Cryostructure Victim Report

Cryostructure Victim Report

Share details of your transaction and upload any supporting documents so investigators can review your report.
Reporter Information
Full Name

First NameMiddle NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Employer / Occupation
Transaction and Loss Details
How did you come to know Paul Russ or Cryostructure?
When did the transaction(s) occur?
What was purchased? Please include order numbers if available.
Did you receive any product, and if so, did it function as advertised?
Did Paul Russ or Cryostructure attempt to refund you?
Was any refund made by check?
Did any check bounce?
How much money is still owed / total loss?
Briefly describe your experience.
Supporting Documents and Contact Preference
Supporting documents

Cancelof
Best way and time to reach you
Acknowledgements
I acknowledge that the submitted information will be reviewed by Black Widow Arms and provided to law enforcement investigating Cryostructure, LLC and Paul Russ.
I confirm that the information provided is true and accurate to the best of my knowledge.
Submitting this form does not make you a party to any civil action, and it does not create an attorney-client relationship.
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