REPORT ADOPTION SCAM/FRAUD SUBMIT FORM

Submitting this form entitles this information to be added to our scam database. It should not be used as a means of reporting to Law Enforcement Officials. Please remember to submit your complaints to Law Enforcement.

This form uses email to submit.

1. Please fill out your personal contact information:

Name:
Street Address:
City:
State:
Zip:
Phone:
Email:

2. Who is your complaint against? Please fill out the information below to the best of your knowledge:

Name:
Street Address:
City:
State:
Zip:
Phone:
Email:
Website:
Email:
Screen name (s)AIM, MSN, Yahoo or ICQ:
IP address on the individual:

3. Is this in your opinion, a scam or unethical practice against a prospective adoptive parent, expectant mother, birth parent(s), adoptee or anyone else in the adoption world? Is it for money or an emotional scam?



4. Have you seen information that may be similar that has been posted on any other web sites or forums?



5. Other pertinent contact information: (please share ALL information) any little bit can be very helpful.



6. How did you come in contact with this person?



7. Have you reported this person to the authorities? If so whom?



8. What did they recommend?



9. Were you satisfied with their recommendation?



10. What have you done so far?



11. Do you want to pursue legal action?



12. How much money have you invested and lost, if any? Be specific.



13. Please describe below in detail the contact you have had with this person and all information that has been given to you:



14. What would you like to share with others that are inquiring about this person? Would you like your email shared? If so, please specify an email in which you would like used.



15. Other information you feel is important and would like us to know.



16. Do you know of others that have dealt with the individual above? Have you suggested they report their situation to us?

Thank you for taking the time to fill out this report not only for us but on behalf of others in the adoption community! If you haven't contacted your local and federal authorites, please do so immediately!