Counter Notification Form

Counter Notification Form
(1) Your Name:
(2) Your Address:
(3) Your Telephone #:
(4) Your E-mail Address:
(5) Identity of the material that has been removed or to which access has
been disabled:
(6) Location of the material that was removed or to which access has been
disabled before it was taken down or disabled:
By typing or otherwise writing my name here, I, ________, do represent and
warrant, under the penalty of perjury, that I believe, in good faith, that the
material I have identified above was only removed or disabled as the result of a
mistake or misidentification. My submission of this form signifies my consent to
the jurisdiction of the Federal District Court for the judicial district in which the
address I have furnished above is located, or, if the address I provided above is
outside the United States, my consent to the jurisdiction of the Federal District
Court for San Diego County, California. I agree to accept process from the
person who provided notification of the alleged copyright violation(s), which is the
subject of this counter notification form, or from an agent of such person. I
understand that by typing or otherwise writing my name above I am providing an
electronic signature that is in all ways equivalent to providing a physical signature
on a tangible legal document.