DMCA TAKEDOWN REQUEST FORM

DMCA Takedown Request Form

URL of potentially infringing material on PullPatch.com^*

Description of the infringement:^*

Additional comments:

Relationship to copyright holder:^*

I own the copyrighted workMy organization owns the copyrighted workI am an agent authorized to file this notice on behalf of the copyright holder

Your full legal name:^*

Your email address:^*

Company name (optional):

Job title (optional):

Street address:^*

City:^*

State / Province:^*

Postal code:^*

Country:^*

Phone Number (optional):

Good Faith Belief - I have 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.:^*

I AcceptI Don't Accept

Authority to Act Declaration - This question is required. *UNDER PENALTY OF PERJURY*, I hereby declare that the information in this notification is accurate and that I am authorized to act on behalf of the copyright owner.^*

I AcceptI Don't Accept

512(f) Acknowledgment - *I understand that under 17 U.S.C. § 512(f), I may be liable for any damages, including costs and attorneys' fees if I knowingly materially misrepresent that reported material or activity is infringing.*^*

I AcceptI Don't Accept

Please electronically sign this notice by typing your full name in the field below.^*

Please note that we may provide any information you submit in this form to third parties. If you are unsure whether the material you are reporting is in fact infringing (and, for example, not protected by fair use), you may wish to contact an attorney before filing a notification with us.

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