Digital Millennium Copyright Act (DMCA) Form

Name of copyright holder:

Name of person authorized to act on behalf of copyright holder:

Identify the copyrighted work claimed to have been infringed: [Insert location of copyrighted material eg: URL]

Include a representative list of such works at that site: [eg: text, picture on front page, html code etc]

Identification of the material that is claimed to be infringing or to be the subject of infringing activity that is to be removed or access to which is to be disabled: [Insert what you believe proves that they have "borrowed" your intellectual property]

Name of complaining party: [Your Name / Company Name] Address: [Your address] Phone: [Your phone number] E- mail: [Your Email]

I hereby affirm, as the complaining party, that I believe in good faith that the use of the material in the manner complained of is not authorized by the copyright holder, its agent or the law.

I hereby affirm, under penalty of perjury, that the information contained in this notification is accurate, and that I am authorized to act on behalf of the holder of the exclusive right that I claim to be infringed.