Shalikar v. Asahi Beer

Settlement Claim Form

THIS CLAIM FORM MUST BE SUBMITTED NO LATER THAN 05-03-2019

Personal Information
Indicate the Number of Qualifying Asahi Beer Products Purchased between April 5, 2013 and December 20, 2018.
Proof of Purchase

While proof of purchase is not required to submit a Claim Form, the Settlement Administrator has the right to request verification or more information regarding the purchase of the Products for the purpose of preventing fraud. If you do not timely comply or are unable to produce documents or additional information to substantiate the information on this Claim Form if that information of requested of you specifically and the Claim is otherwise not approved, the Settlement Administrator may disqualify your Claim.

Payment
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Sign the Claim Form.

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