Microsoft Products Settlement - Arkansas

Volume Claim Form

Please fill in all of the Required Fields below. When completed turn off your web browser's Pop-Up Blocker and click "Create Printable Claim Form".

Once you click "Create Printable Claim Form", you can either:

Print the Claim Form, fill out remaining information, and submit to the Claims Administrator with any relevant supporting documentation, or
Save the Claim Form as a .PDF file on your computer for completion at a later time

If you require assistance with this process, please call 1-800-572-0455.

Company or Business Name:
Tax ID:
Primary Contact or Notices Correspondent listed on your Volume License Agreement
First Name, M.I., Last Name:
Title:
Department:
Address:
City, State:
Zip Code:		-
(This is where ALL correspondence and voucher(s) will be sent)
Phone Number:		--
Email (Optional):