Impersonation & Privacy Violations Form

Select the option that best fits your situation.

I am being bullied or harassed on Bloc
Someone is pretending to be me on Bloc
I would like to report inappropriate content or behavior
Someone violated my intellectual property rights
I have an account-related issue
I would like to report a privacy concern or exercise my data rights

Describe the violation or issue you want to report

Supporting URLS (optional)

Your Name

First

Last

URLS Select Supporting

Postal address

Please provide a valid email address that can be used to contact you. This may be a professional or business email address. Bear in mind that the reported party may use this email address to contact you.

Confirm your email address

Are you reporting on behalf of an individual or on behalf of a business?

Please provide any additional information that can help us understand your report.

You can provide links (URLs) to examples on your website, your Bloc app or anywhere else on the web. Please note that we are unable to review materials hosted on a third-party application.

Legal Affirmations

I state under penalty of perjury that the above information is accurate.
I acknowledge that all information submitted may be sforwarded to the uploader of the content.

Please check if you agree with the following statements. We will not accept your claim if you do not check these boxes.

Declaration statement

Electronic signature

Your electronic signature should match your full name.