MISS ELLA MAY BLACKMAIL CONTRACT AND PERSONAL INFORMATION FORM

MISS ELLA MAY BLACKMAIL CONTRACT AND PERSONAL INFORMATION FORM

personal information and consent form for blackmail. fill out fully and send £500 upon completion for deposit and initial tribute.
Name*

First NameLast Name
age *
Date of birth*

MonthDayYear
Date
gender*

malefemaleother
Email*
example@example.com
twitter @*
instagram/facebook details *
type N/A if you dont have either
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
marital status *
partner/friend name*
partner/friend phone number *
Please enter a valid phone number.
partner/friend email*
example@example.com
employment status *
employer name *
employer address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
annual salary *
monthly salary*
disposable income*
payment frequency*

weeklybiweeklymonthly
payment commitment *
weekly min. £75 biweekly min. £150
contract type*

arranged set period of time (3 month’s minimum) buyout : £1kno arranged set period of time. ongoing untill buyout is fully paid. buyout : £5k
length of contract.*
for arranged set period contract
photo of ID*

Cancelof
your choice of 3 humiliating pictures of yourself.*

Cancelof
Cancelof
Cancelof
tell me about both your kinks/fetishes and your boundaries/limits*
By submitting this form, I am allowing miss ella may to blackmail me for money and other items. Upon ending of the contract, either by agreed date, or buyout, miss ella may agrees to delete all personal details and photos. No further contact will be made unless agreed upon.
tick the box to show that you understand the terms of this contract.

yes, i understand.
By Signing below I consent fully to being blackmailed and used
Signature*

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