The Settlement Fund Claim Form – Rocket Tax is the claim form issued by the New York City Department of Consumer and Worker Protection (DCWP) for people who were customers of Rocket Tax and were not told its fees. It has four sections and is returned to DCWP with proof of the fees, by mail or email, by October 29, 2026. On this page you can fill out the form online on FillingPDF and download or print the completed PDF; the form and the claim process are published by DCWP at nyc.gov.
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What is Settlement Fund Claim Form – Rocket Tax?
The Settlement Fund Claim Form – Rocket Tax is the form consumers complete and send to the NYC Department of Consumer and Worker Protection (DCWP) to claim restitution under a settlement in which Rocket Tax agreed to refund consumers whose fees were not disclosed.
The settlement is between DCWP and Rocket Tax, which the form defines as the businesses owned and operated by Alexia Agnant, Cerissa Campbell, Demetress Corporation, Rocket Tax Service Inc., and Rocket Tax Inc. Despite the tax-related name, the form concerns the fees Rocket Tax charged for preparing tax returns. It is not a property tax document.
The form has four sections:
- Section I: General Information: your contact details, the Rocket Tax location you used and the approximate dates of service.
- Section II: Rocket Tax Fees: what you were charged and when and how you learned of the fees.
- Section III: Affirmation: a statement made under penalty of perjury.
- Section IV: Consumer Release Form: a release of Rocket Tax and the people and businesses named in it.
A checklist of proof documents sits between Sections II and III. DCWP decides the amount of any refund. The agency's page also offers the same claim form in Spanish, titled Formulario de Reclamo en Español.
Who needs to file Settlement Fund Claim Form – Rocket Tax?
You may be eligible for restitution if you were a customer at Rocket Tax between December 1, 2023 and May 1, 2025 and Rocket Tax failed to disclose its fees to you. Both conditions must be met.
The form lists five Rocket Tax business addresses in Brooklyn, NY, and you select every location that applies to you:
- 580 Livonia Avenue
- 1714 Pitkin Avenue
- 390 Crescent Street
- 2602 Linden Boulevard
- 3914 Church Avenue
Each section (I to IV) must be completed by the claimant. By signing Section III you confirm that your information is true and that DCWP is not your personal attorney. By signing Section IV you state that you have not otherwise received any compensation or refund for the same claim. The form does not describe how someone may submit a claim for another person.
DCWP decides the amount of any refund. It cannot provide money for insurance, incidental costs, or damages due to pain and suffering, and it cannot advise whether a refund is taxable income.
When to file Settlement Fund Claim Form – Rocket Tax
The deadline to submit a claim is October 29, 2026. DCWP reviews and processes claims in the order it receives them and pays eligible refunds until no money remains in the Settlement Fund or the submission deadline passes, whichever comes first. A claim sent close to the deadline may therefore arrive after the fund is used up, so submit as soon as your form and proof are ready.
Your claim covers service at Rocket Tax between December 1, 2023 and May 1, 2025. DCWP lists no renewal or separate filing window. For questions, call (212) 436-0333 or email [email protected].
Documents you need
- Receipts or fee statements from Rocket Tax, to show that Rocket Tax failed to disclose additional tax preparation fees.
- Copies of the tax return(s) you filed at Rocket Tax, as proof of the fees and the years of service.
- Proof of the tax refund deposit amount for each year you filed at Rocket Tax, for example a bank statement or a copy of a check.
- Any other proof you describe on the Other (please describe) line of the form.
- Note: the form says that if you cannot provide these documents, DCWP may not be able to process your claim.
How to fill out Settlement Fund Claim Form – Rocket Tax
Confirm you are eligible
Check that you were a Rocket Tax customer between December 1, 2023 and May 1, 2025 and that Rocket Tax did not disclose its fees to you. Read the instructions on the first page before you start.
Enter your contact details
In Section I, type your Name, Email Address, Phone Number and Mailing Address. Use an address where you can receive mail that requires a signature, because DCWP sends any refund there.
Select your preferred contact method
Under Preferred Method of Contact, mark Email, Phone or Mail.
Mark the Rocket Tax locations
Under Rocket Tax Business Address, select every location that applies: 580 Livonia Avenue, 1714 Pitkin Avenue, 390 Crescent Street, 2602 Linden Boulevard or 3914 Church Avenue.
Add the dates of service
Enter the Approximate Date(s) of Service at Rocket Tax, which must fall within the claim period.
Describe the fees in Section II
Enter how much Rocket Tax charged you in the dollar field. Then answer when you found out about the fees and how you found out.
Check your proof documents
Under Required documents, mark each type of proof you are sending: receipts or fee statements, copies of tax returns, proof of refund deposit amount, or Other with a description.
Complete the Section III affirmation
Read the affirmation made under penalty of perjury. Type or print your name and the date in Print Name and Date.
Complete the Section IV release
Read the Consumer Release Form, which confirms you have received no other compensation or refund for this claim. Type or print your name and the date again.
Review and download the completed PDF
Check that all four sections are complete, then download or print the completed PDF from FillingPDF. Assemble it with your proof documents and submit it through the channels described under How to submit.
How to submit Settlement Fund Claim Form – Rocket Tax
You can submit the completed claim form and your supporting documents to DCWP by mail or by email.
- Mail: NYC Department of Consumer and Worker Protection, Attn: Rocket Tax Restitution, 42 Broadway, 9th Floor, New York, NY 10004.
- Email: [email protected].
Send the full form, all four sections, together with the proof documents you checked in the Required documents list. Submit by October 29, 2026. DCWP mails any refund, with signature required, to the Mailing Address you give in Section I, so make sure it is correct.
For questions, call (212) 436-0333 or email [email protected]. The form sets no fee for filing a claim. FillingPDF lets you fill out and download the PDF; submission follows the channels above.
Common mistakes to avoid
- Skipping a section. The instructions say the form has four sections (I-IV) and you must complete each one.
- Sending the form without the supporting documents. The form warns that DCWP may not be able to process a claim without them.
- Giving a mailing address that is wrong or out of date. DCWP mails any refund, signature required, to the address you give in Section I.
- Leaving the Rocket Tax Business Address boxes unmarked instead of selecting every location that applies to you.
- Typing or printing your name and date in only one of Section III and Section IV; each section has its own Print Name and Date.
- Submitting after October 29, 2026, or waiting until late; payments stop when the fund is empty or the deadline arrives, whichever comes first.
- Signing Section IV after already receiving other compensation or a refund for the same claim; the release states you have not.
- Expecting DCWP to pay for insurance, incidental costs, or pain and suffering; the form says it cannot.
Frequently asked questions
What is the Rocket Tax Settlement Fund Claim Form?
It is the DCWP form for claiming restitution under the settlement in which Rocket Tax agreed to refund money to eligible consumers. You complete four sections and send it with proof of the fees to the NYC Department of Consumer and Worker Protection.
Is this an NYC property tax form?
No. Although the name mentions tax, this claim form concerns fees Rocket Tax charged for preparing tax returns. It is a DCWP settlement claim, not a document for paying or disputing NYC property tax.
Who is eligible to file a Rocket Tax claim?
You may be eligible if you were a Rocket Tax customer between December 1, 2023 and May 1, 2025 and Rocket Tax failed to disclose its fees to you. DCWP reviews each claim and decides the amount of any refund.
What is the deadline to submit the Rocket Tax claim form?
The deadline is October 29, 2026. DCWP pays eligible claims in the order received until the Settlement Fund is empty or the deadline passes, whichever is first, so submitting early is safer.
Where do I send the Rocket Tax claim form?
Mail it to NYC Department of Consumer and Worker Protection, Attn: Rocket Tax Restitution, 42 Broadway, 9th Floor, New York, NY 10004, or email it to [email protected]. Include your supporting documents.
What documents do I need for a Rocket Tax claim?
The form asks for proof that Rocket Tax did not disclose its fees: receipts or fee statements, copies of tax returns filed at Rocket Tax, or proof of your refund deposit. Without these, DCWP may not be able to process your claim.
Can I fill out the Rocket Tax claim form online?
Yes. You can fill out the PDF online on FillingPDF and download or print it. FillingPDF is an independent service and does not submit the claim; you send it to DCWP by mail or email.
Will the refund be treated as taxable income?
The form says DCWP cannot advise whether a refund is taxable income. DCWP also decides the refund amount and cannot pay for insurance, incidental costs, or damages for pain and suffering.
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