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Claim Form
Complete the fields below to report that a domain name using our service infringes upon a trademark.
Domains By Proxy ("DBP") provides a private registration service. We are neither a domain name registrar, nor a hosting provider and cannot modify our customers' domain names or website content. DBP supports the protection of intellectual property rights. If you believe that a domain name utilizing DBP's service infringes your (or your client's) trademark or service mark rights, please complete the form below. Upon receipt of a complete Claim Form, as well as any additional supporting information which DBP may, in its discretion, request from the complaining party, DBP will initiate a claim investigation.
*Required Field
Nature of complaint:
Domain name infringes on a trademark
Domain name(s) at issue:*
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First name:*
Law firm name (if you are an attorney):
Email address:*
Federal trademark registration number:*

A good faith certification, under penalty of perjury, stating:*
  1. Person making request is an authorized representative of the trademark holder.
  2. The domain name infringes the rights of the trademark holder.
  3. The use of the domain name claimed to be infringing is not defensible.
The statement 'I, [FULL NAME], certify in good faith, under penalty of perjury' must be included in the certification you insert in the box below in order for us to investigate the issue.’
Provide any additional information in the space provided below:
Upload supporting documentation (e.g. screenshot of alleged infringement, formal demand letter):
We accept the following file formats: .png,.jpg,.pdf,.jpeg,.bmp,.gif,.tif,.tiff
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Total size limit = 28 MB
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Last name:*
Affected company or individual:
Phone number:*
The jurisdiction or geographical area to which the mark applies:*
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