In Re: Suboxone (Buprenorphine Hydrochloride and Nalaxone) Antitrust Litigation
Civil Action No. 2:13-md-02445 (E.D. Pa.)

Instructions for Submitting Your Consumer Claim Form

If you are a member of the End Payor Class as a consumer, you may file a claim for a share of the Settlement Fund. You must complete this Claim Form and mail it to the Settlement Administrator at the address provided below postmarked, or submit your claim online at, no later than February 17, 2024.

Consumer identities will not be made public during any part of the claims process.

• Complete all required portions of the attached Claim Form:

1. Complete Section A.

2. Answer the question in Section B to determine your eligibility.

3. Provide information about your total purchases of Co-Formulated Buprenorphine/Naloxone ("Suboxone") in Section C.

4. If possible, provide documentation of at least one purchase of Co-Formulated Buprenorphine/Naloxone ("Suboxone") as described in Section D.

5. Review and sign the Claim Form in Section E, which includes the Certification that the information you provide is true and correct to the best of your knowledge.

• By signing and submitting the Claim Form, you are swearing under penalty of perjury that you qualify to submit a claim according to the criteria given in Section B.

• You have two options for submitting a Claim Form:

o You can mail the completed and signed Claim Form and Certification by First-Class U.S. Mail, postage prepaid, postmarked no later than February 17, 2024, to:

Settlement Administrator 54388
c/o A.B. Data, Ltd.
P.O. Box 173080
Milwaukee, WI 53217

o You can complete and submit the Claim Form and Certification using the Settlement Administrator’s website, When you complete the online Claim Form, you will receive an acknowledgement that your claim has been submitted. If you choose this option and file a claim electronically, your electronic signature and submission of the form will conform to the requirements of the Electronic Signatures Act, 15 U.S.C. § 7001, et seq., and will have the same force and effect as if you signed the Claim Form in hard copy.

• If your completed Claim Form is not postmarked or filed online by February 17, 2024,, you will not receive any payment from the Settlement. Submission of this Claim Form does not ensure that you will share in the payments related to the Settlement.