+1 845 2433 477 info@citisdofairfunds.com

Citi Fair Fund

INFORMATION ABOUT THE CLAIMANT

1. Beneficial Owner Information:

First, Middle, Last or Entity Name (if the Beneficial Owner is a corporation, trust, estate, etc.)

2. Mailing / Contact Information:

3. Enter Social Security Number or Tax Identification Number (“EIN”) in the appropriate box below.

If you are not a U.S. citizen, please include a copy of your passport or other identification.

4. Claimant Account Type (check appropriate box below):

FOR INVESTMENT FRAUD VICTIMS:

FOR ADVANCE FEE FRAUD VICTIMS:

TRANSACTION INFORMATION

YOU MUST SUBMIT DOCUMENTATION TO SUPPORT THE INFORMATION BELOW. FAILURE TO PROVIDE PROPER DOCUMENTATION MAY RESULT IN THE REJECTION OF YOUR CLAIM.

5. BP AMERICAN DEPOSITARY SHARES (“ADS”) BEGINNING HOLDING ON APRIL 26, 2010:

Enter Total Number of Shares of BP ADS (CUSIP: 055622104) held as of the opening of trading on April 26, 2010. If none, write “0” or “Zero.

6. BP ADS PURCHASES FROM APRIL 26, 2010 THROUGH AND INCLUDING MAY 26, 2010:

List (in chronological order) separately each purchase and/or acquisition of BP ADS made after the opening of trading on April 26, 2010 through May 26, 2010. Please note that transactions in BP ADS that are pursuant to, or in connection with, a swap, an option or other derivative instrument are not eligible.

Questions regarding eligibility?

Please visit the FAQs for answers to the most commonly asked questions.

Need to talk to someone?

We’re here to help. US based support, Monday thru Friday, 8:30am to 5pm EST.