You are only eligible for recovery if you have incurred a qualified leak. Please see the claim eligibility guidelines and leak eligibility periods and filing deadlines for more information.

If you believe you are a class member of the Cox vs. Shell oil, et. al. settlement and have had one or more qualifying leaks, please complete this online form, print, sign and mail it or print a blank claims eligibility form (CEF), complete and mail it. Class member does not include purchasers under a contract for deed or other tenants who are not owners of the real property or structures where a PB plumbing system or PB yard service line is installed.

Please choose one of the following to continue:

Filing and printing a Claims Eligibility Form: (Please note that a screen print of the following two forms is not considered a valid claims eligibility form. In order to print a valid claims eligibility form, you must first complete and submit one of the following two forms. Once you submit one of the following forms, you will get your reference number and will be prompted to print the valid claims eligibility form.)

Print blank Claims Eligibility Form to be filled out by hand and mailed

Enter Claims Eligibility Form information online, print form and mail

Print supplement leak form to list additional leaks for:

• Single-Unit properties
• Multi-Unit properties

Reprint a Claims Eligibility Form you previously entered

In order to view or print a Claims Eligibility Form or supplemental leak form you will need to use Adobe Acrobat Reader. This free software can be downloaded by clicking here.

(Acrobat and the Acrobat logo are trademarks of Adobe Systems Incorporated)

Tools to assist with form entry:

Print CEF help worksheet to assist with the CEF form entry

See and Print Leak Evaluation Table (designed to assist you as you categorize your leaks)

Take the Leak Evaluation Query (online tool to help categorize leaks)

Once the Claims Eligibility Form has been completed and mailed:

Check the status of your CEF

View the claims process checklists (to understand the CPRC claims process)