Mayhew, et. al v. KAS Direct, LLC Claim Form Instructions INSTRUCTIONS FOR COMPLETING THE CLAIM FORM If you believe you are an eligible Settlement Class Member and you wish to apply for a Settlement benefit, you must complete and submit a Claim Form. Please read the full Class Notice available at www.babyganicssettlement.com carefully before completing a Claim Form. You may submit your Claim Form online at the Settlement website or by completing the enclosed Claim Form and mailing it to the Settlement Administrator: ONLINE: Visit the Settlement website at: www.babyganicssettlement.com and submit your claim online. MAIL: Babyganics Settlement Administrator, 1650 Arch Street, Suite 2210, Philadelphia, PA 19103 If you submit your Claim Form online, you must do so on or before October 29, 2018. If you are mailing your Claim Form, first-class United States Mail, it must be postmarked no later than October 29, 2018. If you have questions about this Claim Form, please visit the website at www.babyganicssettlement.com, or contact the Settlement Administrator via email: info@babyganicssettlement.com or toll-free at 1-888-332-0279. CLAIM FORM REMINDER CHECKLIST Before submitting this Claim Form, please make sure you: 1. Complete all fields in Section A (Name and Contact Information) of this Claim Form. 2. List all of the Babyganics Products purchased in Section B of this Claim Form. A list of Babyganics Products is included with this Claim Form. You may also attach a separate sheet if more space is necessary. 3. YOU MUST sign the Attestation under penalty of perjury in Section C of this Claim Form. 4. Include copies of your Proof of Purchase documentation that you are submitting in support of your Claim Form. Do not send original documents. Please keep a copy of your Claim Form for your records.
Your claim must be postmarked by: October 29, 2018 Mayhew, et. al v. KAS Direct, LLC Claim Form BBG CF Page 1 SECTION A: NAME AND CONTACT INFORMATION Provide your name and contact information below. It is your responsibility to notify the Settlement Administrator of any changes to your contact information after the submission of your Claim Form. First Name Last Name Street Address City State Zip Code Phone Number E-Mail Address SECTION B: BABYGANICS PRODUCT PURCHASE VERIFICATION Provide the following information regarding Purchases of Babyganics Products you made during the Class Period and indicate which Purchases you are attaching Proof of Purchase documentation. Proof of Purchase means a valid receipt or other documentation reflecting a purchase of a specific Covered Product during the Class Period. There is no Product Limit for Products for which Proof of Purchase is provided. Maximum of 8 Products without Proof of Purchase. Limit 1 Claim Form per Household. Product Code Babyganics Product # Products Purchased Approximate Date(s) of Purchase(s) (MM/YYYY) Proof of Purchase Attached? 001 EXAMPLE: FOAMIN FUN SHAMPOO & BODY WASH 1 01/2018 YES YOU MUST COMPLETE AND RETURN THIS PAGE OF THE CLAIM FORM
Your claim must be postmarked by: October 29, 2018 Mayhew, et. al v. KAS Direct, LLC Claim Form BBG CF Page 2 SECTION C: ATTESTATION UNDER PENALTY OF PERJURY I declare, under penalty of perjury, that the information in the Claim Form is true and correct to the best of my knowledge, and that I purchased the Covered Product(s) claimed above in the United States during the Class Period for personal or household use and not for resale. I understand that my Claim Form may be subject to audit, verification, and Court review. Neither myself nor anyone from my Household has previously submitted a Claim Form in this Settlement. Signature Date Print Name Please note that you will not be eligible to receive any settlement benefits unless you sign above YOU MUST COMPLETE AND RETURN THIS PAGE OF THE CLAIM FORM
BABYGANICS PRODUCT LIST 001 Foamin Fun Shampoo & Body Wash + 16oz Refill 002 Shampoo & B.W. FF 315ml. 003 Shampoo & B.W. Lav 315ml. 004 Shampoo & B.W. Refill FF 32oz. 005 CND Shampoo & B.W. FF 315ml. 006 CND Shampoo & B.W. Lav 315ml. 007 CND Shampoo & B.W. Refill 32oz. 008 Bubble Bath Lav 20oz. 009 Bubble Bath, 20oz, FF 010 Shampoo & B.W. Travel Lav 3oz. 011 Shampoo & B.W. Travel FF 3oz. 012 Shampoo & B.W. Lav 18oz. 013 Washcloths Lav 20ct. 014 Washcloths FF 20ct. 015 Newborn Washcloths 24ct 016 Vapor Bath 12oz. 017 Hair Detangler 6oz. 018 Shampoo & B.W. FF 18oz. 019 Bubble Bath, 12oz, Orange Blossom 020 Bubble Bath, 20oz, CV 021 Shampoo & BW, 16oz, Night Time Orange Blossom 022 Foam Shampoo & BW, 16oz, CV 023 Shampoo & B.W. Lav 16oz. (6pk) 024 Foam Shampoo & BW, 16oz, FF 025 AMZ FFP 16oz Shampoo + Body Wash FF (3pk) 026 AMZ FFP 16oz Shampoo + Body Wash Night Time (3pk) 027 AMZ FFP Bubble Bath FF 20oz. (2PK) 028 AMZ FFP Bubble Bath Orange Blossom12oz. (2pk) 029 AMZ FFP Bubble Bath CV 20oz. (2PK) 030 AMZ FFP 16oz Shampoo + Body Wash CV (3pk) 031 Bubble Bath CV 2oz. 032 Shampoo & BW CV 3oz. 033 Shampoo & BW CV 7oz. 034 Bubble Bath CV 9oz. 035 CND Shampoo & BW CV 16oz 036 CND Shampoo & BW FF 16 oz. 037 Conditioning Shampoo CV, 12oz 6pc 038 Conditioning Shampoo FF, 12oz 6pc 039 AMZ FFP Conditioning Shampoo FF, 12oz 3pk 040 AMZ FFP Conditioning Shampoo CV, 12oz 3pk 041 AMZ FFP 7oz Shampoo + Body Wash CV (3pk) 042 Dish Soap Citrus 18oz. 043 Dish Soap FF 18oz. 044 Dishwasher Powder 40oz. 045 Foam Dish & Bottle Soap Refill, 32oz, FF 046 Foam Dish & Bottle Soap, 3.38oz, FF 047 Foam Dish & Bottle Soap, 16oz FF 048 Dish Soap FF 16oz. Shrink 049 Foam Dish & Bottle Soap, 16oz, Citrus 050 Dish Soap Citrus 16oz. Shrink 051 Foam Dish & Bottle Soap Refill, 32oz, Citrus BABYGANICS PRODUCT LIST 052 AMZ Foam Dish Soap + Refill, 18.6oz, FF, 2pk 053 AMZ Dish Soap + Refill Citrus 054 AMZ Foam Dish Soap + Refill, 16oz, FF (3pk) 055 AMZ Foam Dish Soap + Refill, 16oz, Citrus (3pk) 056 AMZ FFP Dish & Bottle Soap Refill, 32oz, FF 057 AMZ FFP Foam Dish & Bottle Soap Refill, 32oz, Citrus 058 CND Foam Dish & Bottle Soap, 16oz FF 059 Insect Wipes (2pk) 060 Insect Wipes 15ct. 061 Baby Wipes, 40ct 062 Baby Wipes, 100ct 063 Hand & Face Wipes, 30ct, FF 064 Flushable Wipes, 60ct 065 Baby Wipes, 400ct 066 Baby Wipes, 100ct, TGT 067 AMZ FFP Baby Wipes 100ct 3pk 068 AMZ FFP Baby Wipes 100ct (6pk) 069 AMZ FFP Hand and Face Wipes 30ct. (4pk) 070 AMZ FFP Baby Wipes 40ct. (6pk) 071 AMZ FFP Flushable Wipes 60ct. (3pk) 072 Baby Wipes, 800ct 073 Baby Wipes, 10ct 074 ECP Wipes Combo 3x100ct + 3x40ct + 3x60ct 075 Diaper Rash Wipes 40ct. 076 Diaper Rash Wipes 100ct. 077 Diaper Rash Wipes 400ct. 078 400ct Newborn Box wipe 079 Diaper Rash Cream 4oz. 080 Diaper Rash Cream 4oz Fragrance Free 081 Newborn Diapers Bag 36ct. 082 Diapers Size 1 Bag 40ct 083 Diapers Size 2 Bag 36ct. 084 Diapers Size 3 Bag 31ct. 085 Diapers Size 4 Bag 27ct. 086 Diapers Size 5 Bag 23ct. 087 Diapers Size 2 Box 108 ct. 088 Diapers Size 3 Box 92 ct. 089 Diapers Size 4 Box 80ct. 090 Diapers Size 5 Box 68ct. 091 Diapers Size 6 Bag 20ct. 092 Diapers Size 6 Box 58ct. 093 Newborn Diapers, 36ct, Bag 094 Size 1 Diapers, 40ct, Bag 095 Size 2 Diapers, 36ct, Bag 096 Size 3 Diapers, 31ct, Bag 097 Size 4 Diapers, 27ct, Bag 098 Size 5 Diapers, 23ct, Bag 099 Size 6 Diapers, 20ct, Bag 100 Size 2 Diapers, 108ct, Box 101 Size 3 Diapers, 92ct, Box 102 Size 4 Diapers, 80ct, Box
BABYGANICS PRODUCT LIST 103 Size 5 Diapers, 68ct, Box 104 Size 6 Diapers, 58ct, Box 105 Size 1 Diapers, 116ct, Box 106 Swim Diapers (SM) 12ct. 107 Swim Diapers (MD) 11ct. 108 Swim Diapers (LG) 10ct. 109 Clean Hands Kit 110 Soothing Solutions Bundle 111 Diaper Bag Essentials Kit 112 Regimen Kit Fragrance Free 113 Regimen Kit Orange Blossom 114 Hero Essentials Cube Gift Set 115 HBA Trial/Travel Pod Gift Set 116 Summer Essentials Pod Gift Set 117 OXO Gift Set 118 Hand Sani Peggable FF 50ml. 119 Foam Hand Sani, 1.7oz, Frag Free, Counter Display, 24/12 120 Hand Sani, 1.7oz, FF, Double Faced Counter Display 121 Foam Hand Sani 8.45oz, Frag Free 122 Hand Sani FF 8.45oz. Shrink 123 Foam Hand Soap, 8.45oz, Frag Free 124 Foam Hand Soap, 8.45oz, Frag Free, Shrink 125 Foam Hand Soap, 8.45oz, FF 126 Hand Soap Lav 250ml. 127 Foam Hand Sani Refill, 16oz, Frag Free 128 Hand Sani Wipe Cannister 175ct. 129 Hand Sani Wipes, 75 Packets Resealable Bag, Mandarin 130 Foam Hand Sani, 1.7oz, Tang, Counter Display, 24/12 131 Hand Sani, 1.7oz/1.7oz, Mand, Counter Display, 2/8 132 Foam Hand Soap, 1.7oz, Tang, Counter 3/8 133 Foam Hand Sani, 8.45oz, Tang 134 Hand Sani Tang 8.45oz. Shrink 135 Foam Hand Sani, 8.45oz, Tang SHRINK REWORK 136 Hand Sani Wipes, 20ct Pack Soft, Mandarin 137 CND Hand Soap Lav 8.45oz. 138 CND Hand Soap FF 8.45oz. 139 Hand Soap Apple 250ml. 140 Hand Soap Tang 250ml. 141 Hand Sani Wipes, 100ct Canister, Mandarin 142 Hand Sani Apple 250ml. 143 Hand Sani Wipes, 20ct Packets Box, Mandarin 144 Foam Hand Sani, 1.7oz, Mix Case, Counter Display 24/12 145 Hand Sani FF/Tang Mixed Case 1.7oz. 146 Foam Hand Sani Refill, 16oz, Tang 147 AMZ FFP 8.45oz Hand Sani FF (3pk) 148 AMZ FFP 8.45oz Hand Sani Tang (3pk) 149 AMZ FFP 8.45oz Hand Soap Apple (3pk) 150 Foam Hand Soap, 8.45oz, CV 151 Foam Hand Soap, 8.45oz, CV, Shrink 152 AMZ FFP 1.7oz Hand Sani FF (6pk) 153 AMZ FFP 1.7oz Hand Sani FF (12pk) BABYGANICS PRODUCT LIST 154 AMZ FFP 1.7oz Hand Sani Tang (6pk) 155 AMZ FFP 1.7oz Hand Sani Tang (12pk) 156 AMZ FFP 8.45oz Hand Soap CV (3pk) 157 AMZ FFP Hand Sanitizer Wipes 100ct 2pk 158 AMZ FFP Individual Hand Sani Wipes 75ct. (2pk) 159 AMZ FFP Hand Sani Refill FF 16oz. (2pk) 160 AMZ FFP Hand Sani Wipes 20ct. (4pk) 161 Hand Sani Mandarin 50ml Twin pack 162 Air Freshener Lav 10oz. 163 Laundry Detergent FF 1L. 164 Stain & Odor Remover, 32oz, FF 165 Stain Remover 32oz. Shrink 166 Laundry Detergent FF 64oz. 167 Laundry Detergent Lav 64oz. 168 Dryer Sheets, 120ct, Baby Fresh 169 BG Travel Stain Remover 2oz 170 Laundry Detergent FF 4oz 171 CND Stain remover 32oz. 172 BG Laundry 4oz 173 Fabric Freshener Spray 24oz. 174 Fabric Freshener Spray Travel 100ml 175 Stain & Odor Remover, 2oz, Spot Off Marker 176 Laundry Detergent FF 128oz. 177 Nasal Spray 178 Toothpaste Watermelon 4 oz.. 179 Toothpaste Strawberry 4oz. 180 Teething Gel Box 10ct. 181 Teething Gel Bag 4/6 10ct. 182 Protective Ointment 6/4 3oz. 183 Protective Ointment 16oz. 184 Daily Lotion w/ SPF 12oz FF 185 Lotion Cucumber 6/4 3oz. 186 Lotion FF 6/4 3oz. 187 Lotion Cucumber 4/4 16oz. 188 Lotion FF 4/4 16oz. 189 Shampoo & B.W. CV 16oz 190 Protective Ointment 7.5oz. 191 Eczema Kit 192 Eczema Pads 4ct. 193 Eczema Wash 4oz 194 Eczema Care Moisturizing Cream 3oz Frag Free 195 Eczema Care Cream 8oz Value Size 196 Eczema Wash 6/4 8oz. 197 Lip Balm FF 4/12.25oz. 198 BG Lip and Cheek Balm Clip Strip 199 Cold Stick 4/6 200 Eczema Cream 6/4 3oz. 201 Eczema Cream 8oz. 202 Lotion Orange Blossom 4/4 12oz. 203 Lotion Chamomile 4/4 17oz. 204 Daily Lotion CV 9oz.
BABYGANICS PRODUCT LIST 205 Sun/Bug Duo Pack 2oz 206 Sunscreen Lotion SPF50 8oz. 207 50SPF Sunscreen Lotion/Stick Combo 6oz/.47oz 208 Sun Lotion 50SPF 2oz/Bug Spray 6oz. Combo 209 Single Use Sunscreen 50spf 1oz 210 Sunscreen Lotion 50SPF 8oz. (Carton 2pk) 211 Sunscreen Spray 50spf 6oz. 212 Sunscreen Stick 50spf.47oz 213 Baby Suncreen Lotion Single Use Packets 50SPF 12Pack 214 Sunscreen Lotion 50spf 6oz. 215 Toddler Suncreen Lotion 30SPF 6oz 216 Suncreen Lotion 30spf 6oz. 217 Sunscreen Spray 30spf 6oz. 218 Sun Spray 50spf & Bug Spray Combo 6/6oz. 219 Sun Screen & Bug Spray 6&6 oz. 220 Bug Spray 2/12 2oz. 221 Sunscreen Lotion Bag.25oz 222 Sunscreen Lotion 50spf 2oz. 223 Bug Spray 60z. 224 Pestiside Free Bed Bug Spray Travel Size 225 Lip Balm 30spf 4/12 Orange 226 BG Lip Balm w/ 20 SPF.15oz Apple Berry 227 2OZ GRIME FIGHTER ON THE GO 228 All Purpose Cleaner Lav 32oz. 229 All Purpose Cleaner FF 32oz. 230 Glass and Surface Lav 32oz. 231 Glass and Surface FF 32oz. 232 Floor Cleaner Lav 16oz. 233 Floor Concentrate, 16oz, FF 234 Tub and Tile Lav 32oz. 235 Tub/Tile Cleaner, 32oz, FF 236 Tub & Tile FF 32oz. Shrink 237 All Purpose Travel Wipes 25ct. 238 All Purp Wipes, 75ct, FF 239 Toy/Highchair Cleaner, 17oz, FF 240 Toy Cleaner 17oz. Shrink 241 All Purpose Cleaner, 32oz, Citrus 242 All Purp Cleaner, 32oz, Citrus, Shrink 243 Spray Mop 244 Spray Mop replacement Pad 245 Toy Cleaner travel 6oz. 246 Toy/Table/Highchair Wipes, 25ct, FF 247 AMZ FFP All Purpose Wipes 75ct 2pk