc Midwest SHG premium or similar price premium in the United States. If you have questions regarding completion of the schedule of purchases, please contact the Claims Administrator by email at info@SHGzincAntitrustSettlement.com or by calling 1-855-967-3548 . INDIRECT PURCHASES ARE NOT ELIGIBLE.
SECTION D – SUPPORTING DOCUMENTATION
Submit your supporting documents below. You may also submit additional documentation later using the "Upload Documentation" tab.
Instructions
Click on the "Choose File" button.
Select a document to upload.
Type a brief description of the document in the "File Description" box (ex: purchase invoice 2/2/2011).
Click the blue "Add File" button.
Make sure the name of the file appears in the box under "File List".
Repeat the same steps to add additional documents.
Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.
Select File for Upload:
File Description:
File List: No Files Selected
SECTION E - CERTIFICATION & SIGNATURE
BY SIGNING AND SUBMITTING THIS CLAIM FORM, CLAIMANT OR CLAIMANT’S REPRESENTATIVE CERTIFIES AS FOLLOWS:
I (we) have read the Notice and this Claim Form.
Claimant is a member of the Settlement Class (as defined in the Settlement Agreement and described in answer to FAQ 6 ) and is not one of the entities or individuals excluded from the Settlement Class (as is also described in the Notice).
Claimant has not submitted a Request for Exclusion (as described in answer to FAQ 13 ).
Claimant has not submitted any other claim covering the same transactions and knows of no other person having done so on its/their/his/her behalf.
Claimant acknowledges that, as of the Effective Date of the Settlement (as defined in the Settlement Agreement and described in answer to FAQ 19 ), it shall be bound to the Release set forth in the Settlement Agreement. Specifically, Claimant as a Releasing Party acknowledges that it will be deemed to have released the Defendants and certain of their related entities and persons (called the “Released Parties”) as follows: Upon the Effective Date and in consideration of payment of the Settlement Amount into the Escrow Account, Releasing Parties shall be deemed to and do completely remise, release, acquit, and forever discharge Released Parties from any and all claims, including Unknown Claims (as defined below), demands, actions, suits, injuries, and causes of action, parens patriae actions, cross-claims, counter-claims, charges, judgments, obligations, debts, setoffs, rights of recovery, liabilities, or damages of any nature, whenever or however incurred (whether actual, punitive, treble, compensatory, or otherwise), including claims for costs, fees, expenses, penalties, and attorneys’ fees, whether class or individual, regardless of whether those claims currently exist, are known, or have matured, that the Releasing Parties, or any of them, ever had, now has, or hereafter can, shall or may have, directly, representatively, derivatively, or in any other capacity against any of the Released Parties, whether state or federal, whether in law or equity or otherwise, that was alleged or could have been alleged in the Action based on, arising out of or relating in any way, in whole or in part, to any conduct, act, or omission alleged in the Action, or could have been alleged in the Action or that forms a factual predicate of the Action, from the beginning of time until the Execution Date, including, without limitation, any such claim under any federal or state antitrust, anti-manipulation, unfair competition, unfair practices, fraud, racketeering, price discrimination, unjust enrichment, unitary pricing or trade practice law (the “Released Claims”). (Please see Section D of the Settlement Agreement for additional information regarding the Release.) And Claimant acknowledges that it shall forever be enjoined from prosecuting any or all of the Released Claims against any of the Released Parties (as defined in the Settlement Agreement and described in answer to FAQ 12 ).
Claimant submits to the jurisdiction of the Court with respect to this Claim Form and for purposes of enforcing the releases set forth in the Settlement Agreement, if approved by the Court.
Claimant agrees to furnish such additional information with respect to this Claim Form as the Claims Administrator or the Court may require; and
Claimant acknowledges that it will be bound by and subject to the terms of any Final Judgment and Order of Dismissal that may be entered by the Court in this Action.
I (WE) CERTIFY, UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE UNITED STATES OF AMERICA, THAT ALL OF THE INFORMATION PROVIDED BY ME (US) ON THIS CLAIM FORM AND ALL SUPPORTING DOCUMENTATION PROVIDED IN CONNECTION WITH THIS CLAIM FORM IS TRUE, CORRECT AND COMPLETE.
Signature of Claimant *
Date
Signature of Authorized Representative Completing Claim Form (if any)
Date
Capacity of Authorized Representative (if other than an individual (e.g. trustee, executor, administrator, custodian or other nominee))
YOUR CLAIM FORM MUST BE POSTMARKED BY JANUARY 28, 2022 OR SUBMITTED ONLINE BY 11:59 PM EASTERN TIME ON JANUARY 28, 2022
You should be aware that it could take a significant amount of time to fully process all Claim Forms. Please notify the Claims Administrator of any change of address.