Copyright Complaint Form

Your Full Legal Name

Your Title or Job Position

Telephone Number

Fax Number

Street Address

City

State / Province

Zip / Postal Code

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Description of the work(s) allegedly infringed

URL or other description of location of the work(s) allegedly infringing

By checking the following boxes, I state under penalty of perjury that:

I am the owner, or an agent authorized to act on behalf of the owner of an exclusive right that is allegedly infringed; I have a good faith belief that the use of the material in the manner complained of is not authorized by the copyright owner, its agent, or the law; This notification is accurate; and I acknowledge that under Section 512(f) of the DMCA any person who knowingly misrepresents that material or activity is infringing may be subject to liability for damages.

Typing your full name in this box will act as your digital signature

Copyright Complaint Form

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