Phil Nicolosi Law

Protecting Your Business From The Ground Up

DMCA Designated Agent Service Intake Form

Please provide the following information in order to subscribe to our DMCA Agent Service. Shortly after you submit your information, you will be sent a payment link to complete your order. We may then contact you to gather more details about your website, to the extent necessary.

  • If an individual is the service provider (sole-proprietor), please provide the full legal name, OR provide the full legal name of any business entity that is the service provider instead (in the First Name box) as it appears on the organizing documents (i.e. "Acme, LLC"). What you list here will appear on the DMCA records as the name of the service provider. This means the full legal name of an individual sole-proprietor, corporation or LLC name if applicable. We WILL NOT do any independent review of applicable secretary of state databases to determine the actual service provider correct legal entity name-this is your responsibility to confirm before submitting this form. Note, the US Copyright Office will require us to provide the actual full, LEGAL address for your company and not a P.O. Box unless you receive permission to do so. (This address is visible on the DMCA database, but not the service provider phone or email contact info.). FAILURE TO PROVIDE THE "REAL" BUSINESS ADDRESS (WHERE SERVICE OF LEGAL PROCESS SHOULD BE MADE), WILL LIKELY RESULT IN THE SERVICE PROVIDER NOT HAVING THE PROTECTION GRANTED UNDER THE DMCA.
  • Provide the principal business address of the website/app operator. Service providers are required to supply the full physical street address and not a P.O. Box (or virtual address). However, you may petition the Copyright Office for permission to use a P.O. Box (or virtual address). You will be required to take this step separately after registration. Please note, any address information will be reflected on the DMCA database in connection with the service provider.

    If the use of a P.O. Box for the ISP business address was already approved by the U.S. Copyright Office and you wish to continue to list this address, check yes below. (this may apply where the ISP had a prior registration using a different DMCA designated agent).

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  • AFTER YOU SUBMIT PAYMENT, YOU DO NOT NEED TO REGISTER WITH THE COPYRIGHT OFFICE-WE DO THIS FOR YOU UNDER OUR MASTER ACCOUNT.
  • This field is for validation purposes and should be left unchanged.