Free TAKE IT DOWN Act Removal Request Form generator

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Your TAKE IT DOWN Act Removal Request Form

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Removal request: intimate visual depiction published without consent
Submitted to: [Site name] ([https://example.com])
Send to: [contact email], or use the online form at [your request page URL]

1. Your name, or the name of the person you represent: ______________________
2. How we can reach you (email or phone): ______________________
3. You are:  [ ] the person depicted   [ ] a parent or guardian of the minor depicted   [ ] an authorized representative
4. Is the person depicted under 18?   [ ] yes   [ ] no
5. Where the content appears (paste every URL, one per line):
   ______________________
   ______________________
6. Brief description that lets us identify the image or video (do not attach it):
   ______________________
7. Good-faith statement: I have a good-faith belief that the identified content is an intimate visual depiction of me (or the person I represent) published without consent, and the information in this request is accurate.
   [ ] I agree
8. Signature (typed is acceptable): ______________________   Date: ______________

What happens next: [Site name] gives every request a ticket number, removes valid reports and any known identical copies within 48 hours of a complete request, and tells you the outcome. Requests involving a minor can also be made through NCMEC's Take It Down service (takeitdown.ncmec.org); adults can use StopNCII.org to prevent re-uploads on participating platforms. This process is provided under Section 3 of the TAKE IT DOWN Act, enforced by the Federal Trade Commission.