Claim Form

To make a claim, you must submit a claim form so that it is received by the Claims Administrator on or before DECEMBER 16, 2016.

> You can obtain a claim form by clicking here.

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 DECEMBER 16, 2016.

The address of the Claims Administrator is:

THE NOTICE COMPANY
NEW HAWAII HEPATITIS CLASS ACTION
PO BOX 778
HINGHAM, MA  02043