Claim Form

Open Energy 34 Watt Solar Tiles Could Pose a Risk of a Fire

Class Counsel strongly recommends that you de-activate your system now, before removal or replacement, due to the potential fire hazard. If you need help de-activating your system, please contact the Claims Administrator at 1 (844) 619-9804.

Instructions:
To receive benefits you must submit a Claim Form. You may submit a claim online or by mail. The deadline to submit a claim is March 8, 2017. You are strongly encouraged to submit your Claim Form immediately. Forms will be processed in the order received and early submissions will get priority when scheduling solar panel replacement work.

To submit by mail, print out this form and complete the form legibly in blue or black ink. Please do your best to answer all relevant questions or write “I don’t know.” If you have any questions about filling out the Claim Form, contact the Claims Administrator at 1 (844) 619-9804 or info@solarpanelsettlement.com. The Claims Administrator may contact you if you omit any information or if they have questions regarding your submission.

If more than one Claim Form is submitted for the same property (for example, multiple owners), the Claims Administrator and/or Special Master will distribute the Settlement Benefits based on the information provided and the terms of the Settlement Agreement.

Please make sure that you have indicated your choice of benefits in Section 5 by checking the appropriate box.

If the address for the property does not match certain records in the possession of the Claims Administrator, you may be asked to provide proof that Open Energy 34 Watt Solar Tiles are or were installed on the property. In this instance, the Claims Administrator will provide guidance as to acceptable proof.

Submit online:


1. SETTLEMENT CLASS MEMBER INFORMATION






Property Address (where Open Energy 34 Watt Solar Tiles are or were installed):









Current Mailing Address (if different)
















2. OWNERSHIP INFORMATION

Instructions:
Not all questions will necessarily apply to your situation. If documents need to be submitted with your Claim Form, please provide a copy, as indicated.

A. Property Owners:










(If you answered this question "yes," you will need to
provide a copy of the sale documents.)







B. Contractor/Builder Filers (who replaced Solar Tile systems)

Instructions:

You should fill this section out if you received an assignment of rights related to the Solar Tiles from a Settlement Class Member, or took those rights over, by, for example, replacing their Solar Tiles with a different solar power system following a fire or replaced them for free.







C. Other Claim Filers: If you are (or believe you are) a Settlement Class Member, but did not purchase a property with Open Energy 34 Watt Solar Tiles, or receive rights under Section B above, please explain the nature of your relationship to the Solar Tiles or Settlement Class and basis for your claim so the Claims Administrator and Special Master can evaluate the claim. Please attach additional sheets or relevant documentation as needed.




3. OPEN ENERGY SOLAR TILE INFORMATION
Instructions:
Please answer these questions to the best of your ability.





4. PREVIOUS REPLACEMENT
Instructions:
If the Open Energy 34 Watt Solar Tiles on the property were previously, completely removed and replaced (either with a new solar system or a replacement roof without a solar system), please fill out this section. If the Solar Tiles are still installed on the roof of the property, do not fill out this section.














5. AVAILABLE BENEFITS
Instructions: The table below summarizes the benefits available to eligible Settlement Class Members under this Settlement. Benefits vary depending your individual circumstances. Please review the table carefully and check the appropriate box to indicate your choice of benefits within the category that applies to you. If you have any questions, please contact the Claims Administrator.


  Primary Homeowner Categories Contractor Other
 
Category 1 Category 2 Category 3 Category 4
Category 5 Category 6
Which category best describes you?
I currently own the property.

and

I currently have Solar Tiles installed on my roof.

[Note: If you are an individual plaintiff in the Everett case pending in Placer County and you still have Solar Tiles installed on your roof; you are not included in Category 1. You will be contacted directly and do not need to submit a Claim Form to claim you benefit.]

I used to have
Solar Tiles
installed on my
roof.

and

I paid to
remove/replace the
tiles.

I live in a Centex
development.

and

I used to have Solar
Tiles installed on my
roof.

and

Centex previously
removed and replaced
them.

I do not live in a Centex
development.

and

I used to have Open Energy 34
Watt Solar Tiles installed on my
roof.

and

My tiles were previously removed
or replaced at no cost to me.

I am a contractor or other person who voluntarily removed or replaced a Settlement Class Member’s Open Energy 34 Watt Solar Tile system at no cost to the owner. None of the other
categories apply.
The benefits available to you are as follows.
I currently own the property.

and

I currently have Solar Tiles installed on my roof.

[Note: If you are an individual plaintiff in the Everett case pending in Placer County and you still have Solar Tiles installed on your roof; you are not included in Category 1. You will be contacted directly and do not need to submit a Claim Form to claim you benefit.]

I used to have
Solar Tiles
installed on my
roof.

and

I paid to
remove/replace the
tiles.

I live in a Centex
development.

and

I used to have Solar
Tiles installed on my
roof.

and

Centex previously
removed and replaced
them.

I do not live in a Centex
development.

and

I used to have Open Energy 34
Watt Solar Tiles installed on my
roof.

and

My tiles were previously removed
or replaced at no cost to me.

   

The benefits available to you are as follows.
Choose one of the options below: (Category 1)


Have an approved contractor replace your Solar Tile system with a new rack mounted panel system. You pre-pay the permit fees and cost of inverter (estimated to cost $1,500). If money remains after claims, fees, costs, and awards are paid, permit fees and inverter costs will be reimbursed from the Settlement Fund. However, this reimbursement is not guaranteed.


Have an approved contractor remove your Solar Tile system and replace it with conventional, non-solar roof tiles. Also receive a payment of $54.25 per solar tile removed.


Receive a payment of $60 per Solar Tile on your roof. Class Counsel strongly recommends Option 1 or Option 2 due to the alleged fire risk. If you choose Option 3, you are acknowledging the risk of fire and are waiving your insurer’s right to seek compensation for any fire damage that results in the future from the Solar Tiles.

Category 2


Receive a cash payment of $132.98 per Solar Tile replaced.

Category 3


Received a cash payment of $500 (per home).

Category 4

You are most likely not entitled to any benefits, but your claim will be reviewed and assessed to determine if you are eligible for a share of any remaining money under the terms of the Settlement Agreement (See Section 2.C above). Category 5 Choose one of the options below:




[Contractors: If you removed and replaced multiple systems, please submit a separate Claim Form for each separate Property.]

Category 6



6. SIGNATURE

By signing this Claim Form, I declare that all the information that I supplied in this Claim Form is true and correct to the best of my knowledge and belief. By signing it, I authorize the Claims Administrator to contact contractors or any other parties with knowledge regarding the solar panel system above.



(Type your full name)