Trademark Infringement Report Form

Describe your relationship to the rights owner.

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

Email

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

Name of the rights owner

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

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

signature statement email

What is the trademark?

Please provide information for one trademark at a time. You will have an opportunity to list additional trademarks at the end of this section.

Where is the trademark registered?

What is the trademark registration number (if applicable)?

If possible, also provide a link (URL) leading directly to the trademark registration.

Why do you believe that this content infringes the rights owner's trademark rights?

Objects such as Pages, groups or profiles contain many individual photos, posts and other pieces of content. It's uncommon for the trademarks in all of these pieces of content to belong to one rights owner or infringe only one party's rights. If you believe that this object is infringing your trademark rights in their entirety, you may continue with this report.

What type of content are you reporting?

Photo, video or post
Ad
Other

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.

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.