Sample/Example DMCA Notification of Infringement | DMCA Takedown Notice Form

Use this takedown notice to notify an ISP of infringing content that appears on its servers. We at LearnAboutLaw have used this exact form several times–so far we never had to take it beyond this level.


[Service Provider Name]
[Service Provider Address]

To Whom It May Concern,

I am writing to you to avail myself of my rights under the Digital Millennium Copyright Act (DMCA). This letter is a Notice of Infringement as authorized in § 512(c) of the U.S. Copyright Law. I wish to report an instance of what I feel in good faith is an instance or Copyright Infringement. The infringing material appears on the Service for which you are the designated agent. You are registered with the U.S. Copyright Office as the Designated Service Provider Agent to receive notifications of alleged Copyright infringement with respect to users of the Service for which you are the Designated Agent. 1. The material which I contend belongs to me, and appears illegally on the Service is the following: [Describe the infringing material. For example, a song entitled, Blue Suede Shoes, and a song entitled, Hound Dog, both performed by Elvis Presley].

2. The material appears at the website address: [provide the full website address, and a link to the page on which the material appears].

3. My contact information is as follows: [provide your name, address, telephone number, and email address].

4. I have a good faith belief that the use of the material that appears on the service is not authorized by the copyright owner, its agent, or by operation of law.

5. The information in this notice is accurate, and I am either the copyright owner or I am authorize to act on behalf of the copyright owner. I declare under the perjury laws of the United States of America that this notification is true and correct.

[your signature]
[your name]

Or: Sample Form | Example DMCA Counter-Notice Form

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