IP infringement in Advertisement Report Form

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the your complaint

Type of your complaint

Copyright
Trademark

Describe the work you want to report

Location of the content that you'd like to report

Name of the rights owner

This may be your full name or the name of the organisation for which you are the authorised representative.

Identity of content owner

Influencer
Advertiser
Bloc User
None of the above

Location of original work (optional)

Your relationship to the protected work

Owner
Owner's authorised representative

Do you have proof of rights and authorization?

Have scanned copies of certificates, license agreements, or other materials to prove that you are the owner of the content ready for when we get in touch to prove you are the owner of the content and have protective rights.

Your Name

First

Last

If you choose to submit this report, we will provide the rights owner's name, your email address and the nature of your report to the person who posted the content that you are reporting. This person may use the information that you provide to contact you about the report and attempt to resolve the issue. For this reason, you may wish to provide a valid business or professional email address.

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 links (URLs) leading directly to the specific content that you are reporting.

You can report multiple links (URLs) in this report. To do this, enter 1 link (URL) per line.

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 have a good faith belief that the reported use of the copyrighted work described above, in the manner complained of, is not authorised by the owner of the content, its authorised representative, or the law.
I state under penalty of perjury that the above information is accurate, and that I am the owner of the content or I am authorised to act on behalf of the content owner.
I acknowledge that all information submitted in my IP infringement notification may be forwarded 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

By submitting this notice, you state that you have a good faith belief that the reported use described above, in the manner that you have complained of, is not authorised by the intellectual property rights owner, its agent or the law; that the information contained in this notice is accurate; and, under penalty of perjury, that you are authorised to act on behalf of the owner of the intellectual property rights at issue.

Electronic signature

Your electronic signature should match your full name.