Poultry Wages Settlement

If You Received a Notice You Can Update Your Information and Update Your Earnings.

If You Did Not Get a Notice by Email or Postcard You Can Participate Now.

Check to See if You Worked in a Covered Poultry Processing Place Between 2000 and 2021.

Update Your Information
Participate
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POULTRY WAGES SETTLEMENT PARTICIPATION FORM

Jien v. Perdue Farms, No. 1:19-cv002521

If you did not get a postcard or email notice, you must fill out and submit a participation form online or postmarked on or before MONTH DAY YEAR.

You must complete all the sections on this form and sign it to be able to get money from these Settlements.

If you submit a participation form, you are swearing that you worked at one or more of the Defendants’ poultry processing plants, hatcheries, and feed mills in the United States from January 1, 2000 until July 20, 2021. If you only worked for Pilgrim’s Pride, George’s, and/or George’s Foods, you are swearing you worked at one or more of their poultry processing plants in the United States from January 1, 2009 until July 20, 2021.

YOUR NAME* (FIRST LAST): *

UNIQUE ID FROM EMAIL OR POSTCARD NOTICE (IF YOU DID NOT GET A NOTICE, LEAVE THIS BLANK):

Street Address: *

City: *

State: *

Zip Code: *

Mobile Phone Number:

Email: *

UPLOAD SUPPORTING DOCUMENTS

Instructions:

1. Please provide a copy of an official photo identification (like a driver’s license or an employee ID from one of the companies) OR a copy of your pay history from the payroll service provider (see www.PoultryWages.com on how to obtain one) OR a copy of at least one paycheck/paystub from your time working at one of the companies.

Please use the browse option, by clicking on “Select Files” below, to upload your supporting documentation.

Select files

Files To Be Uploaded	Size	Action

AND

2. Please complete the following chart, including the company(ies) you worked for, your workplace(s), the dates you worked, how much you were paid per hour, your average weekly hours, and your job title(s).

We will first use this information to try to match your information with the data we were provided. If we cannot, we may conduct an independent audit of it. We may contact you by email, letter, or phone to ask for more information. Please keep your contact information up-to-date.

Employer: *

State: *

Facility: *

Start Date: *

End Date: *

Pay Rate: *

Average Hours / Week: *

Position: *

Confirm Proof Enclosed:

Must click Add to save your information.

Employer

State

Facility

Start Date

End Date

Average Hours/Week

Position

Has Proof

Action

If you are a “U.S. person,” complete the Substitute IRS Form W-9 below. You are a U.S. person if you are a U.S. citizen or a U.S. resident alien. A U.S. “resident alien” is an individual who meets either the “Green Card Test” or the “Substantial Presence Test.” An undocumented individual is treated as a U.S. person for tax purposes if the Substantial Presence Test is met.

The Substantial Presence Test is met if you are physically present in the U.S. on at least:

31 days during 2024, and
183 days counting:
- All the days you were present in 2024, and
- 1/3 of the days you were present in 2023, and
- 1/6 of the days you were present in 2022.

IMPORTANT:

If you are not a U.S. person, you should not complete Form W-9 and do not need to complete Form W-9 to get a payment. You will still be eligible for a payment if you cannot complete the Substitute IRS Form W-9 because you are not a U.S. person.

Substitute IRS Form W-9

Taxpayer Identification Number Certification

Social Security Number (SSN)/Individual Taxpayer Identification Number (ITIN):

Print your name as it appears on your federal income tax return (First Name and Last Name for Individuals):

Under penalties of perjury, I certify that:

1. The number shown on this form is my correct taxpayer identification number; and

2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding; and

3. I am a U.S. citizen or other U.S. person (including a U.S. resident alien).

Note: If you have been notified by the IRS that you are subject to backup withholding, you must cross out item 2 above.

Click here to strike item 2 above. Do not check this box unless you have been notified by the IRS that you are subject to backup withholding.

By signing this participation form, I state that the information in this form is accurate and complete to the best of my knowledge. I agree and consent that the Settlement Administrator and Class Counsel may contact me electronically via email, phone, and/or mobile phone. I agree to give more information about my participation if the Settlement Administrator asks me to do so. If I do not provide adequate documentation when asked (or requested), I understand my participation in these settlements may be denied.

Signature of U.S. Person:: *