Section 1 Fraud / ScamDetails Type of fraud / scam - None -Identity fraudCard fraudSkimmingCounterfeit CardsPhishingAdvanced Fee ScamFund Transfer ScamPyramid SchemeOther How did you first receive the scam? - None - Phone callEmailMailPersonal Contact Date you were contacted Year202220232024 Year MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Day12345678910111213141516171819202122232425262728293031 Day Amount you were asked to pay Currency - None - Rs USD Euro Other Amount Mode of payment - None - Cash Cheque Debit / Credit Card Payment Online Payment Fund Transfer Please provide brief details of the fraud/scam below Section 2 Your details Title - None - Mr Mrs Miss Ms Dr. Prof. First name(s) or initials Last name (Anonymous is acceptable) Address Town or Village Telephone Email Note: It is an offence for any person to use an information and communication service including a telecommunication service for the purpose of causing annoyance, incovenience to any person. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. What code is in the image? * Submit
