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Claim Form Request
INSTRUCTIONS
READ THESE INSTRUCTIONS CAREFULLY. IF YOU FAIL TO FOLLOW THESE INSTRUCTIONS, YOU MAY LOSE CERTAIN BENEFITS TO WHICH YOU MIGHT OTHERWISE BE ENTITLED.
  1. Summary of Key Provisions
    The settlement will provide a cash payment if you are the original owner of an Apple MacBook or MacBook Pro computer (certain models) or separately purchased an Apple 60W or 85W MagSafe MPM-1 (“T”) Power Adapter, the Adapter showed signs of Strain Relief Damage, and you purchased a Replacement Adapter (defined below) within the first three years following the initial purchase of the computer or Adapter. The amount of the cash payment will vary. You may also be able to obtain a replacement adapter at no charge from Apple if your Adapter shows signs of Strain Relief Damage in the future. Please refer to the full Notice for an explanation and chart of the cash payment amounts.

    To receive a cash payment under the settlement, you must fill out and return your Claim Form (“Claim Form”) postmarked on or before March 21, 2012. If you fail to return a valid Claim Form by the deadline, your claim will be rejected and you will lose all rights to these benefits.

    Do not use your Claim Form to request a replacement adapter. Please refer to the full Notice for how to request a replacement adapter.

    Unless you request exclusion from the class as explained in the Class Notice, you will be bound by the Settlement Agreement and Release and the Final Judgment even if you do not return the Claim Form.
  2. WHO IS ELIGIBLE TO CLAIM A CASH REFUND UNDER THE SETTLEMENT
    To qualify, you must be a United States resident who (1) is the original owner of an Apple MacBook or MacBook Pro computer listed here and/or (2) purchased a standalone 60W or 85W MagSafe MPM-1 (“T”) Power Adapter. For convenience, these computers are referred to as the “Subject Computers” and the adapters shipped with the Subject Computer or purchased standalone are referred to as “Adapters.” You must also have purchased an Apple-branded 60W or 85W MagSafe MPM-1("T") Power Adapter (referred to as a “Replacement Adapter”) as a replacement because your Adapter showed signs of Strain Relief Damage. You must have purchased the Replacement Adapter at your own expense within the first three years following the initial purchase of the Subject Computer or Adapter.
  3. One Claim Form Per Subject Computer or Adapter.
    If you purchased more than one Subject Computer or Adapter, experienced an Adapter failure and paid for a Replacement Adapter for more than one Subject Computer or Adapter, and you wish to make claims for multiple Subject Computers or Adapters, you must fill out a separate Claim Form for each Subject Computer. If you purchased more than one Replacement Adapter for the same Subject Computer or Adapter, you must also fill out a separate Claim Form for each Replacement Adapter purchase. (You may claim refunds for no more than three Replacement Adapters per Subject Computer.) This website will permit you to generate multiple customized copies of your Claim Form if necessary.
  4. How To Make A Claim for a Cash Refund
    To make a claim, complete and submit this Claim Form, along with the required documentation, in compliance with the instructions below. Send the original of the signed Claim Form and a copy of the required documentation to MagSafe Power Adapter Claims Administrator, c/o Kurtzman Carson Consultants LLC, P.O. Box 43043, Providence, RI 02940-3043. Please keep copies for your records.

    Proof of Purchase You must attach a Proof of Purchase of your Replacement Adapter to your Claim Form. “Proof of Purchase” means an invoice, receipt or other document (such as a credit card statement or cancelled check) evidencing that the product you purchased was a Replacement Adapter, the price paid, date of purchase, and the name and address of the entity from whom the Replacement Adapter was purchased. If the Proof of Purchase does not specifically identify the purchase of a Replacement Adapter or the price paid, you may submit a receipt, bank or credit card statement, or Apple email receipt, showing a purchase from any Apple store (online or in-person) in the amount of $79 or greater, and must declare in the Claim Form that the product purchased was a Replacement Adapter, state the price paid (if not shown in the Proof of Purchase), and highlight the item in the Proof of Purchase that includes the Replacement Adapter. You can request a duplicate copy of your Apple receipt for a replacement adapter purchase by clicking here and completing the required information

  5. Claims Deadlines
    You must mail the Claim Form postmarked on or before March 21, 2012. If you fail to return your Claim Form by the required date, your claim will be rejected, and you will be deemed to have waived all rights to receive a cash payment under this settlement.

    Remember: To be valid, your Claim Form must be completely and accurately filled out, signed and dated, and must include all requested information, including Proof of Purchase. If your Claim Form is incomplete, untimely, illegible, or contains false information, it may be rejected by the Claims Administrator.

    TO MAKE A CLAIM, YOU MUST MAIL IN YOUR CLAIM FORM. Claim Forms may be generated on this website. You are not filing a claim by generating your Claim Form on this website. You must print and mail in your signed Claim Form and a copy of the required documentation to MagSafe Power Adapter Claims Administrator, c/o Kurtzman Carson Consultants LLC, P.O. Box 43043, Providence, RI 02940-3043.


    To provide your information and create a personalized Claim Form, please click the “Continue” button.