Submit a Claim

Claim Form

Claimant Information

Please provide contact information below. You must notify the Settlement Administrator if your contact information changes after you submit this Claim Form.

First Name

Last Name

Address 1

Address 2

City

State

Zip Code

Phone

Claim Information

To be eligible to receive a cash payment, you must prove you are an eligible Class Member by either providing your Spa Pump Recall claim number or Proof of Purchase documentation.

How would you like to prove your eligibility to receive a cash payment?*

I have my Spa Pump, have participated in the recall, and want to provide my Spa Pump Recall Claim Number.I no longer have my Spa Pump and I will provide Proof of Purchase documentation.

Payment Election

Please select one of the following payment options, which will be used should you be eligible to receive a settlement payment. Please remember that the Court in charge of this case still has to decide whether to approve the Settlement. Payments will be made once the Court approves the Settlement and after appeals are resolved. Please be patient.

IMPORTANT NOTES:

For PayPal, Venmo, and Zelle payments, if there are any discrepancies, if the account is no longer active, or if the Settlement Administrator deems that payment cannot or should not be made based on the provided information, the Settlement Administrator will either contact you for clarification or be authorized to default to a Check payment.
If domestic or international payment limits apply to your payment, you may receive more than one transmission or you may default to a Check payment.
Venmo and Zelle payments cannot be made to accounts outside of the United States.
A valid address is required to process payments. Failure to provide a valid address may result in a delay in check issuance or electronic delivery of funds.
Payments by Check will be made out to the Name and mailed to the address on this Claim Form.

Attestation & Signature

By signing below and submitting this Claim Form, I declare under penalty of perjury under the laws of the United States of America that (1) I purchased the Class Product listed above between May 2021 and May 2024, (2) I have already participated in the Spa Pump Recall conducted in cooperation with the Consumer Product Safety Commission, and (3) all of the information on this Claim Form is true and correct to the best of my knowledge.

I understand that my Claim Form may be subject to audit, verification, and Court review.

Signature

Date