Copyright Counter-notification Form
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Copyright Counternotification Form

Name(*)
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First and Last Name

Address(*)
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City(*)
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State(*)
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Email
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Title of Work(*)
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If there are more than one, please separate by semicolon. If the title of work includes a semicolon, please signify by enclosing in single quotation. It may be necessary to use additional forms if you run out of space.

Description of Infraction(*)
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Describe the material claiming to be violated with enough details to help us identify the work (such as content, length, URL)

Good Faith Statement(*)
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Please check the box above to confirm statement is true.

Good Faith Statement(*)
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Digital Signature(*)
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