Empress Qiyana Blackmail Contract

Empress Qiyana's Blackmail Contract

$end, Submit, Serve
Fill out contract and send with $30 upon completion for the deposit.
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Gender

FemaleMale
Email*
example@example.com
Phone Number*

Area CodePhone Number
Facebook Details*
If you do not have facebook, place N/A
Maritial Status*
Partner/Bestfriends Name*
Partner/Bestfriends Email*
Partner/Bestfriends Phone Number*
Employment Status*
Employers Name*
Income and Frequency*
Disposable Income*
Payment Amount:*
Frequency?*

WeeklybiweeklyMonthly
Type of Contract:

Arranged for set period of time, minimum 6 months/ No BuyoutUnarranged with $150 Buyout
How Many Months do you wish to serve?
Include at least 3 or more humiliating photos of yourself with the application.
Image 1*

Browse Files

Cancelof
Image 2*

Browse Files

Cancelof
Image 3*

Browse Files

Cancelof
Image 4*

Browse Files

Cancelof
Tell me about your kinks and limitations
By submitting this form, I am allowing Empress Qiyana to blackmail me for money and other items. Upon ending of the contract, either by agreed date, or buyout, the goddess agrees to delete all personal date and photos. No further contact will be made unless agreed upon.

By Signing below I consent fully to being blackmailed and used
Signature*

Clear
All payments made to my various payment methods

linktr.ee/empressqiyana
Should be Empty:

Empress Qiyana's Blackmail Contract