File an E-Claim

IMPORTANT NOTICE: All former Terminix customers have until July 15, 2021 to submit a completed and signed proof of claim form, together with any supporting documentation, or a completed and signed reinstatement form.

IF YOU ARE AN EXISTING OR FORMER TERMINIX CUSTOMER, YOU MAY BE ENTITLED TO A REFUND OR OTHER RELIEF IF YOU COMPLETE AND SUBMIT THIS CLAIM FORM TO THE COURT-APPOINTED RECEIVER.  PLEASE REFER HERE FOR ADDITIONAL INFORMATION.

    1. Consumer Information


    You may provide your Terminix Customer Number or Terminix Sales Agreement Number



    2. Refund Claim; Former Customers

    If you were a Terminix customer that resides in Baldwin County or Mobile County, and you cancelled your contract with Terminix due to Terminix increases in annual renewal payments for 2019 or 2020, you are eligible to receive one of the following:

    1. A one-time payment of 650.00; or
    2. An amount equal to the difference between your 2018 Terminix contract price and the amount you paid to purchase a termite contract with another provider in the years 2019 or 2020.



    OPTION 1: If you would like to receive the one-time payment of $650.00, please sign here, Skip to number 3, and complete the final section (Attestation) of this claim form:



    OPTION 2: If you would like to receive the difference between your 2018 Terminix contract price and the amount you paid to your new provider in 2019 or 2020, please sign here, complete the rest of this page, and complete the final section (Attestation) of this claim form:


    3. Property Damage Claims

    If you are an existing or former Terminix customer in the State of Alabama, and you own a property serviced by Terminix that you believe contains termite damage, you may be entitled to a payment for those damages.

    Are you an existing or former Terminix customer:


    Have you already tried to resolve this dispute with Terminix directly since the issuance of the Consent Judgment on December 2, 2020:







    4. Other Claims

    If you are an existing or former Terminix customer in the State of Alabama, and you have been unable to resolve your dispute with Terminix, you are entitled to submit that dispute to the Receiver.

    Are you an existing or former Terminix customer:


    Have you already tried to resolve this dispute with Terminix directly since the issuance of the Consent Judgment on December 2, 2020:





    ATTESTATION

    Supporting Documents: Please attach copies of any documents that support your claim, such as: (a) a copy of your contract with Terminix; (b) a copy of your contract with another provider for the years 2019 and/or 2020 (if applicable); (c) copies of your cancelled checks to your new provider for the years 2019 and/or 2020, or other documentation reflecting payments made by you to your new provider for the years 2019 and/or 2020 (if applicable); (d) copies of pictures of property damage (if applicable).





    I declare under penalty of perjury that the above information is correct.