Case 4:18-cv-00941-BP Document 126-1 Filed 02/12/20 Page ......Case 4:18-cv-00941-BP Document 135-1...

Case 4:18-cv-00941-BP Document 126-1 Filed 02/12/20 Page 2 of 129

EXHIBIT C-1

CLAIM FORM AND INSTRUCTIONS

Hornbeck, et al. v. Orscheln Farm and Home, LLC, et al.,

Case Number 18-00941-cv-W-BP (W.D. Mo.)

Please read all of the following instructions carefully before filling out your Claim Form.

1. Please review the Long Form Class Notice (the “Notice”) that you received when you

complete your Claim Form. The Long Form Class Notice is available on the settlement website

at [WEBSITE] or by calling the Settlement Administrator at [INSERT SETTLEMENT PHONE

NUMBER].

2. Under the terms of the Settlement in this class action lawsuit, you may be entitled to

relief based on your purchase(s) of the following products during the stated Class Period:

Products Package Size Class Period

MileMaster 303 Tractor

Hydraulic Fluid

3/2 gal. January 23, 2017 to present


Hydraulic Fluid

5 gal. May 25, 2013 to present


Hydraulic Fluid


H-K 303 Tractor Transmission

Hydraulic Fluid

3/2 gal. May 25, 3013 to April 30, 2016


Hydraulic Fluid

5 gal. May 25, 2013 to March 21, 2019

Orscheln Premium 303 Tractor

Hydraulic & Transmission

Fluid

5 gal. September 3, 2014 to August 16, 2017

SuperTech 303 Tractor

Hydraulic Oil

5 gal. February 17, 2016 to February 10,

2018

If you wish to receive relief under the Settlement Agreement, you must timely complete and

submit Part A of the Claim Form to receive a monetary award based on your purchase(s)

of the products listed above (the “303 THF Products”) during the relevant Class Periods.

The Part A monetary award is for reimbursement based on your 303 THF Product purchases and

is estimated to be a minimum of $18 for each 3/2-gallon jug of Product you purchased during the

Class Period, $27 for each 5-gallon bucket, and $200 for each 55-gallon drum.

3. Under the Settlement Agreement, you also may be entitled to a Part B award for

reimbursement for the cost of any repairs, parts, and/or specific equipment damage that you

contend resulted, in whole or in part, from your use of a 303 THF Product during the relevant

Class Period. If you wish to receive this relief, you must timely complete and submit Parts

A and B of the Claim Form. Be sure to attach all supporting documents as well as any further


information you have supporting your claim for additional funds due to alleged equipment

losses, repairs and/or parts purchases.

4. You are not entitled to reimbursement under this Settlement if you were already

reimbursed for your purchases or for repairs, parts, or damage to specific equipment that you

contend was caused by your use of the above listed 303 Tractor Hydraulic Fluid Products during

the Class Period.

5. If you would like an acknowledgment of receipt of your Claim Form, send it by Certified

Mail, Return Receipt Requested.

6. To submit the Claim Form, you must do one of the following: (i) complete an electronic

claim form and submit it via the settlement website at [WEBSITE] on or before [INSERT BAR

DATE]; or (ii) complete a paper Claim Form and send it via fax to [INSERT SETTLEMENT

FAX NUMBER], via United States mail, postage prepaid to [INSERT SETTLEMENT

MAILING ADDRESS], or via e-mail to [INSERT SETTLEMENT E-MAIL ADDRESS] by

[INSERT BAR DATE].

7. Once your Claim Form is received, the Settlement Administrator will review the Claim

Form for compliance. Your claim for monetary relief may be rejected for failure to complete the

information requested in the Claim Form or for failure to provide sufficient supporting

documentation. The Claims Administrator may contact you for additional information.

8. Keep a copy of your completed Claim Form for your records. If your claim is rejected,

the Settlement Administrator will notify you by U.S. Mail or e-mail of the rejection and the

reasons for such rejection.


CLAIM INFORMATION – PART A

Claimant Name: Phone Number:

_____________________________________________ ________________________

Street Address: Email Address:

_____________________________________________ ________________________

City, State, Zip Code:

_____________________________________________



Hydraulic Fluid



Hydraulic Fluid



Hydraulic Fluid



Hydraulic Fluid

3/2 gal. May 25, 3013 to April 30, 2016


Hydraulic Fluid

5 gal. May 25, 2013 to March 21, 2019



Fluid



Hydraulic Oil


2018

List your purchases of any 303 THF Products purchased during the stated Class Period.

Do not list any purchases that you returned to the store after purchase.

Product

Purchased

Date

Purchased

Store (Name and Location) Product Size

(3/2 gal.; 5

gal.; 55 gal.)

Qty. Payment

Method


List the equipment in which you used the Products during the stated Class Period:

Type of Equip. Year Make Model

Pursuant to 28 U.S.C. § 1746, I declare under penalty of perjury the foregoing is true and correct

and that the above-described purchases were not for the purpose of resale to others.

Signature: _______________________________ Date: ____________________

Print Name: ____________________________


CLAIM INFORMATION – PART B

Complete Part B of this Claim Form only if you seek reimbursement for any repairs, parts,

and/or specific equipment damage that you contend resulted, in whole or in part, from your

use of the following products during the stated Class Period:



Hydraulic Fluid



Hydraulic Fluid



Hydraulic Fluid



Hydraulic Fluid

3/2 gal. May 25, 3013 to April 30, 2016


Hydraulic Fluid

5 gal. May 25, 2013 to March 21, 2019



Fluid



Hydraulic Oil


2018

1. Plaintiffs allege that use of the 303 Tractor Hydraulic Fluid products listed above (“the

303 THF Products”) can cause damage to tractors and other equipment in which it is used.

Defendants deny these allegations and deny that the 303 THF Products cause damage to tractors

or other equipment. As part of this Class Settlement, Class Members are entitled to submit

claims for reimbursement for repairs, parts, and specific equipment damage that the Class

Member contends resulted, in whole or in part, from use of these Products during the Class

Period.

2. The repairs, parts, and specific equipment damage may include, without limitation,

repairs, parts and equipment purchases required to remedy damage to seals, pumps, filters, gears,

clutch and brake systems, power take-off (PTO) systems and losses incurred as a result of

equipment being damaged beyond reasonable repair as a result of damage and increased or

excessive wear resulting from use of the 303 THF Products. Such increased wear and damage

may include, without limitation, scratching, corrosive wear, rippling, ridging, pitting, spalling

and scoring of the gears and metal components, seal damage, spiral gear damage, metal abrasion,

corrosion, surface wear, clutch wear and breakage, wet brake damage, pump failure, leakage, and

damage from deposits, sludging and thickening.

3. Consequential or other losses (such as down time) that might have been incurred as a

result of equipment being damaged are not recoverable under the Settlement Agreement. Other

examples of damage and loss not covered by this Settlement include damage caused by


negligence of the owner/operator of the equipment; damage caused by the use of a 303 THF

Product prior to the start date of the relevant Class Period; damage caused by the use of any

tractor hydraulic product not listed above; and damage caused by normal wear and tear. If the

damage to equipment resulted in part from any of these causes and in part from the 303 THF

Product’s use, then a claim would be appropriate.

4. To recover losses from this Repairs/Parts/Specific Equipment Damage portion

of the Settlement Fund, you must provide the information requested in #8, below. You must also

submit the cost of the repairs and/or parts as well as the date(s) said repair(s) were done and/or

parts purchased. If the equipment has not been repaired, you may submit documentation

regarding the damage to the equipment and the estimated cost of such repair.

5. If you contend the equipment was damaged beyond reasonable repair, you must indicate

that in response to question 8.g. and also then respond to questions 8.h. through 8.m. You should

submit a description of the damage and the reasons you contend repairs were not reasonable,

justified or feasible.

6. If you have documentation supporting your claim and/or the amounts sought for the

repairs, parts, or specific equipment damage, you must submit it with your Claim Form. Such

documentation includes, but is not limited to, receipts, invoices, credit card statements, bank

statements, cancelled checks, equipment and/or damages parts photographs, and/or sworn

statements from you or other witnesses to the claimed damage or repair.

7. In the event there are more valid claims than funds available, repair, parts, and specific

equipment damage claims will be reimbursed pro rata based on the amount of each Qualified

Settlement Class Member’s valid claim for repairs, parts, and specific equipment damage.

8. For each piece of equipment that you contend required a repair or parts purchase or

suffered equipment loss due in whole or in part to your use of a 303 THF Product during the

Class Period, please provide the following information:

a. Identify the piece of equipment that you contend required a repair or parts or was

damaged beyond reasonable repair due in whole or in part to your use of a 303 THF Product

during the Class Period:

Equipment:__________________________________________________

Make/Model/Year:____________________________________________

b. Describe the repair(s), parts, or specific equipment damage that you claim

resulted from your use of a 303 THF Product:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_____________________


c. When did the repairs, parts purchase, or specific equipment damage occur?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

d. What was the cost of the repairs or parts purchase and/or value of the specific

equipment damage that occurred?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

e. For what purpose was the equipment being used when it required repairs, parts, or

sustained damage?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

f. Describe generally how you maintained the equipment:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

g. Do you claim that your equipment was damaged beyond repair?

Yes:___ No:____

If your answer to question 8.g. is yes, please also respond to the following questions f.

through k, below. If your answer to question 8.g., is no, you may skip to question 9.

h. Identify the piece of equipment that you contend was damaged beyond reasonable

repair due in whole or in part to your use of a 303 THF Product during the Class Period:

Equipment:__________________________________________________

Make/Model/Year:____________________________________________

i. When was the equipment damaged beyond reasonable repair?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

j. Did you attempt to repair the equipment? Yes:___ No:____


k. If your answer to question 8.h is yes, please describe in detail the attempted repair

and the costs of the attempted repair:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

l. If your answer to question 8.h is no, please describe in detail why you did not

attempt to repair the equipment:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

m. Describe in detail why repairing the equipment was not reasonable, justifiable, or

feasible:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

9. Have you received compensation for your purchase of any 303 tractor hydraulic fluid

product or for any repairs, parts, specific equipment damage or total equipment loss relating to

the alleged deceptive marking of or alleged damage caused by any 303 tractor hydraulic fluid

product?

Yes:___ No:___

10. If your answer to Question 9 was yes, please list the 303 products and/or any repairs,

parts, specific equipment damage or total equipment loss for which you were reimbursed:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

Pursuant to 28 U.S.C. § 1746, I declare under penalty of perjury the foregoing is true and correct.

Signature: ____________________ Date: ____________________


Print Name: _____________________________

If you have any questions about this form or the Settlement, please contact the Settlement

Administrator

at:

Settlement Administrator

[INSERT SETTLEMENT MAILING ADDRESS]

[INSERT SETTLEMENT PHONE NUMBER]

[INSERT SETTLEMENT WEBSITE]

You may also contact Class Counsel at:

Thomas V. Bender

Horn Aylward & Bandy, LLC

2600 Grand Boulevard, Ste. 1100

Kansas City, MO 64108

(816) 421-0700 (phone)

(816) 421-0899 (fax)

[email protected]

Please do not contact Defendants, the Court, or the Court Clerk’s Office about the

Settlement.


EXHIBIT C-2

PART B CLAIM FORM AND INSTRUCTIONS

Hornbeck, et al. v. Orscheln Farm and Home, LLC, et al.,


Please read all of these instructions carefully before filling out your Part B Claim Form.

1. Please review the Long Form Class Notice (the “Notice”) and the Mailed Class Notice

with Purchase Data that you received when you complete your Claim Form. The Long Form

Class Notice is available on the settlement website at [WEBSITE] or by calling the Settlement

Administrator at [INSERT SETTLEMENT PHONE NUMBER].

2. Under the terms of the Settlement in this class action lawsuit, you may be entitled to

relief based on your purchase(s) of the following products during the stated Class Period:



Hydraulic Fluid



Hydraulic Fluid



Hydraulic Fluid



Hydraulic Fluid

3/2 gal. May 25, 3013 to April 30, 2016


Hydraulic Fluid

5 gal. May 25, 2013 to March 21, 2019



Fluid



Hydraulic Oil


2018

3. IF your purchases during the Class Period of the products listed above (“303 THF

Products”) are accurately set forth in the Mailed Class Notice with Purchase Data, you will

receive your Purchase Price Relief award based on those listed purchase(s) of the 303 THF

Products automatically and do not need to submit Part A of the Claim Form. Note that the

Purchase Data only reflects purchases of Orscheln Premium 303 Tractor Hydraulic &

Transmission Fluid and MileMaster 303 Tractor Hydraulic Fluid from Orscheln Farm and Home,

LLC during the time period of September 3, 2014 to August 16, 2017.

4. IF your purchases of the 303 THF Products during the Class Period are not

accurately or completely set forth in the Mailed Class Notice with Purchase Data, you may

complete and submit a Request for Correction Form. If you purchased MileMaster 303 Tractor

Hydraulic Fluid from Orscheln after August 16, 2017, those purchases are not reflected in this

Mailed Class Notice with Purchase Data, and you will need to complete and submit a Request for


Correction Form in order for those purchases to be considered. Also, if you purchased any of the

303 THF Products from retailers other than Orscheln Farm and Home, LLC, those purchases are

not reflected in this Mailed Class Notice with Purchase Data, and you will need to complete and

submit a Request for Correction Form in order for those purchases to be considered. The Request

for Correction Form can also be completed and submitted online at the settlement website at

[INSERT SETTLEMENT WEBSITE].

5. Under the Settlement Agreement, your purchase price reimbursement shall be based on

your 303 THF Product purchases. That award is estimated to be a $18 for each 3/2-gallon jug of

Product you purchased during the Class Period, $27 for each 5-gallon bucket, and $200 for each

55-gallon drum.

6. Under the Settlement Agreement, you also may be entitled to a Part B award for

reimbursement for the cost of any repairs, parts, and/or specific equipment damage that you

contend resulted, in whole or in part, from your use of a 303 THF Product during the relevant

Class Period. If you wish to receive this relief, you must timely complete and submit this

Part B Claim Form. You must submit this Part B Claim Form to be eligible for the cost of

any repairs, parts, and specific equipment damage relief, EVEN IF your purchases were

accurately set forth in the Mailed Class Notice with Purchase Data. Be sure to attach all

supporting documents as well as any further information you have supporting your claim for

additional funds due to alleged equipment losses, repairs and/or parts purchases. This Part B

Claim Form can also be completed and submitted online at the settlement website at [INSERT

SETTLEMENT WEBSITE].

7. You are not entitled to reimbursement under this Settlement if you were already

reimbursed for your purchases or for repairs, parts, or damage to specific equipment that you

contend was caused by your use of the above listed 303 Tractor Hydraulic Fluid Products during

the Class Period.

8. If you would like an acknowledgment of receipt of your Part B Claim Form, send it by

Certified Mail, Return Receipt Requested.

9. To submit the Part B Claim Form, you must do one of the following: (i) complete an

electronic claim form and submit it via the settlement website at [WEBSITE] on or before

[INSERT BAR DATE]; or (ii) complete a paper Claim Form and send it via fax to [INSERT

SETTLEMENT FAX NUMBER], via United States mail, postage prepaid to [INSERT

SETTLEMENT MAILING ADDRESS], or via e-mail to [INSERT SETTLEMENT E-MAIL

ADDRESS] by [INSERT BAR DATE].

10. Once your Part B Claim Form is received, the Settlement Administrator will review the

Claim Form for compliance. Your claim for monetary relief may be rejected for failure to

complete the information requested in the Claim Form or for failure to provide sufficient

supporting documentation. The Claims Administrator may contact you for additional

information.


11. Keep a copy of your completed Part B Claim Form for your records. If your claim is

rejected, the Settlement Administrator will notify you by U.S. Mail or e-mail of the rejection and

the reasons for such rejection.


CLAIM INFORMATION – PART B

Claimant Name: Phone Number:

_____________________________________________ ________________________

Street Address: Email Address:

_____________________________________________ ________________________

City, State, Zip Code:

_____________________________________________

Complete Part B of this Claim Form only if you seek reimbursement for any repairs, parts,

and/or specific equipment damage that you contend resulted, in whole or in part, from your

use of the following products during the stated Class Period:



Hydraulic Fluid



Hydraulic Fluid



Hydraulic Fluid



Hydraulic Fluid

3/2 gal. May 25, 3013 to April 30, 2016


Hydraulic Fluid

5 gal. May 25, 2013 to March 21, 2019



Fluid



Hydraulic Oil


2018

1. Plaintiffs allege that use of the 303 Tractor Hydraulic Fluid products listed above (“the

303 THF Products”) can cause damage to tractors and other equipment in which it is used.

Defendants deny these allegations and deny that the 303 THF Products cause damage to tractors

or other equipment. As part of this Class Settlement, Class Members are entitled to submit

claims for reimbursement for repairs, parts, and specific equipment damage that the Class

Member contends resulted, in whole or in part, from use of these Products during the Class

Period.

2. The repairs, parts, and specific equipment damage may include, without limitation,

repairs, parts and equipment purchases required to remedy damage to seals, pumps, filters, gears,

clutch and brake systems, power take-off (PTO) systems and losses incurred as a result of

equipment being damaged beyond reasonable repair as a result of damage and increased or

excessive wear resulting from use of the 303 THF Products. Such increased wear and damage


may include, without limitation, scratching, corrosive wear, rippling, ridging, pitting, spalling

and scoring of the gears and metal components, seal damage, spiral gear damage, metal abrasion,

corrosion, surface wear, clutch wear and breakage, wet brake damage, pump failure, leakage, and

damage from deposits, sludging and thickening.

3. Consequential or other losses (such as down time) that might have been incurred as a

result of equipment being damaged are not recoverable under the Settlement Agreement. Other

examples of damage and loss not covered by this Settlement include damage caused by

negligence of the owner/operator of the equipment; damage caused by the use of a 303 THF

Product prior to the start date of the relevant Class Period; damage caused by the use of any

tractor hydraulic product not listed above; and damage caused by normal wear and tear. If the

damage to equipment resulted in part from any of these causes and in part from the 303 THF

Product’s use, then a claim would be appropriate.

4. To recover losses from this Repairs/Parts/Specific Equipment Damage portion

of the Settlement Fund, you must provide the information requested in #8, below. You must also

submit the cost of the repairs and/or parts as well as the date(s) said repair(s) were done and/or

parts purchased. If the equipment has not been repaired, you may submit documentation

regarding the damage to the equipment and the estimated cost of such repair.

5. If you contend the equipment was damaged beyond reasonable repair, you must indicate

that in response to question 8.g. and also then respond to questions 8.h. through 8.m. You should

submit a description of the damage and the reasons you contend repairs were not reasonable,

justified or feasible.

6. If you have documentation supporting your claim and/or the amounts sought for the

repairs, parts, or specific equipment damage, you must submit it with your Claim Form. Such

documentation includes, but is not limited to, receipts, invoices, credit card statements, bank

statements, cancelled checks, equipment and/or damages parts photographs, and/or sworn

statements from you or other witnesses to the claimed damage or repair.

7. In the event there are more valid claims than funds available, repair, parts, and specific

equipment damage claims will be reimbursed pro rata based on the amount of each Qualified

Settlement Class Member’s valid claim for repairs, parts, and specific equipment damage.

8. For each piece of equipment that you contend required a repair or parts purchase or

suffered equipment loss due in whole or in part to your use of a 303 THF Product during the

Class Period, please provide the following information:

a. Identify the piece of equipment that you contend required a repair or parts or was

damaged beyond reasonable repair due in whole or in part to your use of a 303 THF Product

during the Class Period:

Equipment:__________________________________________________

Make/Model/Year:____________________________________________


b. Describe the repair(s), parts, or specific equipment damage that you claim

resulted from your use of a 303 THF Product:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

_____________________

c. When did the repairs, parts purchase, or specific equipment damage occur?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

d. What was the cost of the repairs or parts purchase and/or value of the specific

equipment damage that occurred?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

e. For what purpose was the equipment being used when it required repairs, parts, or

sustained damage?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

f. Describe generally how you maintained the equipment:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

g. Do you claim that your equipment was damaged beyond repair?

Yes:___ No:____

If your answer to question 8.g. is yes, please also respond to the following questions f.

through k, below. If your answer to question 8.g., is no, you may skip to question 9.

h. Identify the piece of equipment that you contend was damaged beyond reasonable

repair due in whole or in part to your use of a 303 THF Product during the Class Period:

Equipment:__________________________________________________

Make/Model/Year:____________________________________________


i. When was the equipment damaged beyond reasonable repair?

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

j. Did you attempt to repair the equipment? Yes:___ No:____

k. If your answer to question 8.h is yes, please describe in detail the attempted repair

and the costs of the attempted repair:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

l. If your answer to question 8.h is no, please describe in detail why you did not

attempt to repair the equipment:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

m. Describe in detail why repairing the equipment was not reasonable, justifiable, or

feasible:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

9. Have you received compensation for your purchase of any 303 tractor hydraulic fluid

product or for any repairs, parts, specific equipment damage or total equipment loss relating to

the alleged deceptive marking of or alleged damage caused by any 303 tractor hydraulic fluid

product?

Yes:___ No:___

10. If your answer to Question 9 was yes, please list the 303 products and/or any repairs,

parts, specific equipment damage or total equipment loss for which you were reimbursed:

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________


Pursuant to 28 U.S.C. § 1746, I declare under penalty of perjury the foregoing is true and correct.

Signature: ____________________ Date: ____________________

Print Name: _____________________________

If you have any questions about this form or the Settlement, please contact the Settlement

Administrator

at:

Settlement Administrator

[INSERT SETTLEMENT MAILING ADDRESS]

[INSERT SETTLEMENT PHONE NUMBER]

[INSERT SETTLEMENT WEBSITE]

You may also contact Class Counsel at:

Thomas V. Bender

Horn Aylward & Bandy, LLC

2600 Grand Boulevard, Ste. 1100

Kansas City, MO 64108

(816) 421-0700 (phone)

(816) 421-0899 (fax)

[email protected]

Please do not contact Defendants, the Court, or the Court Clerk’s Office about the

Settlement.


- 2 -

Company, Inc., Mid-States Distributing Company, Inc., and/or other retailers at any

point in time in the following package sizes during the following periods: (1) 3/2 gal.

from May 25, 2013 to April 30, 2016; (2) 5 gal. from May 25, 2013 to March 21,

2019;

o Orscheln Premium 303 Tractor Hydraulic & Transmission Fluid purchased from Orscheln Farm and Home, LLC at any point in time from September 3, 2014 to

August 16, 2017; and,

o CITGO-manufactured SuperTech 303 Tractor Hydraulic Oil in the United States from Walmart Inc. and/or other retailers at any point in time from February 17,

2016 to February 10, 2018.

• Defendants deny all of the allegations made by Plaintiffs in the lawsuit and deny that they did anything wrong. Defendants further state that the labels for these 303 Tractor Hydraulic Fluid

Products were truthful, appropriate, and adequate in all respects and that the 303 Tractor

Hydraulic Fluid Products do not cause damage to tractors or equipment. Defendants further

believe that they have, at all times, complied with applicable federal and state laws.

• If you are an eligible member of the Settlement Class, the Proposed Settlement may automatically provide you with a cash award calculated based on your purchases of the 303

Tractor Hydraulic Fluid Products during the Class Period, if Defendants have records of your

purchase history. That award is estimated to be 100% of the amount you paid for the 303

Tractor Hydraulic Fluid Products during the Class Period, based on the products’ average sales

price. If Orscheln Farm and Home, LLC had records of your purchase history, your combined

purchases of Orscheln Premium 303 Tractor Hydraulic & Transmission Fluid and MileMaster

303 Tractor Hydraulic Fluid from Orscheln during the time period of September 3, 2014 to

August 16, 2017 will be reflected in this Mailed Class Notice with Purchase Data.

How to Recover Purchase Price Relief

• If your purchase history is reflected in this Mailed Class Notice with Purchase Data and if you wish to receive only this Purchase Price Relief award, you do not have to do anything as long

as the information regarding your purchases of the 303 Tractor Hydraulic Fluid Products

during the Class Period are included with this Mailed Class Notice with Purchase Data is

accurate.

How to Revise Purchase History

• If you are an eligible member of the Settlement Class, you may complete and submit the enclosed Request for Correction Form if this Mailed Class Notice with Purchase Data has

information regarding your purchase(s) of the 303 Tractor Hydraulic Fluid Products that you

believe are wrong or incomplete. If you purchased MileMaster 303 Tractor Hydraulic Fluid

from Orscheln after August 16, 2017, those purchases are not reflected in this Mailed Class

Notice with Purchase Data, and you will need to complete and submit a Request for Correction

Form in order for those purchases to be considered. Also, if you purchased any of the 303


- 3 -

THF Products from retailers other than Orscheln Farm and Home, LLC, those purchases are

not reflected in this Mailed Class Notice with Purchase Data, and you will need to complete

and submit a Request for Correction Form in order for those purchases to be considered. The

Request for Correction Form can also be completed and submitted online at the settlement

website at [INSERT SETTLEMENT WEBSITE].

How to Recover for Repairs, Parts, Specific Equipment Damage

• As part of this Class Settlement, Settlement Class Members are entitled to submit claims for reimbursement for the costs of any repairs, parts, and specific equipment damage that the

Settlement Class Member contends resulted from, in whole or in part, the use of the specified

303 Tractor Hydraulic Fluid Products during the Class Period (i.e., “Repairs/Parts/Specific

Equipment Damage”). The “Repairs/Parts/Specific Equipment Damage Claims Review

Process” is the process for reviewing and paying claims made by Settlement Class Members

for the additional repairs, parts, and specific equipment damage the Settlement Class Member

contends resulted from, in whole or in part, the use of the 303 Tractor Hydraulic Fluid Products

during the Class Period and is available at [WEBSITE].

• Such losses may include, without limitation, repairs, parts and equipment purchases required to remedy damage to seals, pumps, filters, gears, clutch and brake systems, power take-off

(PTO) and losses incurred as a result of equipment being damages beyond reasonable repair as

a result of damage and increased or excessive wear. Such increased wear and damage may

include, without limitation, scratching, corrosive wear, rippling, ridging, pitting, spalling and

scoring of the gears and metal components, seal damage, spiral gear damage, metal abrasion,

corrosion, surface wear, clutch wear and breakage, wet brake damage, pump failure, leakage,

and damage from deposits, sludging and thickening.

• Consequential or other losses (such as down time) that might have been incurred as a result of equipment being damaged are not recoverable under this Settlement Agreement. Other

examples of damage and loss not covered by the Proposed Settlement include damage caused

by negligence of the owner/operator of the equipment; damage caused by the use of a Product

prior to the start date of the Class Period; damage caused by the use of any 303 product not

listed above; damage caused by normal wear and tear; and damages or losses of any kind other

than the damage to or loss of a specific piece of equipment. If the damage to equipment

resulted in part from any of these causes and in part from the 303 THF Product’s use, then that

damage is recoverable.

• To be eligible to recover for repairs, parts, and specific equipment damage, you must provide the information requested on the enclosed Part B Claim Form, which includes narrative

information describing the equipment malfunction, repairs and/or parts purchases as necessary

to fully describe what occurred and what repair/parts or other actions were required for your

equipment. You must also submit the cost of the repairs and/or parts as well as the date said

repairs were done and/or parts purchased. If you have documentation supporting your claim

and/or the amounts sought for repairs, parts, or specific equipment damage, you must submit

it with your Claim Form. The Part B Claim Form can also be completed and submitted online

at the settlement website at [INSERT SETTLEMENT WEBSITE].


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• If the equipment was damaged beyond reasonable repair or has not been repaired, you must indicate that in response to Question 8.g. on the Part B Claim Form and also then respond to

Questions 8.h. through 8.m. You should submit a description of the damage and the reasons

you contend repairs were not reasonable, justified or feasible.

You are not entitled to reimbursement under this Settlement if you were already reimbursed for

your purchases or for repairs, parts, or damage to specific equipment that you contend was

caused by your use of the above listed 303 Tractor Hydraulic Fluid Products during the Class

Period.

YOUR RIGHTS AND CHOICES IF YOU ARE A MEMBER OF THE CLASS:


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Hornbeck, et al. v. Orscheln Farm and Home, LLC, et al.


SETTLEMENT CLASS MEMBER PURCHASE DATA DURING THE CLASS PERIOD

THE 303 TRACTOR HYDRAULIC FLUID PRODUCT PURCHASE INFORMATION FOR

___________________ DURING THE CLASS PERIOD IS AS FOLLOWS:

Total 5-gallon THF Product Purchased: _____ Distribution Amount: $________

▪ (This includes purchases of Orscheln Premium 303 and MileMaster 303from Orscheln Farm and Home, LLC during the time period of

September 3, 2014 to August 16, 2017.)

TOTAL DISTRIBUTION AMOUNT TO BE PAID: $____________

If you believe this information does not accurately set forth your purchases of the specified 303

THF Products during the Class Period, you may timely complete and submit the enclosed Request

for Correction Form, which is also available for completion at the settlement website at

________________.

If you purchased MileMaster 303 Tractor Hydraulic Fluid from Orscheln after August 16, 2017,

those purchases are not reflected in this Mailed Class Notice with Purchase Data, and you will

need to complete and submit a Request for Correction Form in order for those purchases to be

considered. Also, if you purchased any of the 303 THF Products from retailers other than Orscheln

Farm and Home, LLC, those purchases are not reflected in this Mailed Class Notice with Purchase

Data, and you will need to complete and submit a Request for Correction Form in order for those

purchases to be considered.


Case 4:18-cv-00941-BP Document 126-1 Filed 02/12/20 Page ......Case 4:18-cv-00941-BP Document 135-1...

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