Payment Election

If you received a postcard or email about the Settlement, using this form you may indicate how you would like to get paid. This is not a Claim Form, and you do not have to fill it out, unless you prefer to receive payment electronically.

Do NOT fill out this form if you did not get a postcard or email about the Settlement. Instead, if you were not sent a notice of the Settlement in the mail or by email, but believe you are part of the Class, you will need to fill out a General Claim Form by clicking here.

Claimant Information:

Please provide the Unique ID found on your Email or Postcard Notice.* Help


Please select what type of claimant you are:*

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Payment Election:

Please indicate how you would like to receive your payment.*

  •  check Paper check by mail
  •  pay pal PayPal
  •  pay pal Zelle
Certification:
 By checking this box, I affirm, under oath subject to penalty of perjury, that (1) I am not an employee, officer, or director of State Farm; and (2) the responses I have provided above are true and correct to the best of my knowledge.*