If you received a personalized notice in the mail or via email with a Notice ID and Confirmation Code, please enter the codes you were provided below.

Please remember to enter the full Notice ID exactly as it appears on your personalized Notice, (i.e. 12345678).

If you did not receive a personalized Notice in the mail or via email, click below to complete a Claim Form.

The deadline for submitting this proof of claim form is

Instructions for Completing the Enclosed Claim Form

Note: If you have a current water and sewer billing account with City of Harper Woods and you wish to receive your pro rata share as a credit on your bill, you do not need to complete this form.

IN ORDER TO RECEIVE A CASH REFUND AS PART OF THIS CLASS ACTION SETTLEMENT, YOU ARE REQUIRED TO SUBMIT A WRITTEN CLAIM. IF YOU DO NOT SUBMIT A WRITTEN CLAIM, YOU WILL RECEIVE YOUR PRO RATA SHARE OF THE NET SETTLEMENT FUND IN THE FORM OF A CREDIT ON YOUR WATER AND SEWER BILLING ACCOUNT, OR IN THE FORM OF A CREDIT ON YOUR DECEMBER 2022 PROPERTY TAX BILL IF YOU DO NOT HAVE A WATER AND SEWER BILLING ACCOUNT.

Sections A, B and C must be completed and submitted in order for this Claim Form to be valid.

NOTE: If you received multiple Notices, each Notice is associated with a separate Account # and service address. Please submit a separate Claim Form for each Account # for which you paid the City of Harper Woods for water and/or sewer service.

ALL CLAIMS ARE SUBJECT TO VERIFICATION

Section A - Name And Contact Information (Mailing Address)

Provide your name and contact information below. The Claims Administrator will send your refund checks to your Mailing Address. It is your responsibility to notify the Claims Administrator of any changes to your contact information after the submission of your Claim Form.

* Required Fields

Section B - Information About Water & Sewer Charges Paid During The Class Period

List the address of the affected property below only if it is different from the Mailing Address provided above. Please submit a separate Claim Form for each Property for which you paid the City of Harper Woods for water and/or sewer service.

Affected Property 1

Provide the period of time in which you paid stormwater charges to the City of Harper Woods:

 
Affected Property 2

Provide the period of time in which you paid stormwater charges to the City of Harper Woods:

 
Affected Property 3

Provide the period of time in which you paid stormwater charges to the City of Harper Woods:

 
Affected Property 4

Provide the period of time in which you paid stormwater charges to the City of Harper Woods:

 
Affected Property 5

Provide the period of time in which you paid stormwater charges to the City of Harper Woods:

 
Section C - Certification Statement For Entire Claim Form

I affirm under penalty of perjury that all information in this Claim Form is true and accurate and by submitting this Claim Form, I certify that I paid the City of Harper Woods for water and/or sewer services between September 28, 2011 and April 30, 2022 (the “Class Period”). I understand the Claims Administrator may contact me to request further verification of information provided on this Claim Form.

Your Claim Form has been submitted successfully.

Please print this page for your records.

Your Claim Details
Submitted Claim ID:
Confirmation Code:
You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
CLAIM INFORMATION
First Name
Last Name
Street Address
Street Address 2
City
State
Zip Code
Email Address
Phone Number
Signature
Date

If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at Info@HarperWoodsSettlement.com

Click here to edit your Claim.

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