SIIA Internet Anti-Piracy Intake Form

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SIIA'S INTERNET CONTENT PIRACY REPORTING FORM

The following form is to report a case of Internet Content piracy. Examples of Internet Content piracy include, illegally posting a magazine article or chapter from a textbook on a website, Internet auctions for scanned textbooks on CD, or illegally posting news stories on a website.

SIIA investigators may need to contact you for additional information and, therefore, will request contact information about you. An asterisk (*) denotes required fields. This form cannot be submitted without all required information. If you would prefer to report a case over the phone, please call our Anti-Piracy Hotline at (800) 388-7478 or send e-mail to netpiracy@siia.net. You may also complete the form and fax it to SIIA Anti-Piracy at (202) 289-7097.

All sources are kept strictly confidential. Your name will not be released.

* Type of Site:

If "Other", please specify:

* Internet Address (please provide complete URL):

* Materials Pirated:

Publisher Name or Publication Title Identify Infringed Content ISSN or ISBN

If the site is a FTP site:

Username:

Password:

If the site is an Auction:

Auction #

Seller's ID:

Seller's Name:

Your Contact Information:

First Name:

Last Name:

Email Address:

Please give any additional information that may be relevant to SIIA's investigation:

Thank you for your assistance. An SIIA representative may contact you for additional information. All source information is kept strictly confidential.