INSTRUCTIONS FOR COMPLETING THIS CLAIM FORM AND SUBMITTING A CLAIM FOR PAYMENT

You only need to submit a Claim Form if you spent money for certain repairs relating to Denso-manufactured low-pressure fuel pumps (“Fuel Pump”) covered under the Settlement and you have not previously been reimbursed.

To determine whether you are a Class Member eligible to make a claim, or for more information regarding the class action Settlement, please see FAQ 6 and Part C of FAQ 8. If you still have questions regarding the claims process, call 844-552-0070 or email info@SubaruFuelPumpsSettlement.com.

1. You must timely complete, sign and submit this Claim Form and provide the Supporting Documentation and Declaration(s) to receive reimbursement of out-of-pocket expenses pursuant to the terms of the Settlement. You can complete and submit the Claim Form with the Supporting Documentation and Declaration(s) online by clicking the green File a Claim button below. Check the Claim Form carefully to make sure all of the information is correct and that you have filled in any missing information.
2. Capitalized terms in this Claim Form have the same meaning as provided in the Settlement Agreement. No funds will be paid out unless and until the Settlement is finally approved by the Court, including the resolution of any appeals in favor of upholding the Settlement.
3. You must submit your completed Claim Form and the Supporting Documentation and Declaration(s) no later than ninety (90) days after the Court issues the Final Order and Final Judgment, which will be no earlier than February 16, 2025. Check this website periodically for updates.

Important: Keep a copy of your completed Claim Form and the Supporting Documentation and Declaration(s). If your claim is rejected for any reason, you will be notified.

File a Claim