Must be Postmarked BABY PRODUCTS ANTITRUST LITIGATION SETTLEMENT By or Received No clo The Garden City Group, Inc. Later D tin Or 9017-4979 BBA ——e weseseece MIMD Faxc1-888-476-7153 Emait Questions@babyproductsantitrustsettlement.com ‘Claim Number: Cortrol Number: CLAIM FORM AND RELEASE Your Signed Claim Must be Postmarked, Faxed or Sent Electronically in PDF Format to The Claims Administrator No Later than August 22, 2014 1, WHATTHIS CLAIM FORM CONCERNS ‘This claim form cancams the Amended Seltlerent of two consalideted lawsuits that were fled by two groups cf consumers claiming that Bobies °R” Us kad conspired with certain baby product manufacturers to restict competion in violation of feceral antiust law. Plaintiis essert that this conduct caused you fo pay higher prices at Toys “R" Us and Babies °R” Us for. BatyBjom baby carriers, Britax car seats; Madiaen strolets; Medela Purp In Sle breast pumps; Peg Perego car seats, strllers and high chairs; and all Kids Line products, such a5 atb sets, blankets, valances, sheets, wall decorations, baskets, pilows, pads, hampers, porta aib sels, amps, shelves, stackers, rugs, or mobiles (Settlement Products”. Plains’ daims are cispuied and Defendants deny entering into ary con- Spiredies or engaging in any cther unlawful conduct. The parties have agreed to sel the figation in eu of tial Please read the Full Notice (available at wwwbabyproductsantitrustsettiement.com) carefully before filing out this Form. 2 ELIGIBLE FAYMENTS ‘Youmay be eile lorecover a setfemert payment for each of the following products you purchased at Toys °R” Us or Babies SR’ Us during the time periods ineicated: BabyBjéen baby carriers between February 2, 2000 and April 30, 2005; Britax car seats between Jenvary 1, 1969 and January 31, 2011; Maclaren strollers between October 1, 1999 and January 31, 2041, Medela Pump In Style breast pumps between tly 1, 1999 and January 31, 2011; eg Perego car seats, strolers or high chairs between Jy 1, 1909 and Janvery 31, 2011; andor Al Kids Line products belween January 1, 1999 and Decerrber 31, 2008. ‘You may be eligible lo recover a seltlement payment for all purchases for which you provide a proper claim form and ‘supporting documentation. Reimbursement of valid claims may be reduced ifthe total amount of rroney due to eligible consumers in this Amended Settlement exceeds the lolal amounis available. This is described in greater delal in the Full Nolice avaiable et ‘wanubabyprocuctsantitrustsettlementicom, Inaddtion to the cash payment you may recover the inti distibution of settlement func described above, ifyouile a dim {orm with supporing docurreniation, you may be eligle 1o receive via exnall a coupon for purchases of Defendants’ products at Toys SR’ Us. To be eligible fer his secondary cistibutin, you must () cach or deposit any check youreceive as part ofthe iil disirbution, (i have received less than three times the amount cf calculated damages for which you are digble; and (i) provide a vad exnall ‘adkess. Any coupon that you receive 2s pat of this secondary distribution willbe fully transferrable. 3. HOW YOU CAN QUALIFY FOR AND RECEIVE PAYMENT Unless you previously submitted a valid Claim Form with supporting doourrentation or have been identified from the records cf Babies ‘R’ Us 2 a Class Member, in order io be eligible for and receive any compensation from the settlement, you must. . {lout this Claim Form ints entirely, : ‘sign the vetificaon statement at the end of the Chaim Form, . relum this completed Cleim Fom with your supporting documentation, if any, no later than August 22, 2014, Allicfarmation submitted will be kept confidential ‘QUESTIONS OR NEED HELP? CALL THE CLAIMS ADMINSTRATOR AT 1-888-2926492 CR VISIT WWW.BABYPRODUCTSANTITRUSTSETTLENENT.COM2 (NM 000 cay: State and Zip Code: Country (Other than U.S.): Home Telephone Number: [(—_) - Work Telephone Number: [("_) - Email Address} EART I= BABY PRODUCT PURCHASE INFORMATION ‘You may be entiled to a settlement payment for each ofthe baby products listed above you purchased at Toys ‘R” Us or Babies “R” Us during the time periods indicated. To recover a settlement payment for your purchase(s), you must attach documentation showing your purchase(s) cf the products listed above. Examples of the types cf documents that ‘may constitute Valid documentary procf of purchase include, but are net limited to: receipts, cancelled checks, credit card statements, photograrhs, or corroborating, swom affidavits from two cther people. Itwill be within the discretion of the Claims Administrator to determine what constitutes valid documentary procf cf purchase. In order to allcw the Claims ‘Administrator to verify your claim, you must complete the following chart to the best cf your ability. ‘TO VEW GCG'S PRIVACY NOTICE, PLEASE VISIT HTTP:/WWW.GCGINC.COMPRIVACY ‘QUESTIONS OR NEED HELP? CALL THE CLAIMS ADMINISTRATOR AT 1-888-252-8482 OR VISIT WWWBABYPRODUCTSANTITRUSTSETTLEMENTCOM,3 OME N(CC Date of Purchase Place of Purchase Product Purchased Brand ____ Vol oie YO nO (€G name of marufacire) ya soe id Tea svat) cit ¥ Model Siete Price Brae —____ iy ontre YO NO (i nave oT anTaEa va v Sere —______ ea sre) city Model sia ; | |p, Lot Se Sawa ania) ontine YO nO (eg fame of manufacturer) ya Sore | | Type (ea sre) ciy siete Prive Brand ee rol one YQ nO (ea Tae of rarutacre) ya v See —_____ (ea sve) ciy Model site | hice Bed iol ontre YO NO (Ca rave Tranter) ya Store Type. ——_— Tea svaley aay Model State Price (Aad additional pages, if necessary) ‘QUESTIONS OR NEED HELP? CALL THE CLARMS ACMINISTRATOR AT 1-868-282-8482 OR VISIT WAWBABYPRODUCTS ANTITRUSTSETTLEMENTCOM,‘ A PART Il - VERIFICATION | declare under penalty of perjury of the laws of the United States of America that all the information provided in this Claim Fonm is, to the best of my knowledge, accurate and correct. ‘Signature Date Please keep a copy of your completed Claim Form and copies of any attached documentation for your records, Please mail, fax or email your completed Claim Form, with your proofs of purchase, to: BABY PRODUCTS ANTITRUST LITIGATION SETTLEMENT lo The Garden City Group, Inc. PO Box 9679 Dublin, Otio 43017-4979 1-888-202-8492 Fax:1-888-476-7153 Email: Questions@babyproductsantitrustsettlement.com Your Signed Claim Must be Postmarked, Faxed or Sent Electronically in PDF Format to ‘The Claims Administrator so That It is Postmarked or Received No Later than August 22, 2014. ‘QUESTIONS OR NEED HELP? CALL THE CLAIMS ADMINISTRATOR AT 1-868-282-8482 OR VISIT WWWEABYPRODUCTS ANTITRUSTSETTLEMENTCOM,