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Copyright Infringement Notification Form

The Digital Millennium Copyright Act provides a "notice and take-down" process for copyright owners who believe their intellectual property rights have been infringed. The Act allows copyright owners to notify an Online Service Provider (OSP) of allegedly infringing material that resides on the OSP's system and to request the OSP to remove or block access to such material.

A notice by a copyright owner, or a person authorized to act on the owner's behalf, under the Act must substantially conform to the requirements set forth below:

17 U.S.C. § 512(c)(3) – Elements of Notification.

(A) To be effective under this subsection, a notification of claimed infringement must be a written communication provided to the designated agent of a service provider that includes substantially the following:

(i) A physical or electronic signature of a person authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.

(ii) Identification of the copyrighted work claimed to have been infringed, or, if multiple copyrighted works at a single online site are covered by a single notification, a representative list of such works at that site.

(iii) Identification of the material that is claimed to be infringing or to be the subject of infringing activity and that is to be removed or access to which is to be disabled, and information reasonably sufficient to permit the service provider to locate the material.

(iv) Information reasonably sufficient to permit the service provider to contact the complaining party, such as an address, telephone number, and, if available, an electronic mail address at which the complaining party may be contacted.

(v) A statement that the complaining party has a good faith belief that use of the material in the manner complained of is not authorized by the copyright owner, its agent, or the law.

(vi) A statement that the information in the notification is accurate, and under penalty of perjury, that the complaining party is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.

Contact information for Qwest's Designated Agent is as follows. You may notify Qwest's Designated Agent by mail or by submitting the form below.

Qwest Security
600 Stinson Blvd., #3N
Minneapolis, MN 55413
Attn: Designated Agent
Telephone: 612-664-4382
Fax: 612-664-4868
Email: infring@qwest.com

Anyone who knowingly misrepresents that material is infringing is liable for any damages incurred by an OSP or a User as a result of the OSP relying on such misrepresentation in removing or blocking material.

* required information

     
Contact Information

Name of Copyright Owner or Authorized Representative*:

Mailing Address*:

E-mail Address*:

Daytime Phone Number*:

Fax Number:

Specific Details of Infringing Material

Identification of copyrighted work you claim to be infringed*:

Identification of material you claim to be infringing the copyrighted work and a description of where the infringing material resides, i.e., full URL(s)*:

Action requested and/or additional information:

By submitting this notification, you are indicating that you have a good faith belief that the material complained of is not authorized by the copyright owner, its agent, or the law. Further, the information in this notification is accurate, and under penalty of perjury, the complaining party, if not the copyright owner, is authorized to act on behalf of the owner of an exclusive right that is allegedly infringed.

Signed By:


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