Investigation Intake Form
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Name
*
First
Last
Detail 2 – Email
*
Detail 3 – Country of Residence
*
I am reporting a
*
– Please select –
Blackmail – Ransomware
Blackmail – Sextortion
Exchange Hack/Collapse
Fraud – Account Takeover
Fraud – Impersonation
Scam – Investment
Scam – Phishing
Scam – Romance
Other
Are you reporting a theft in progress?
*
—
Yes
No
Does the total value of stolen funds exceed USD$25,000?
*
—
Yes
No
Has this incident been reported to law enforcement?
*
—
Yes
No
Incident Details
*
Transaction Details
Detail 2 – Amount
*
Detail 3 – Receiving Address
*
Detail 4 – Sending Address
Detail 5 – Transaction Hash
Submit