DON’T GET MAD, GET EVEN

Information About the Auction:

To report multiple auctions, please complete separate application for each unique seller.

* = Required Fields

Name of Auction Site (ex. eBay)*:

Name of Auction Seller (i.e., Seller’s ID)*:

Seller’s Shipping or Contact Information (if known):

Auction Listing Number(s)*:

Date the Auction Closed:

Pirated Software Purchased: Software Publisher: Software Title: Software Version: Quantity Purchased:

Seller’s PayPal Information:

How much did you pay for the pirated or counterfeit software*?

Have you reported this piracy to anyone else? If So, to whom? What was their response?

Why do you believe the software you received is pirated or counterfeit?*

 

Your Contact Information
First Name*:
Last Name*:
Mailing Address*:
Address Cont:
City*:		State*:
Zip*:		Country:
Telephone*:		Email Address*:
How did you hear about SIIA and the Don’t Get Mad, Get Even Program:
Please provide any additional information about the piracy here:
By clicking submit, I understand and agree that: The information furnished to the SIIA in this application is true based on my personal knowledge. Prior to purchasing the software I am reporting on this form, I was unaware that I was purchasing counterfeit or pirated software. I have not sold software or have been affiliated with anyone who has sold software on any auction site or any other online or offline outlet. Neither I nor any family member or relative of mine is the seller I am reporting and I do not have any prior or existing non-business relationship with the seller, or assisted or worked with the seller in any way. I have reviewed and agree to all the terms and conditions for participating in the program as outlined in this document.