Claim submission form

Claim Submission Form

Step 1 of 3: Contact and loss basics

ConfidentialSecure handlingNo spam, no nonsense

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Basic contact details so we can reach you.

Full name *

Email *

Phone *

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Tell us what happened in broad terms.

Approximate amount lost *

How did you pay the scammers?

Bank transferOnline paymentCryptocurrencyGift cardOther

If other, please describe

When did it happen?

WeeksMonthsYears Rough estimate is fine

Names, companies, platforms, usernames, anything.

Names of companies or individuals involved

Are you currently working with any company or individual?

YesNo

If yes, please describe

If you have them. If not, submit anyway.

Proof of Identity (POI)

Proof of Deposit (POD)

Proof of Address (POA)

Privacy note

Documents are handled confidentially. If you can’t upload now, submit the form and we’ll follow up.

Only if crypto was involved.

Have you ever dealt with cryptocurrency?

YesNo

If yes, which exchanges or wallets have you used?

Have you used cryptocurrency to send money to a scammer?

YesNo

Cryptocurrency addresses you have used

If crypto wasn’t involved, you can ignore this section.

Timeline, promises made, red flags, what you have now.

Describe your experience *

Tip: include platform names, usernames, and any transaction IDs.

Your submission is confidential.