🚨 Caution

Misusing this template can result in:

• perjury charges
• liability for financial damages
• exposure of personal information

Understand the risks or appoint an authorized representative.

📋 Template

STATEMENT OF PURPOSE
This is formal notification of copyright infringement under the provisions of Section 512(c) of the
Digital Millennium Copyright Act (”DMCA”). The purpose of this message is to seek removal of the infringing content referenced herein.

INFRINGING CONTENT URLS
http://________________________

ORIGINAL COPYRIGHTED CONTENT SOURCE URL
http://________________________

STATEMENT OF GOOD FAITH
I have a good faith belief that the use of the material in the manner complained of is not
authorized by the copyright owner, its agent, or the law.

STATEMENT OF ACCURACY AND AUTHORITY
The information in this notification is accurate, and under penalty of perjury, I am the owner, or
an agent authorized to act on behalf of the owner, of an exclusive right that is allegedly
infringed.

CONTACT INFORMATION
Name:
_____________________________

Email address:
__________@______.___

Mailing address:
____________________
____________________

Phone number:
(___) ___ - ____

ELECTRONIC SIGNATURE OF COPYRIGHT HOLDER OR THEIR AUTHORIZED REPRESENTATIVE

_____________________________