This form is designed to collect information from individuals who have experienced fraud. By completing it, you provide the details needed for our team to review your case and determine whether it qualifies for support. Please note that submitting this form does not guarantee assistance, and all information will be handled confidentially and used solely for the purposes of assessment.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Full Name *FirstLastEmail * links occur? Phone Number *Preferred Contact Method *CallTextEmailWhere do you currently live? *CITY/STATE/ZIPWhere did the fraud occur? *CITY/STATE/ZIPWhen did the fraud occur? *DATE Where was the other party located (if known)? *CITY/STATE/ZIP or UNKNOWN Is the incident ongoing? *YesNoHave you contacted the authorities? *YesNoWhat agencies have you contacted?Police / Local Law EnforcementDistrict Attorney / Prosecutor’s OfficeFederal Agencies (FBI, FTC, etc.)State Regulatory AgenciesConsumer Protection AgenciesLegal Aid / Public DefenderPrivate InvestigatorOther (please specify)OtherWhen did you contact the agency/agencies?Within the last weekWithin the last monthWithin the last 3 monthsWithin the last 6 monthsMore than 6 months agoI don’t rememberLeave blank if not applicableType of Fraud *Love/Romance ScamInvestment ScamGeneral FraudOnline Marketplace ScamBusiness/Contract FraudIdentity TheftOtherPlease describe what happened *Please share all important information you have/knowEstimated financial loss (if any):Non-financial or emotional impact (if any):Date of first contact/event *Most recent contact/event *Date you first suspected fraud: *Subject's Name / Alias *FirstLastIf unknown, put UNKNOWN on both fieldsSubject's Phone Number and E-mail *Subject's Date of Birth *Subject's Last Known Address *Known locations the subject has lived in (city/state/country): *Social media links / usernames *How did you meet the subject? *In PersonOnline Dating PlatformSocial MediaOtherAre you aware of any other victims? *YesNoIf yes, how many victims are you aware of?Do you have any recorded calls or video with the subject? *YesNoHow did you save these recordings?Hard DrivePhone StoragePhysical copies (hard copies/printed)Cloud (Google Drive, iCloud, etc)If yes, were recordings made using your own device or account?YesNoUnsureOther evidence collected: *Text messages / chatsEmailsScreenshotsPhotos / documentsBank transfer or payment recordsSocial media messagesOtherOther evidence Do you still have the original files (not screenshots or forwarded copies)? *YesNoUnsureRecovering funds lost to fraud is unlikely. In most cases, money is only recouped through a court-ordered judgment. Our investigation aims to help you gather evidence to support your case and pursue potential prosecution, but we cannot guarantee financial recovery. *I understandWhat is your intention for this investigation? *Recoup fundsPersonal PeaceExpose fraudSeek ProsecutionOtherI confirm that the information I have provided is accurate and acknowledge that the outcome of this review will determine whether my case is eligible for assistance. *I acknowledgeSign with your full name *Submit ApplicationOTHER SERVICES:
