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DAVID C. SHONKA

Acting General Counsel

JANET M. EVANS (DC Bar No. 358467) 

ELIZABETH JONES SANGER (WI Bar No. 1080449) 

Federal Trade Commission

600 Pennsylvania Avenue, NW 

Mail Drop CC-10528 

Washington, DC 20580 

(202) 326-2125, -2757 (Tel.)

(202) 326-3259 (Fax) 

jevans@ftc.gov; esanger@ftc.gov

Attorneys for Plaintiff

FEDERAL TRADE COMMISSION

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

SAN FRANCISCO DIVISION

FEDERAL TRADE COMMISSION,

Plaintiff,

 v. 

BREATHOMETER, INC., a corporation, 

and

CHARLES MICHAEL YIM, individually and as 

Chief Executive Officer of Breathometer, 

Inc.,

Defendants.

Case No. 3:17-cv-314-LB

STIPULATED FINAL ORDER FOR 

PERMANENT INJUNCTION AND 

OTHER EQUITABLE RELIEF

Plaintiff, the Federal Trade Commission (“Commission” or “FTC”), filed its Complaint 

for Permanent Injunction and Other Equitable Relief (“Complaint”) in this matter, pursuant to 

Section 13(b) of the Federal Trade Commission Act (“FTC Act”), 15 U.S.C. § 53(b). The 

Commission and Defendants stipulate to the entry of this Stipulated Final Order for Permanent 

Injunction and Other Equitable Relief (“Order”) to resolve all matters in dispute in this action 

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between them.

THEREFORE, IT IS ORDERED as follows:

FINDINGS

1. This Court has jurisdiction over this matter.

2. The Complaint charges that Defendants participated in deceptive and unfair acts or

practices and disseminated false advertisements in violation of Sections 5 and 12 of the FTC 

Act, 15 U.S.C. §§ 45(a) and 52, in connection with the advertising, labeling, promotion, 

offering for sale, sale, or distribution of Breathometer Original (“Original”) and Breathometer 

Breeze (“Breeze”) breathalyzers. 

3. Defendants neither admit nor deny any of the allegations in the Complaint, except as

specifically stated in this Order. Only for purposes of this action, Defendants admit the facts 

necessary to establish jurisdiction. 

4. Defendants waive any claim that they may have under the Equal Access to Justice Act,

28 U.S.C. § 2412, concerning the prosecution of this action through the date of this Order, and 

agree to bear their own costs and attorney fees.

5. Defendants waive all rights to appeal or otherwise challenge or contest the validity of

this Order.

DEFINITIONS

For the purpose of this Order, the following definitions apply: 

1. “Breathalyzer Device” means any device advertised for use by consumers to measure

their blood or breath alcohol concentration in connection with driving decisions. 

2. “Corporate Defendant” means Breathometer, Inc. and its successors and assigns.

3. “Covered Product” means any Device other than a Breathalyzer Device.

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4. “Defendants” means the Individual Defendant and the Corporate Defendant, 

individually, collectively, or in any combination.

5. “Device” means any instrument, apparatus, implement, machine, contrivance, implant, 

in vitro reagent, or other similar or related article, including any component, part, or accessory, 

which is:

a) recognized in the official National Formulary, or the United States 

Pharmacopeia, or any supplement to them,

b) intended for use in the diagnosis of disease or other conditions, or in the cure, 

mitigation, treatment, or prevention of disease, in humans or other animals, or

c) intended to affect the structure or any function of the body of humans or other 

animals, and

which does not achieve any of its principal intended purposes through chemical action within or 

on the body of humans or other animals and which is not dependent upon being metabolized for 

the achievement of any of its principal intended purposes; provided that, for the purpose of this 

order, “Device” does not include evidential breath alcohol testers that have been tested and 

approved by the Department of Transportation.

6. “Including” means “including but not limited to.”

7. “Individual Defendant” means Charles Michael Yim.

ORDER

I. PROHIBITED REPRESENTATIONS: CLAIMS REGARDING

BREATHALYZER DEVICES

IT IS ORDERED that Defendants, Defendants’ officers, agents, employees, and all 

other persons in active concert or participation with any of them, who receive actual notice of 

this Order, whether acting directly or indirectly, in connection with the advertising, labeling, 

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promotion, offering for sale, sale, or distribution of any Breathalyzer Device are permanently 

restrained and enjoined from making, or assisting others in making, expressly or by implication, 

including through the use of a product or program name, endorsement, depiction, or illustration, 

any representation that the Breathalyzer Device:

A. Detects consumers’ blood alcohol levels; or

B. Is comparable or superior to other Breathalyzer Devices or to devices for blood 

or breath alcohol concentration detection used by law enforcement,

unless the representation is non-misleading and, at the time of making such representation, they

possess and rely upon competent and reliable scientific evidence that is sufficient in quality and 

quantity based on standards generally accepted in the relevant scientific fields, when considered 

in light of the entire body of relevant and reliable scientific evidence, to substantiate that the 

representation is true.

For purposes of this Provision, competent and reliable scientific evidence means testing 

that demonstrates that the manufactured device meets the accuracy specifications set for 

evidential breath alcohol testers that have been tested and approved by the Department of 

Transportation as laid out in Highway Safety Programs; Model Specifications for Devices to

Measure Breath Alcohol, 58 FR 48705, Sept. 17, 1993, that is, repeated testing (at least 10 

measurements per condition, at three decimal places) must demonstrate accuracy to within ± 

0.005 BAC, with a standard deviation within ± 0.0042, at 0.020, 0.040, 0.080; and to within ±

0.008 BAC, with a standard deviation within ± 0.0042, at 0.160 BAC. Tests must demonstrate 

the same levels of accuracy after the device has “soaked” in a temperature control chamber of 

20° C (± 1° C) for one hour, and also at 30° C (± 1° C) for one hour. Further, to ensure stability 

of readings, the tests for accuracy at 0.080 must be repeated thirty days after the initial tests, to 

ensure that the device holds calibration.

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Unless otherwise specified, all such tests must be performed in the absence of drafts and 

at prevailing normal laboratory temperature, humidity, and barometric pressure. Ethyl alcohol 

must be used to prepare the test samples. A Department of Transportation approved calibrating 

unit of the type that uses aqueous alcohol solutions thermostated at 34° C and a ratio of 

headspace concentration of 0.000393 must be used to provide the BAC samples. The 

calibrating unit must be capable of delivering 10 complete vapor samples with alcohol depletion 

of not more than 1%.

Tests must further demonstrate that the product does not suffer from acetone 

interference at .020 BAC under the following two conditions: 70 microliters acetone per 500 ml 

solution, and 115 microliters acetone per 500 ml solution. 

In addition, repeated tests (at least 10 measurements) must show accuracy within ± .005 

BAC at 0.000, with no single result greater than 0.005 BAC. These tests must be conducted on 

one or more persons who have not consumed alcohol in the past 48 hours nor smoked within the 

past 20 minutes, using his or own breath.

II. PROHIBITED REPRESENTATIONS: OTHER DEVICE CLAIMS

IT IS FURTHER ORDERED that the Individual Defendant, his agents, employees, and 

all other persons in active concert or participation with any of them, who receive actual notice 

of this Order, whether acting directly or indirectly, in connection with the advertising, labeling, 

promotion, offering for sale, sale, or distribution of any Covered Product, are permanently 

restrained and enjoined from making, or assisting others in making, directly or by implication, 

including through the use of a product or program name, endorsement, depiction, or illustration, 

any representation about the absolute or comparative safety, health benefits, performance, or 

efficacy of any Covered Product, unless the representation is non-misleading, and, at the time of 

making such representation, they possess and rely upon competent and reliable scientific 

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evidence that is sufficient in quality and quantity based on standards generally accepted by 

experts in the relevant disease, condition, or function to which the representation relates, when 

considered in light of the entire body of relevant and reliable scientific evidence, to substantiate 

that the representation is true.

For purposes of this Provision, competent and reliable scientific evidence means tests, 

analyses, research, or studies that (1) have been conducted and evaluated in an objective manner 

by experts in the relevant disease, condition, or function to which the representation relates; (2) 

that are generally accepted by such experts to yield accurate and reliable results; and (3) that are 

randomized, double-blind, and placebo-controlled human clinical testing of the Covered 

Product when such experts would generally require such human clinical testing to substantiate 

that the representation is true. In addition, when such tests or studies are human clinical tests or 

studies, all underlying or supporting data and documents generally accepted by experts in the 

field as relevant to an assessment of such testing as described in the Provision of this Order 

entitled Preservation of Records Relating to Competent and Reliable Human Clinical Tests or 

Studies must be available for inspection and production to the Commission.

III. PROHIBITED MISREPRESENTATIONS REGARDING TESTS

IT IS FURTHER ORDERED that the Individual Defendant, his agents, employees, and 

all other persons in active concert or participation with any of them, who receive actual notice 

of this Order, whether acting directly or indirectly, in connection with the advertising, labeling, 

promotion, offering for sale, sale, or distribution of any Covered Product, are permanently 

restrained and enjoined from misrepresenting, or assisting others in misrepresenting, expressly 

or by implication, including through the use of a product name, endorsement, depiction, or 

illustration:

A. That the performance or benefits of the Covered Product are scientifically or 

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clinically proven or otherwise established;

B. That the performance or benefits of the Covered Product have been proven by 

government lab-grade testing; or

C. The existence, contents, validity, results, conclusions, or interpretations of any 

test, study, or other research.

IV. PRESERVATION OF RECORDS RELATING TO COMPETENT AND 

RELIABLE HUMAN CLINICAL TESTS OR STUDIES

IT IS FURTHER ORDERED that, with regard to any human clinical test or study 

(“test”) upon which the Individual Defendant relies to substantiate any claim covered by the 

Provision of this Order entitled Prohibited Representations: Other Device Claims, the 

Individual Defendant must secure and preserve all underlying or supporting data and documents 

generally accepted by experts in the field as relevant to an assessment of the test, including:

A. All protocols and protocol amendments, reports, articles, write-ups, or other 

accounts of the results of the test, and drafts of such documents reviewed by the test sponsor or 

any other person not employed by the research entity;

B. All documents referring or relating to recruitment; randomization; instructions, 

including oral instructions, to participants; and participant compliance;

C. Documents sufficient to identify all test participants, including any participants 

who did not complete the test, and all communications with any participants relating to the test; 

all raw data collected from participants enrolled in the test, including any participants who did 

not complete the test; source documents for such data; any data dictionaries; and any case report 

forms;

D. All documents referring or relating to any statistical analysis of any test data, 

including any pretest analysis, intent-to-treat analysis, or between-group analysis performed on 

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any test data; and

E. All documents referring or relating to the sponsorship of the test, including all 

communications and contracts, between any sponsor and the test’s researchers.

Provided, however, the preceding preservation requirement does not apply to a reliably 

reported test, unless the test was conducted, controlled, or sponsored, in whole or in part by: 

(1) Individual Defendant; (2) his officers, agents, representatives, or employees; (3) any other 

person or entity in active concert or participation with him; (4) any person or entity affiliated 

with or acting on his behalf; (5) any supplier of any component contained in the product at issue 

to any of the foregoing or to the product’s manufacturer; or (6) the supplier or manufacturer of 

such product. For the purposes of this Provision, “reliably reported,” for a human clinical test 

or study (“test”), means a report of the test has been published in a peer-reviewed journal, and 

such published report provides sufficient information about the test for experts in the relevant 

field to assess the reliability of the results.

For any test conducted, controlled, or sponsored, in whole or in part, by Individual 

Defendant, he must establish and maintain reasonable procedures to protect the confidentiality, 

security, and integrity of any personal information collected from or about participants. These 

procedures must be documented in writing and must contain administrative, technical, and 

physical safeguards appropriate to his organization’s size and complexity, the nature and scope 

of his activities, and the sensitivity of the personal information collected from or about the 

participants.

V. PROHIBITED CONDUCT REGARDING THE BREATHOMETER APP 

IT IS FURTHER ORDERED that Defendants, Defendants’ officers, agents, employees, 

and all other persons in active concert or participation with any of them, who receive actual 

notice of this Order, are permanently restrained and enjoined from re-enabling the Breathometer 

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app’s breathalyzer functions, which were disabled prior to entry of this Order.

VI. CONSUMER NOTICE

IT IS FURTHER ORDERED that Defendants must provide adequate and timely notice 

of this Order to owners of both Original and Breeze by email and on the Breathometer website 

homepage. 

A. For the purposes of this paragraph, adequate and timely notice means:

1. An email, sent within five days of entry of this Order, in the exact wording and 

format set forth in Attachment A, with the subject line “Your Breathometer Breathalyzer Refund,” and 

without any other materials accompanying the email; and

2. A prominent notice on the Breathometer website homepage, posted within two 

days of entry of this Order, and remaining on the homepage until 90 days after entry of this Order, in the 

exact wording set forth in Attachment B, in a location that does not require the website visitor to scroll to 

see the notice, even if accessing the website from a mobile phone or tablet.

B. The notices must provide the link to an online Claim Form containing the exact 

wording set forth in Attachment C, in an easily legible format.

VII. CONSUMER REDRESS

IT IS FURTHER ORDERED that Defendants must provide full refunds to owners of 

Breathometer Brand Breathalyzer Devices as follows:

A. Refunds must be for the full amount claimed by the owner in the online Claim 

Form (set forth in Attachment C), unless Defendants have already fully refunded such owner.

B. Defendants must provide refunds to any owner who submits the online Claim 

Form within 125 days after entry of this Order; such refund must be provided within 90 days of 

Defendants’ receipt of a completed Claim Form from an owner.

C. Defendants must not require owners to submit any documentation other than the 

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completed Claim Form nor impose any condition on owners seeking refunds.

D. Within 230 days of entry of this Order, Defendants must provide the FTC with 

records sufficient to show the dates, times, and form of notifications to each owner, the refunds 

requested and paid to each such owner, any refund requests that were denied due to a prior full 

refund, and any refunds paid by Defendants to individual consumers after June 9, 2016.

E. In the event that refunds paid to owners pursuant to this Provision total less than 

$1 million, Defendants, jointly and severally, must pay to the Commission, within 235 days of 

entry of this Order, the difference between the refunds paid and $1 million; provided that, cash 

refunds paid by Defendants to individual consumers after June 9, 2016 will be considered to 

have been made pursuant to this Provision.

F. Defendants relinquish dominion and all legal and equitable right, title, and 

interest in all assets transferred pursuant to this Order and may not seek the return of any assets.

G. All money paid to the Commission pursuant to this Order may be deposited into 

a fund administered by the Commission or its designee to be used for equitable relief, including 

consumer redress and any attendant expenses for the administration of any redress fund. If a 

representative of the Commission decides that direct redress to consumers is wholly or partially 

impracticable or money remains after redress is completed, the Commission may apply any 

remaining money for such other equitable relief (including consumer information remedies) as 

it determines to be reasonably related to Defendants’ practices alleged in the Complaint. Any 

money not used for such equitable relief is to be deposited to the U.S. Treasury as 

disgorgement. Defendants have no right to challenge any actions the Commission or its 

representatives may take pursuant to this paragraph.

H. The facts alleged in the Complaint will be taken as true, without further proof, in 

any subsequent civil litigation by or on behalf of the Commission, including in a proceeding to 

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enforce its rights to any payment or monetary judgment pursuant to this Order, such as a 

nondischargeability complaint in any bankruptcy case.

I. The facts alleged in the Complaint establish all elements necessary to sustain an

action by the Commission pursuant to Section 523(a)(2)(A) of the Bankruptcy Code, 11

U.S.C. § 523(a)(2)(A), and this Order will have collateral estoppel effect for such purpose.

J. Defendants acknowledge that their Taxpayer Identification Numbers (Social 

Security Numbers or Employer Identification Numbers), which Defendants must immediately 

furnish to the Commission, may be used for collecting and reporting on any delinquent amount 

arising out of this Order, in accordance with 31 U.S.C. §7701.

VIII. CUSTOMER INFORMATION

IT IS FURTHER ORDERED that Defendants, Defendants’ officers, agents, employees, 

and all other persons in active concert or participation with any of them, who receive actual 

notice of this Order, whether acting directly or indirectly, are permanently restrained and 

enjoined from failing to provide sufficient customer information to enable the Commission to 

efficiently monitor consumer refunds as prescribed by the Provision of this Order entitled 

Consumer Redress. If a representative of the Commission requests in writing any information 

related to redress, Defendants must provide it, in the form prescribed by the Commission, 

within 14 days.

IX. ORDER ACKNOWLEDGMENTS

IT IS FURTHER ORDERED that Defendants obtain acknowledgments of receipt of this 

Order:

A. Each Defendant, within 7 days of entry of this Order, must submit to the 

Commission an acknowledgment of receipt of this Order sworn under penalty of perjury.

B. For 3 years after entry of this Order, for any business that the Individual 

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Defendant, individually or collectively with the Corporate Defendant, is the majority owner or 

controls directly or indirectly, and each Corporate Defendant, must deliver a copy of this Order 

to: (1) all principals, officers, directors, and LLC managers and members; (2) all employees, 

agents, and representatives who participate in conduct related to the subject matter of the Order; 

and (3) any business entity resulting from any change in structure as set forth in the Provision

titled Compliance Reporting. Delivery must occur within 7 days of entry of this Order for 

current personnel. For all others, delivery must occur before they assume their responsibilities.

C. From each individual or entity to which a Defendant delivered a copy of this 

Order, that Defendant must obtain, within 30 days, a signed and dated acknowledgment of 

receipt of this Order.

X. COMPLIANCE REPORTING

IT IS FURTHER ORDERED that Defendants make timely submissions to the 

Commission:

A. Within one year after entry of this Order, each Defendant must submit a 

compliance report, sworn under penalty of perjury:

1. Each Defendant must: (a) identify the primary physical, postal, and 

email address and telephone number, as designated points of contact, which representatives of 

the Commission may use to communicate with Defendant; (b) identify all of that Defendant’s 

businesses by all of their names, telephone numbers, and physical, postal, email, and Internet 

addresses; (c) describe the activities of each business, including the goods and services offered, 

the means of advertising, marketing, and sales, and the involvement of any other Defendant 

(which the Individual Defendant must describe if he knows or should know due to his own 

involvement); (d) describe in detail whether and how that Defendant is in compliance with each 

Provision of this Order; and (e) provide a copy of each Order Acknowledgment obtained 

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pursuant to this Order, unless previously submitted to the Commission.

2. Additionally, the Individual Defendant must: (a) identify all telephone 

numbers and all physical, postal, email and Internet addresses, including all residences; (b) 

identify all business activities, including any business for which the Individual Defendant 

performs services whether as an employee or otherwise and any entity in which the Individual 

Defendant has direct or indirect control; and (c) describe in detail the Individual Defendant’s 

involvement in each such business, including title, role, responsibilities, participation, authority, 

control, and any ownership.

B. For 10 years after entry of this Order, each Defendant must submit a compliance

notice, sworn under penalty of perjury, within 30 days of any change in the following:

1. Each Defendant must report any change in: (a) any designated point of 

contact; or (b) the structure of the Corporate Defendant or any entity that such Defendant has 

any ownership interest in or controls directly or indirectly that may affect compliance 

obligations arising under this Order, including: creation, merger, sale, or dissolution of the 

entity or any subsidiary, parent, or affiliate that engages in any acts or practices subject to this 

Order.

2. Additionally, the Individual Defendant must report any change in: (a) 

name, including aliases or fictitious name, or residence address; or (b) title or role in any 

business activity, including any business for which such Defendant performs services whether 

as an employee or otherwise and any entity in which such Defendant has direct or indirect 

control, and identify the name, physical address, and any Internet address of the business or 

entity.

C. Each Defendant must submit to the Commission notice of the filing of any 

bankruptcy petition, insolvency proceeding, or similar proceeding by or against such Defendant 

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within 14 days of its filing.

D. Any submission to the Commission required by this Order to be sworn under 

penalty of perjury must be true and accurate and comply with 28 U.S.C. § 1746, such as by 

concluding: “I declare under penalty of perjury under the laws of the United States of America 

that the foregoing is true and correct. Executed on: _____” and supplying the date, signatory’s 

full name, title (if applicable), and signature.

E. Unless otherwise directed by a Commission representative in writing, all 

submissions to the Commission pursuant to this Order must be emailed to DEbrief@ftc.gov or 

sent by overnight courier (not the U.S. Postal Service) to: Associate Director for Enforcement, 

Bureau of Consumer Protection, Federal Trade Commission, 600 Pennsylvania Avenue NW, 

Washington, DC 20580. The subject line must begin: FTC v. Breathometer, Inc., et al.

XI. RECORDKEEPING

IT IS FURTHER ORDERED that Defendants must create certain records for 10 years 

after entry of the Order, and retain each such record for 5 years. Specifically, the Corporate 

Defendant and the Individual Defendant for any business that he, individually or collectively 

with the Corporate Defendant, is a majority owner or controls directly or indirectly, must create 

and retain the following records: 

A. Accounting records showing the revenues from all goods or services sold; 

B. Personnel records showing, for each person providing services, whether as an 

employee or otherwise, that person’s: name; addresses; telephone numbers; job title or position; 

dates of service; and (if applicable) the reason for termination;

C. Records of all consumer complaints and refund requests, whether received 

directly or indirectly, such as through a third party, and any response; 

D. All records necessary to demonstrate full compliance with each Provision of this 

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Order, including all submissions to the Commission; and 

E. A copy of each unique advertisement or other marketing material. 

XII. COMPLIANCE MONITORING

IT IS FURTHER ORDERED that, for the purpose of monitoring Defendants’ 

compliance with this Order, including any failure to transfer any assets as required by this 

Order:

A. Within 14 days of receipt of a written request from a representative of the 

Commission, each Defendant must: submit additional compliance reports or other requested 

information, which must be sworn under penalty of perjury; appear for depositions; and produce 

documents for inspection and copying. The Commission is also authorized to obtain discovery, 

without further leave of court, using any of the procedures prescribed by Federal Rules of Civil 

Procedure 29, 30 (including telephonic depositions), 31, 33, 34, 36, 45, and 69. 

B. For matters concerning this Order, the Commission is authorized to 

communicate directly with each Defendant. Defendant must permit representatives of the 

Commission to interview any employee or other person affiliated with any Defendant who has 

agreed to such an interview. The person interviewed may have counsel present. 

C. The Commission may use all other lawful means, including posing, through its 

representatives as consumers, suppliers, or other individuals or entities, to Defendants or any 

individual or entity affiliated with Defendants, without the necessity of identification or prior 

notice. Nothing in this Order limits the Commission’s lawful use of compulsory process, 

pursuant to Sections 9 and 20 of the FTC Act, 15 U.S.C. §§ 49, 57b-1. 

D. Upon written request from a representative of the Commission, any consumer 

reporting agency must furnish consumer reports concerning the Individual Defendant, pursuant 

to Section 604(1) of the Fair Credit Reporting Act, 15 U.S.C. §1681b(a)(1). 

Case 3:17-cv-00314-LB Document 8 Filed 01/30/17 Page 15 of 20
Case No. 3:17-cv-314-LB

30th January, 2017

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Stipulated Final Judgment and Order 

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DC Bar No. 370670

BRANDON MYERS

DC Bar No. 1023569 

Covington & Burling LLP

One CityCenter

850 Tenth Street, NW 

Washington, DC 20001 

Tel.: 202-662-5938, -5132 

Fax: 202-778-5938 

Email: jgraubert@cov.com; bmyers@cov.com

COUNSEL FOR MR. YIM

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ATTACHMENT A

[EMAIL NOTICE]

SUBJECT LINE: Your Breathometer Breathalyzer Refund

[EMAIL CONTENT]

Your Breathometer breathalyzer refund

Dear Breathometer customer:

Your Breathometer breathalyzer and the accompanying app have been disabled because

of a potentially serious safety issue. The breathalyzer has been shown in some cases to falsely 

report a low blood alcohol concentration (BAC) reading, even when it’s unsafe for the user to 

drive.

You are receiving this notice as a result of a lawsuit alleging deceptive advertising filed against 

us by the Federal Trade Commission, the nation’s consumer protection agency. We have 

disabled the Breathometer app and have agreed to offer refunds to Breathometer Original and 

Breathometer Breeze customers. 

Visit [clickable URL, linked to Attachment C, a page on the Breathometer website] to file for 

your refund. You must submit your refund request no later than [insert date 90 days after the 

date notice was provided pursuant to Provision VI.A.1. of the Order].

If you have questions, please contact us [800-xxx-xxxx] or BAC@breathometer.com. 

Sincerely,

Team Breathometer

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ATTACHMENT B

[NOTICE ON BREATHOMETER WEBSITE HOMEPAGE]

[clickable button, linked to Attachment C, a page on the Breathometer website]

Important Refund Notice for 

Original and Breeze 

Customers

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ATTACHMENT C

[REFUND CLAIM VIA FILLABLE FORM WEBPAGE]

Breathometer Original and Breathometer Breeze

REFUND CLAIM FORM

FTC v. Breathometer, Inc. and Others

Breathometer Original and Breeze customers are entitled to a refund as a result of a 

settlement in a lawsuit filed against us by the Federal Trade Commission, the nation’s 

consumer protection agency.

Complete and Submit this

Form By

[insert date 90 days after the date notice was provided 

pursuant to Provision VI.A.1. of the Order]

First Name ___________________________

Last Name ___________________________

Address _____________________________

City ______________________

State _________

ZIP Code ___________

Email Address ________________________

Product Serial Number (Optional) ___________

 I bought a Breathometer Original for $49.99. 

Please send me a refund.

 I bought a Breathometer Original for

$_________ (fill in amount you paid).

Please send me a refund.

 I bought a Breathometer Breeze for

$99.99. Please send me a refund.

 I bought a Breathometer Breeze for

$__________ (fill in amount you paid).

Please send me a refund.

Signature ____________________________________________

(type your name, this is your electronic signature)

Date______________________

SUBMIT [clickable button]

Contact us at [800-xxx-xxxx] or BAC@breathometer.com if you have any questions.

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