Intellectual Property Claim

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Your Contact Information

First Name (required) Last Name (required) Address Line 1 (required) States Country (required) Your Email (required) Phone Number (required)

IP Claim Details

Are you the Rights Owner or an Agent? (required) Rights OwnerAgent IP Owner (Legal Name) The specific concern is (required) URL(s) to original work (required) Additional Information (Optional)

Statement

* I have a good faith belief that content(s) in the campaign described above violate(s) my rights described above or those held by the rights owner, and that the use of such content(s) is contrary to law.

* I declare, under penalty of perjury, that the information completed above is correct and accurate and that I am the owner or agent of the owner of the rights described above.

I have read and accept the statements above.

Your Contact Information

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