Scamdoc score claim Form

Your information*
Your own name, even if you are making the request on behalf of someone else.
First name Last name
Contact email address*
I am acting on behalf of...*
- Myself, I am the website owner
- I represent the owner

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Owner information
Identifying the owner is essential to increase the trust score.
What type of legal structure operates the website?*
- Enterprise / Association
- Physical personn
Company name*
Commercial name*
Company number*
Owner information
First Name Last Name
Address
Street Address Street Address line 2 City State / Province Postal code
Country*
Publication manager*
By default, the CEO
First Name Last Name
Email contact*
Email to contact the website
Phone number*
Phone number to contact the website

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URL of the website displaying information about the owner (highly recommended)
Identification of the entity managing the website is essential to increase its Scamdoc score. The expected data are:
- Entity Name
- Company number (si existant)
- Postal address
- Name of the publication manager (or CEO)
- Phone number
- Email contact
If you have a URL displaying these data, please let us know. The absence of those data can have a negative impact on the scoring. If needed, you can save the form and come back to it later (the option is at the bottom of the page).
Publication of the site owner's identification data
The more visible the owner of a site is, the higher the reliability score. The following data will be displayed: Entity information (company name, address, phone, email, first and last name of the publication manager). They will appear as contact information in case of problems with your website.
- I agree that Scamdoc.com may display the owner's identification data.

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You may, if you wish, send attachments to support previously submitted information.
Mandate
At the beginning of the form, you have indicated that you are the owner's representative. Can you send us a mandate mentioning it or any other proof?
Déposer les fichiers ici ou

Types de fichiers acceptés : pdf, jpg, gif, jpeg, png.
Proof of identity
This document is used as a proof that you are the owner of the site or its representative. You can hide information that you consider sensitive. This optional document will not be kept.
Déposer les fichiers ici ou

Types de fichiers acceptés : pdf, jpg, gif, jpeg, png.
Company document
Do you have any legal document identifying the company? Send it to us.
Déposer les fichiers ici ou

Types de fichiers acceptés : pdf, jpg, gif, jpeg, png.

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Personal information*
I have read and acknowledged the processing of the personal information that I am submitting, as outlined below:
Scamdoc will use only the personal information that you supply on this form (including your email address and any ID information) and any personal information you may submit in further correspondence to process your request and fulfill our legal duties.
Accuracy of information*
- I certify that the information in this request is accurate
Completeness of information*
- I understand that Scamdoc will not be able to process my request if the form is not properly filled out or if the request is incomplete. *
Signature
Signed on this date of :*
MM/DD/YYYY (e.g. "12/25/2015)
MM
JJ
AAAA
Signature*
By typing your full name above, you are providing us with your digital signature, which is as legally binding as your physical signature. Please note that your signature must exactly match the first and last names that you entered at the top of this web form in order for your submission to be successful.
CAPTCHA
Email
Ce champ n’est utilisé qu’à des fins de validation et devrait rester inchangé.

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Owner information