In Re: Monsanto Class Action Settlement

City of Long Beach, et al. v. Monsanto Company, et al.

United States District Court, Central District of California - Western Division

Case No. 2:16-cv-03493-FMO-AS

All Settlement Class Members received a mailed copy of the Notice of Pendency of Class-Action Proposed Settlement and Court-Approved Hearing. This mailing included a unique User ID and Confirmation Code which you will need to access this Application. Please refer that mailing for your login credentials and contact the Settlement Administrator if you require confirmation of credentials.

Please enter the User ID and Confirmation Code exactly as it appears on the Notice:

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If you did not receive a personalized Notice in the mail or via email, click below to complete a Claim Form.

Special Needs Fund - Part B Application



Instructions and Information
Please fill out this Special Needs Fund - Part B - Significant Benefit or Cost Allocation Application to the best of your knowledge and the knowledge of the Class Member. Please submit your completed application no later than 1 year and 14 days after the Settlement Administrator’s mailing of Monitoring Fund Payments. Late applications will not be considered by the Special Master. Litigating Entities that do not timely return a completed application forfeit any right to Part B funds.
Please attach no more than twenty-five (25) pages of supporting documentation and evidence of your summary description, past and future costs and expenses, and other important factors and information that may be relevant to the Special Master’s allocation. Only the first 25 pages submitted will be considered by the Special Master.
For any questions about this application or process, you may contact Lead Class Counsel Scott Summy, John Fiske, or Carla Burke of Baron & Budd, P.C., at PCBClassAction@BaronBudd.com. For technical questions related to this application, please contact the Settlement Administrator at info@pcbclassaction.com.


1. SETTLEMENT CLASS MEMBER INFORMATION (REQUIRED*)

2. SIGNIFICANT BENEFIT

2.1. Please describe the Class Member’s actions or work resulting in a significant regional, state, or national benefit regarding PCB contamination related to stormwater. The Class Member may continue this summary by attaching no more than two (2) pages typed, 14-point font, entitled “Part B- Significant Benefit.” (limit 2,500 characters)



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    3. SIGNIFICANT COST

    3.1. Please describe the Class Member’s additional cost or expense, which is not covered by the Monitoring Fund, TMDL Fund, Sediment Fund, or Special Needs Part A Fund, resulting from PCB contamination related to stormwater. The Class Member may continue this summary by attaching no more than two (2) pages typed, 14-point font, entitled “Part B- Significant Cost.” (limit 2,500 characters)



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      4. SPECIAL NEEDS FUND - PART B REQUEST

      4.1. Please provide a total Part B award requested by the Class Member:


      5. DECLARATION

      I hereby declare under penalty of perjury under the laws of the state of that the information within this application and its attachments are true and correct to the best of my knowledge.





      6. Supplemental Documentation Upload

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        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: info@HannaSettlement.com.

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        Your Claim Details

        Submitted Claim ID:
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        You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
        CLAIM INFORMATION
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        Signed By
        Signed At
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