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team-poison — Part 01
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Contact Information
Are there witnesses or other victims to this crime?
Yes - contact me further please..
Have you reported this crime to any law enforcement or government agencies?
Better Business Bureau
Consumer protection agency.
Individual/business that victimized you
Police/other law enforcement.
Private attorney
Provide the specific name of each organization, contact name, contact phone number, email address, date.
reported, and report number (if known).
[left blank]
Digital Signature
By digitally signing this document, I affirm that the information I provided is true and accurate to the best
of my knowledge. I have read the IC3's Privacy Policy, and understand-that this information may be
provided to law enforcement and regulatory agencies. If available, I will provide additional documentation
not included in this complaint, such as email correspondence, payment receipts, or electronic logs, upon
request to the best of my ability. 1 authorize the dissemination of the complaint, or information in the
complaint, to appropriate federal, state, local, tribal or international Law Enforcement Agencies (LEAs) for
purposes of investigating the complaint
b6
b7C
Paae 5 of 5
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