By typing your full name into the following box you sign this form with your electronic signature*.

Title*

Name*

Address*

E-mail address*

Country*

City*

State*

Phone*

Post code / Zip*

Please identify the copyrighted material you believe to be infringed.

URL/s, web address/s or location/s of your copyrighted material.

Upload copyrighted material.

Please describe which parts of the material are being infringed.

Please identify the material you believe to be infringing.

URL/s, web address/s or location/s of infringing material.

Upload infringing material.

Please describe which parts of the material are infringing.

By checking the following checkboxes, I declare:

that I am the copyright owner of the alleged infringed material or I am authorised to act on behalf of the copyright owner*.

that the alleged copyright infringement was not authorised by the copyright owner or an agent acting on behalf of the copyright owner and would also not be considered fair use or be considered legally allowable under copyright law without permission from the copyright owner*.

that all of the information, including declarations, that I have given in support of this claim, are true and accurate*.