DMCA Contact Form - Synergistic Techs

Name*

First Last

Company Name

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

YOUR COPYRIGHTED WORK

Type of Infringement

Copyright
Trademark

Location of copyrighted work (where your authorized work is located):*

LOCATION OF INFRINGING MATERIAL IN THE WEBSITE

Identify the material that you claim is infringing the copyrighted work listed in the item above. You must identify each web page that allegedly contains infringing material. This requires you to provide the URL for each allegedly infringing result, document or item.

Location (URL) of infringing third party content that the website is linking to:*

I have a good faith belief that use of the copyrighted materials described above as allegedly infringing is not authorized by the copyright owner, its agent, or the law.*

Please check to confirm

I swear, under penalty of perjury, that the information in the notification is accurate and that I am the copyright owner or am authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.*

Please check to confirm

Date*

Signature*