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Peterson Oil Customer Claim

COMMONWEALTH OF MASSACHUSETTS

Marandino, et. al. v. Peterson Oil, et. al.

Case No. 1984-CV-0782-BLS2

NO HEAT CLAIM FORM

You should complete this claim form if you allege you lost heat or hot water (a “No Heat Incident”) as a result of fuel delivered by Peterson’s Oil Service, Inc. (“Peterson Oil”) between January 1, 2012 and July 5, 2016 and/or between July 5, 2019 and January 29, 2026. Completing this claim form will allow you to receive a payment for each such No Heat Incident, as described in the Notice Regarding Right to Benefit from Class Action Settlement and/or the Settlement Agreement. You may complete this form online or submit it by mail.

You may receive a payment if you fill out this claim form, if the Settlement Agreement is approved, and if you are found to be eligible for a payment.

The settlement notice describes your legal rights and options. Please visit the official settlement administration website, www.PetersonOilClassActionSettlement.com or call 1-844-625-7313 for more information.

If you wish to submit a claim for a settlement payment, you must provide the information requested below. Please print clearly in blue or black ink. This claim form must be submitted online or mailed and postmarked by February 11, 2026.

I. CLASS MEMBER NAME AND CONTACT INFORMATION

First Name:

Last Name:

Address:

Unit/Apt:

City:

State:

Zip:

Phone:

Email:

II. RELIEF SELECTION

Please select the relief you would like from either Section 2.A, Section 2.B, or both, below.

Please review the notice and settlement agreement (available at www.PetersonOilClassActionSettlement.com) for more information about who is eligible for a payment and the nature of the expenses or losses that can be claimed.

If you do not clearly provide all information requested below, your claim form may be deemed invalid.

NOTE: If you make a claim under option 2.A, you could be eligible for a payment of up to $180 for each No Heat Incident. If you make a claim under option 2.B, you could be eligible for a payment of your actual documented expenses, if those expenses exceeded $500.

You can make a claim(s) from both categories, if applicable.

Please provide as much information as you can to help us determine if you are entitled to a settlement payment from the No Heat Fund.

PLEASE PROVIDE THE INFORMATION LISTED BELOW

2.A. No Heat Incidents Involving Less Than $500 in Out-of-Pocket Expenses.

If you incurred less than $500 in out-of-pocket expenses for any single Heat Loss incident, you are eligible to recover up to $180 for each of those incidents.

Examples of out-of-pocket expenses include: (1) amounts paid to service providers to restore your heating/hot water equipment to operability; (2) amounts paid for equipment/parts necessary to restore your equipment to operability; and/or (3) extraordinary expenses caused by the loss of heat or hot water, such as damage to your property caused by frozen or burst pipes.

If, between January 1, 2012 and July 5, 2016 and/or between July 5, 2019 and January 29, 2026 , you had No Heat Incidents that you suspect were caused by Peterson Oil’s fuel, but they DID NOT result in out-of-pocket expenses totaling more than $500, please list them below. Please only list No Heat Incidents that occurred between January 1, 2012 and July 5, 2016 and/or between July 5, 2019 and January 29, 2026.

NOTE: It is OK if you do not remember exact dates – estimates are sufficient. Your heating service provider may also be able to provide your service records to assist you in completing this form.

Documentation of out-of-pocket expenses is NOT required for this Section.

Please provide a brief explanation as to why you believe each No Heat Incident listed above was a result of Peterson Oil’s Fuel. Some of the reasons you might list are: (1) a technician told you the fuel caused your system to shut down; (2) the cause of the No Heat Incident was a clogged or gelled nozzle, filter and/or oil line; (3) restoring your heat/hot water involved replacement of a nozzle or filter within one year of a prior nozzle/filter replacement; (4) restoring your heat/hot water involved only making adjustments to your equipment; (5) you experienced multiple No Heat Incidents in a short period of time; and/or (6) there was no identifiable mechanical failure. (Note: If there is not enough room, please attach a separate addendum with your explanation.)

2.B. No Heat Incidents Involving $500 or More in Out-of-Pocket Expenses.

If you incurred $500 or more in out-of-pocket expenses for any single Heat Loss incident, you are eligible to recover up to your actual out-of-pocket expenses for each of those incidents.

Examples of out-of-pocket expenses include: (1) amounts paid to service providers to restore your heating/hot water equipment to operability; (2) amounts paid for equipment/parts necessary to restore your equipment to operability; and/or (3) extraordinary expenses caused by the loss of heat and/or hot water, such as damage to your property caused by burst pipes.

If, between January 1, 2012 and July 5, 2016 and/or between July 5, 2019 and January 29, 2026, you had No Heat Incidents that you suspect were caused by Peterson Oil’s fuel, and those incidents DID result in more than $500 in out-of-pocket expenses, please list them below. Please only list No Heat Incidents during time periods that your equipment was using Peterson Oil’s fuel between January 1, 2012 and July 5, 2016 and/or between July 5, 2019 and January 29, 2026 and the amount of your out-of-pocket expenses for each listed incident.

The total sum of these expenses was $ .

Documentation of out-of-pocket expenses IS required for this Section.

Click Here To Upload Documents

In order to be eligible to recover sums above $500 for any single Heat Loss incident you MUST attach supporting documentation to this claim form demonstrating your actual out-of-pocket expenses. This documentation should include copies of statements or receipts from service and/or parts provider(s). Please submit any supporting documentation with your Claim Form.

2C. Both Types of No Heat Incidents

If you experienced No Heat Incidents involving out-of-pocket expenses less than $500 and No Heat Incidents involving out-of-pocket expenses of $500 or more, please be sure to complete both sections and: (a) provide information relating to your No Heat Incident(s) involving out-of-pocket expenses less than $500 in Section 2A; and (b) provide information relating to your No Heat Incident(s) involving out-of-pocket expenses of $500 or more in Section 2B.

III. ASSISTANCE COMPLETING AND RETURNING THIS FORM IS AVAILABLE

If you need assistance completing and/or returning this form, please contact the Settlement Administrator HERE.

IV. YOU ARE REPRESENTING THAT CLAIMS HAVE NOT BEEN ASSIGNED

By completing this claim form, you hereby represent and affirm that you have not assigned, transferred, or conveyed your claims to anyone else, and you agree to hold the Defendants harmless from any claims made by any such assignee.

V. SIGN AND DATE YOUR CLAIM FORM

I declare under penalty of perjury under the laws of the United States and the laws of my State of residence that the information supplied in this claim form by the undersigned is true and correct to the best of my recollection, and that this form was executed on the date set forth below.

I understand that I may be asked to provide supplemental information by the Settlement Administrator before my claim will be considered complete and valid.

Date Signed:

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April 22, 2024 3:16 pm EST

Peterson Oil Customer Claim Uploaded by Peterson OIl Settlement - petersonoilsettlement@optimeadmin.com IP 71.234.148.75