Tea App Incident, Copyright & Evidence Intake Form
Provide factual details and upload supporting evidence about Tea app content for organized review and possible attorney consideration.
Case Information
Full legal name
*
First Name
Middle Name
Last Name
Email address
*
example@example.com
Phone number
Please enter a valid phone number.
Format: (000) 000-0000.
City
State
Preferred contact method
Email
Phone
Text
Consent to keep identity confidential in public-facing reports where reasonably possible
Yes
No
Relationship to the incident
*
Please Select
I am the person shown or discussed
I own the photograph or copyrighted work
Authorized representative
Witness or other
Tea App Content Details
Tea city/community or location where the content appeared
Name or username of the person who uploaded or posted it
Date the content was first posted
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Date you first learned about it
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Direct Tea post/content URL or share link
Tea profile/post/report ID
Is the content still visible?
*
Yes
No
Unsure
Factual description of what happened
*
Categories
*
Unauthorized use of my photo
Copyright infringement
False or misleading statements
Harassment or bullying
Threats
Doxxing or exposure of personal information
Impersonation
Sexual or intimate content
Other
If Other, please explain
Evidence Upload
Evidence upload instructions
Screenshots or photos
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Screen recordings or video
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Additional evidence or correspondence
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Backup evidence link
Screenshot or recording capture date/time
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Does the evidence show the Tea app context, uploader username, date, and surrounding content?
Yes
Partly
No
Were the original unedited files preserved?
Yes
No
Unsure
Evidence notes or explanation
Copyright Ownership & U.S. Copyright Office Registration
Do you own the copyright or have the right to act for the owner?
*
Yes
No
Unsure
Who created or took the photograph or work?
*
Please Select
I took it myself
A photographer took it and assigned the copyright to me
Another person took it
Unknown
Other
Do you have the original file or the earliest available copy?
*
Yes
No
Unsure
Approximate date the photograph or work was created
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Was it published before it appeared on Tea?
*
Yes
No
Unsure
Date of first publication
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Place of first publication
Has this photograph or work been registered with the U.S. Copyright Office?
*
Please Select
Yes — registration issued
Application submitted and pending
No
Unsure
U.S. Copyright Office registration or application number
Effective date of registration, if known
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Upload the registration certificate, application confirmation, or deposit copy
Upload a File
Drag and drop files here
Choose a file
Cancel
of
If you are not the creator, explain how you obtained ownership or authority to act.
Tea Reporting & DMCA History
Was the content reported through the Tea app?
*
Yes
No
Date reported to Tea
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Tea report, ticket, or reference number
Tea response or outcome
Upload Tea response or report confirmation
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Was a formal DMCA takedown notice sent?
*
Yes
No
Unsure
Date the DMCA notice was sent
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Where was the DMCA notice sent?
Did the DMCA notice identify the copyrighted work and infringing Tea content or location?
*
Yes
No
Unsure
Tea response to the DMCA notice
Upload the DMCA notice and related correspondence
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Did Tea request additional information?
*
Yes
No
What was requested and how did you respond?
Was any content removed?
Yes—all
Yes—some
No
Unsure
Was the content reposted after removal?
Yes
No
Unsure
Where else was this reported?
Apple App Store
Google Play
Law enforcement
Attorney
Not reported elsewhere
Other
Other report details, reference numbers, or outcomes
Impact & Requested Outcome
Impact experienced
*
Emotional distress
Reputational harm
Employment or business harm
Dating or relationship harm
Safety concern
Financial loss
No known impact
Other
Describe the impact experienced
*
Requested outcome
*
Preserve evidence
Remove content
Stop further uploads or reposts
Account enforcement
Attorney review
Include in aggregated advocacy reporting
Other
Submission Integrity & Consent
Affirmations
*
The information provided is true and accurate to the best of my knowledge.
I lawfully possess the evidence submitted and have not materially altered it.
I understand this submission does not create an attorney-client relationship and does not guarantee legal action, damages, or removal.
I understand organizers may contact me to verify information or request additional evidence.
I will preserve original files, messages, notices, and metadata.
Consent for Date Safe – MDA internal review and handling
*
I consent to Date Safe – MDA organizers using my submission for verification, evidence organization, advocacy, and possible attorney review.
Public use consent for anonymized excerpts or aggregate statistics
Yes
No
Electronic signature
*
Date signed
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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