Full Name *

Email Address *

We will send the case reference ID to this email.

Phone Number *

Please ensure that at least one of the phone numbers provided is reachable via WhatsApp, Signal, or Skype to enable further communication and to accommodate any requests for additional information from the service provider(s).

Alternate Phone Number

Amount Invested *

Specify the monetary value of the stolen funds or assets, based on the initial investment amount, expressed in either cryptocurrency equivalent or the relevant fiat currency (e.g., USD, EUR, CAD, AUD).

Total Value of Assets *

At the time of filing this report, indicate the total monetary value of the stolen funds or assets, including both the initial invested capital and any accrued interest that was available for withdrawal.

Reported Website and Scam Details *

Please provide a detailed description of your experience and interactions with the reported firm or website. Include relevant information such as the web address (URL), account details, email address, or registration number associated with the reported individual, scheme, or company.

Contact Details of Responsible Individual(s) *

Provide the contact details of individual(s) identified as the scammer(s) on any social channel, including any associated representatives or referrals.