Christopher Santiago, Julia Santiago, and Tim Tagle, et al. vs. Eternity Floors d/b/a L.A. Hardwood Flooring, Inc., a California Corporation; et al

Case No. BC644600

Yvette Thor, et al. vs. L.A. Hardwood Flooring, Inc., a California Corporation, d/b/a Eternity Floors; et al

Case No. BC685349

In the Superior Court of the State of California County of Los Angeles

This Claim Form should be filled out online or submitted by mail if you purchased Chinese-made laminate flooring sold by Eternity Flooring between January 1, 2012 and December 31, 2016, and are seeking relief under this Settlement.

Settlement Class Members who seek payment from the Settlement must complete and return this Claim Form. Claim Forms can be completed here on the settlement website, or can be completed and mailed to the Settlement Administrator at:

Eternity Flooring Products Settlement
c/o Settlement Administrator
1650 Arch Street, Suite 2210
Philadelphia, PA 19103

CLAIM FORMS SUBMITTED BY MAIL MUST BE POSTMARKED OR SUBMITTED ONLINE NO LATER THAN APRIL 14, 2020.

CLAIM FORM INSTRUCTIONS

SECTION A: Claimant Information – Provide the contact information for the Class Member who purchased the Chinese-manufactured laminate flooring.

SECTION B – PURCHASED PRODUCTS: You must answer all questions in Section B in order to be entitled to benefits under the Settlement. Benefits are determined based on the information you provide. The Settlement provides benefits to two groups (also called “subclasses”) of Class Members:

Verified Purchaser:
Verified Purchasers are Class Members who can provide Proof of Purchase, such as an invoice, sales receipt or other writing generated by Eternity Flooring or one of their retail distributors evidencing that the Class Member purchased Chinese-manufactured laminate flooring distributed by the Defendant during the Class Period.

Verified Purchasers may elect to receive either a cash benefit or a Store credit Voucher equal to their verified Original Purchase Price.

Other Purchasers:
Other Purchasers are Class Members who cannot provide Proof of Purchase such as an invoice, sales receipt or other writing generated by Eternity Flooring or one of their retail distributors evidencing that the Class Member purchased the Chinese-manufactured laminate flooring distributed by the Defendant during the Class Period but who can provide the following: the name of the retail store and date when they purchased the Chinese-manufactured laminate flooring, proof of payment to that retailer store and a photograph(s) of the Chinese-manufactured laminate flooring.

Other Purchasers shall only be entitled to receive either a Cash Benefit or, a Store-Credit Voucher, either totaling 50% of their verified Original Purchase Price for the Chinese-manufactured laminate flooring.

Note: Both cash and store credit vouchers are subject to adjustment based on participation. See the settlement website for more information.

SECTION C: Certification Under Penalty of Perjury.


SECTION A — CLAIMANT INFORMATION
* Required Fields
SECTION B — PURCHASED PRODUCTS

The actual benefit you will receive will depend upon, among other things, how many Settlement Class Members submit a timely and complete claim form. Cash or store-credit vouchers will be based on your Original Purchase Price and allocated on a pro-rata basis. The final amount each participant receives will not be known until all class members have decided if they will participate in the settlement and after they have selected the cash award or a store-credit voucher award.

Purchase Information

1. Who purchased the Chinese-manufactured laminate flooring? *

2. Please provide the following information regarding your purchase of Chinese-manufactured laminate flooring:

Approx. Date Purchased
(Month & Year)
Name of the Flooring You Purchased (if known) Name of Store or Retailer Where Purchased City and State of Retailer Where Purchased Total Amount you Paid for this Product

3. You must enclose with this claim form ONE of the following two proofs of purchase. Please check which type of proof of purchase you are enclosing: *

OR


Benefit Election

Please select one of the following: *

SECTION C — SUPPORTING DOCUMENTATION

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.

File List: No Files Selected

    SECTION D — CERTIFICATION UNDER PENALTY OF PURJURY

    By signing below, you are submitting to the jurisdiction of the Superior Court of the State of California County of Los Angeles, and are agreeing to the terms of the Release set forth in the Settlement Agreement.

    I declare under penalty of perjury under the laws of the United States and the state where this Claim Form is signed that the information I have supplied in this Claim Form is true and correct to the best of my recollection, and that this form was executed on the date set forth below.

    I understand that all information provided on this Claim Form is subject to verification and that I may be asked to provide supplemental information by the Settlement Administrator before my Claim will be considered complete and valid.

    Your Claim Form has been submitted successfully.

    HOWEVER, it appears one or more of the documents you uploaded were not successfully received. Please see below for which file(s) had errors and log back in to your existing Claim online to re-upload your document(s). Alternatively, you can send your documents with your Submitted Claim ID to the Settlement Administrator by email to: @.com.

    Please print this page for your records.

    Your Claim Details

    Submitted Claim ID:
    Confirmation Code:
    CLAIM INFORMATION
    First Name
    Middle Initial
    Last Name
    Street Address
    Street Address 2
    City
    State
    Zip Code
    Email Address
    Phone Number
    Signature
    Date

    If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at info@ChineseLaminateSettlement.com