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Use our form to open an investigation with BlockFo and one of our agents will get back to you as soon as possible.

Contact Details

First Name

Last Name

Phone Number

Country of Residence

Representation

Are you represented by a third party?

YesNo

Select a type of representation

LawyerAccountantOther

Representative contact details

First Name of Representative

Last Name of Representative

Email of Representative

Phone Number of Representative

Company name of representative (if applicable)

Country of Representative

Case Details

Select the level of urgency. For active hacks or recent theft please select High for immediate incident response.

HighMediumLow

Case Type

DisclosureTheft

Has a police report been made?

YesNo

Police details

Police Case Number (if available)

Police Force / Region Name

Police Force Country

Do you have a direct police contact?

YesNo

Direct Police Contact Details

First Name of Police Contact

Last Name of Police Contact

Email of Police Contact

Phone Number of Police Contact

Country of Police Contact

Further Information

Have you got a name for this case?

Approximate Monetary Value

Description

Declarations

I consent to my data being stored according to the guidelines set out in the Privacy Notice.

Yes, I acknowledge that submitting this case request does not constitute a guarantee that BlockFo will accept this case. For further information, please see our Terms and Conditions.

No, I am not subject to any sanctions, including but not limited to the US Office of Foreign Assets Control (OFAC), Financial Action Task Force (FATF) Black and Grey list.

I am not classed as a Politically Exposed Person (PEP).

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