Submit Claim | Old Navy Pricing Settlement

You must accurately complete all required portions of this Claim Form and submit the Claim Form under penalty of perjury.

YOU MUST SUBMIT YOUR CLAIM FORM NO LATER THAN May 31, 2022.

PERSONAL INFORMATION

Provide your name and contact information below.

This information will be used to deliver your Settlement Benefit and communicate with you if any problems arise with your claim. It is your responsibility to notify the Claims Administrator of any changes to your contact information after the submission of your Claim Form.

First Name *

Middle Initial

Last Name *

Residential Street Address 1 *

Residential Street Address 2

Country *

City *

State *

Zip Code *

Email Address *

Confirm Email Address *

Telephone Number *

* Required Fields

CONFIRMATION OF CLASS MEMBERSHIP

I declare that I believe that, during the period of time between November 12, 2015 and December 2, 2021, I purchased in-store or online from an Old Navy or an Old Navy Outlet in the United States, excluding purchases made while in Missouri, an item or items where a higher reference price was displayed, and that my purchases during this period totaled (select one):

less than $90.00 (Tier 1) good for $5 for any purchase or off any purchase (no minimum purchase required)

$90.00 or more (Tier 2), good for a total value of $10 for any purchase or off any purchase (no minimum purchase required) and I have attached proof of my purchase(s).

Approximate Date of Purchase	Approximate Location (City) of Purchase	Approximation of Total Spent on Claimed Items
Approximate Date of Purchase	Approximate Location (City) of Purchase	Approximation of Total Spent on Claimed Items

+ Add Purchase

Supporting Documents

Your claim reflects you purchased $90 or more of products (exclusive of returns) from Old Navy or an Old Navy Outlet between November 12, 2015 and December 2, 2021. Per the terms of the settlement agreement, you are required to provide, with this Claim Form, proof of qualifying purchases. Acceptable proofs of your purchases include (a) receipt(s) clearly showing the date of purchase(s) and the total of the purchase(s), or (b) a credit or debit card transaction record clearly showing the date of purchase(s) and the total of the purchase(s). The proofs of purchase must include sufficient information to allow Old Navy to verify the purchase(s).

Your file(s) will be uploaded once you click "Submit" at the end of this form

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EMAIL ADDRESS FOR PURCHASE CERTIFICATE DELIVERY.

Please confirm the email address to which you would like the Purchase Certificate(s) delivered.

Would you like your Purchase Certificate delivered to ?

Yes

ACKNOWLEDGEMENT

I have received notice of the class action Settlement in this case and I am a class member as described in the notice. I agree to release all the claims, known and unknown, stated in Section 2.9 of the Settlement Agreement. I submit to the jurisdiction of the Superior Court of the State of California, County of San Francisco with regard to my claim and for purposes of enforcing the release of claims stated in the Settlement Agreement. I am aware that I can obtain a copy of the full notice and Settlement Agreement at www.ONPricingsettlement.com or by writing the Claims Administrator at the email address Info@ONPricingSettlement.com or the postal address Old Navy Claims Administrator, 1650 Arch Street, Suite 2210, Philadelphia, PA 19103. I agree to furnish additional information to support this claim if required to do so.

I agree that by submitting this Claim Form I certify under the penalty of perjury of the laws of the State of California that the foregoing is true and correct to the best of my knowledge and that checking this box constitutes my electronic signature on the date of its submission.

Signature *

Date

Barba v. Old Navy et al.

Case No.: CGC 19-581937

Superior Court of the State of California in the County of San Francisco

Your Claim Form has been submitted successfully.

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
Middle Initial
Last Name
Residential Street Address 1
Residential Street Address 2
City
State
Province
Zip Code
Postal Code
Country
Email Address
Telephone Number