A&W Concentrate Company Settlement Claim Form
This file contains the settlement claim form for LaShawn Sharpe v. A&W Concentrate Company. It provides information on how to claim refunds for A&W Root Beer and Cream Soda purchases made between specific dates. This important document is essential for eligible consumers to recover part of their purchase costs.
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How do I fill this out?
To fill out this claim form, start by providing your personal information in the Claimant Information section. Next, choose the appropriate option based on your proof of purchase status. Be sure to attach any required documentation before submission.

How to fill out the A&W Concentrate Company Settlement Claim Form?
1
Read the instructions carefully.
2
Fill in your personal information.
3
Select the option that applies to your purchase.
4
Attach proof of purchase if applicable.
5
Submit the completed form by the deadline.
Who needs the A&W Concentrate Company Settlement Claim Form?
1
Consumers who purchased A&W Root Beer products between February 7, 2016, and June 2, 2023 need this form to claim their refunds.
2
Individuals without proof of purchase who still qualify can submit this form for a basic refund.
3
Shoppers who bought these products for personal use and not for resale must ensure they fill out this form correctly.
4
Residents of New York who fall under the class membership are eligible to claim compensation.
5
Anyone who wants to receive their rightful refunds and ensure compliance with legal settlements requires this form.
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What are the instructions for submitting this form?
To submit this form, complete it with accurate information and ensure all necessary fields are filled. You can submit the form online at www.rootbeerandcreamsodasettlement.com or by mailing it to the following address: Sharpe v. A&W Concentrate Co., c/o Kroll Settlement Administration LLC, P.O. Box 225391, New York, NY 10150-5391. Remember to postmark your physical submissions by October 18, 2023, to ensure eligibility.
What are the important dates for this form in 2024 and 2025?
Important dates for this claim form include: February 7, 2016 - Start of purchase eligibility; June 2, 2023 - End of purchase eligibility; October 18, 2023 - Claim submission deadline.

What is the purpose of this form?
The purpose of this form is to enable consumers to claim partial refunds for eligible purchases made from A&W Concentrate Company. It serves as a vital document in the legal settlement for LaShawn Sharpe v. A&W Concentrate Company. This form ensures that consumers can receive compensation for purchases made within the specified time frame.

Tell me about this form and its components and fields line-by-line.

- 1. First Name: Input your first name.
- 2. Last Name: Input your last name.
- 3. Address1: Enter your primary address.
- 4. Address2: Optional field for secondary address information.
- 5. City: Provide your city of residence.
- 6. State: Select or enter your state.
- 7. Zip Code: Input your postal code.
- 8. Telephone Number: Enter your phone number.
- 9. Email Address: Provide a valid email for correspondence.
What happens if I fail to submit this form?
If you fail to submit this form by the deadline, you may forfeit your right to claim any refunds. It is important to submit your claims on time to ensure your eligibility. Always keep a copy of your submission for your records.
- Missed Deadlines: Not submitting by October 18, 2023, could disqualify your claim.
- Ineligibility for Refunds: Failure to submit may result in losing your chance to receive any refunds.
How do I know when to use this form?

- 1. Product Purchase: When you have purchased one or more Challenged Products.
- 2. Claiming Refund: When you seek a refund as part of the legal settlement.
Frequently Asked Questions
How do I fill out the claim form?
Start by entering your personal details and select your purchase option. Be sure to attach any proof of purchase if applicable.
What if I don't have proof of purchase?
You can still submit a claim by selecting the option for those without proof.
When is the submission deadline?
All claims must be submitted by October 18, 2023.
Can I edit the form before submission?
Yes, you can edit the PDF using PrintFriendly's editing tools.
How do I submit my claim?
You can submit your claim online or by mailing it to the designated address.
What happens if I submit my claim late?
Late submissions may not be accepted and could lead to forfeiting any potential benefits.
Is there a maximum refund amount?
Yes, you may receive up to $25 based on your purchases and proof of purchase.
How can I contact support if I have questions?
You can reach out to the claims administrator for assistance with your questions.
Where can I find the list of Challenged Products?
The list is provided within the claim form itself.
What should I do if I made a mistake on my form?
You can edit the PDF to correct any mistakes before submitting.
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