Cyber Report

Full Name *

Phone *

Email *

Date of Birth

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Have you previously utilized our services? (This helps us in linking our records) *

Yes

Have you previously engaged with any cyber services pertaining to this issue? *

Yes

Do you have legal representation regarding this matter? *

Yes

The business you're complaining about

Their Name *

Their Address *

Tell us about the product or service you would like to complain about *

Dating Application

CFD's

Crypto Currencies

Forex

Love Scam

Investment

Other

What happened so far?

Have you already complained to the business? *

Yes

Has the issue you are complaining about occurred within the last 36 months? *

Less than a year ago

Less than three years ago

Over three years ago

Has there been any legal action taken or planned in relation to your complaint? *

Yes

When did the advice, claim, service, or transaction you've complained about take place?

Date

Your complaint

Exemplary Damages

Exemplary damages are typically granted at the discretion of the court when the defendant's behavior is deemed especially harmful.

How did the trading experience affect you Emotionally?

Emotional distress

Fights and arguments with your spouse/family

Low self esteem

All the above

Have you sought medical attention or taken any medication to address the emotional stress caused by this matter?

Supporting Documents (up to 3 docs)

Click or drag files to this area to upload.
(You can upload up to 3 files)

Please submit all the relevant evidence if there is any problem please send it to Support@ciphernetshield.net

Declaration

Finally, please read this declaration

- I would like the Cipher Net Shield office to look into my complaint.

- To the best of my knowledge, everything I have told you is correct.

- Our typical response time is 24 hours or faster during working hours. We treat all provided information as strictly confidential.

- Verify that you are speaking to Cipher Netshield by checking to make sure emails are signed by ciphernetshield.net cyber net report which is the only legitimate Cipher Netshield website.
By submitting the form, you agree to the declaration above.