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Check If You Qualify For A Compensation
Do not fill this form if you never lost money to a scam company
20
Questions
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1
What Is Your Full Name?
*
This field is required.
Name must match your ID document
First Name
Last Name
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2
What Is Your Email?
*
This field is required.
Enter a valid email address where you can receive updates on your case.
example@example.com
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3
Your Phone Number With Country Code
*
This field is required.
Input your phone number with country code
Country Code
Phone Number
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4
What Is Your Current Country Of Residence?
*
This field is required.
Phone number provided should match country of residence
Country where you currently live in.
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5
What Is The Name Of The Scam Company?
*
This field is required.
Input the name of the fraudulent company that you lost money to
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6
How Much Money Did You Loose?
*
This field is required.
Exact amount or aprox. which you lost.
Include the currency
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7
How Did You Make Payment To The Scam Company?
*
This field is required.
choose an option from the list
Please Select
Bank Transfer
Credit/Debit card
USDT (Crypto)
Bitcoin (Crypto)
Other(Crypto)
Please Select
Please Select
Bank Transfer
Credit/Debit card
USDT (Crypto)
Bitcoin (Crypto)
Other(Crypto)
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8
When Was Your First Contact With The Scam Company?
*
This field is required.
exact or aprox. date of first contact
-
Date
Year
Month
Day
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9
How Did You First Learn About The Scam Company?
*
This field is required.
Could be from Google, from a friend etc.
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10
When Was Your Last Payment To The Scam Company?
*
This field is required.
exact or aprox. date of last transaction
-
Date
Year
Month
Day
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11
Website Of The Scam Company?
*
This field is required.
website url of the scam company that you remember
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12
Do You Have Evidence (Emails, Screenshot of chats, payment confirmations)?
*
This field is required.
do you have evidence against the scam company
YES
NO
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13
What Is Your Occupation?
*
This field is required.
Tell us more about your Job or Business
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14
What Is Your Annual Income After Tax?
*
This field is required.
Input only numbers in (€) Euros.
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15
Can You Confirm That All The Money You Lost Was Acquired Legally?
*
This field is required.
Be as honest as possible.
YES
NO
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16
Have You Taken Any Steps In The Past To Recover Your Money?
*
This field is required.
Tell us more about what you have tried to do to get back the money you lost.
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17
In As Much Details As Possible, Tell Us Everything That Happened
*
This field is required.
Tell us how you got scammed, what you were promised, everything. We are good listeners.
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quote
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Ok
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18
Is There Anyone That Can Collaborate Your Story?
*
This field is required.
Like a spouse or any other person who was also scammed
YES
NO
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19
If we proceed with your case, we typically require a commitment fee of 1%. This fee is fully refundable as long as you are committed to the process, promptly provide the necessary documents, and make yourself available for Q&A with our team. Are you comfortable with these conditions?
*
This field is required.
YES
NO
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20
How Do You Rate Your Experience Of Our Website So Far?
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