Pursuant to 17 USC 512(c)(3)(A), this communication serves as a statement that:
I am the exclusive rights holder or the duly authorized representative of the exclusive rights holder for [title of copyrighted material being infringed upon, and, if possible, additional identifying information such as ISBNs, publication dates, if the material is a web page, the URL];
These exclusive rights are being violated by material available upon your site at the following URL(s): [URLs of infringing material];
I have a good faith belief that the use of this material in such a fashion is not authorized by the copyright holder, the copyright holder's agent, or the law;
Under penalty of perjury in a United States court of law, I state that the information contained in this notification is accurate, and that I am authorized to act on the behalf of the exclusive rights holder for the material in question;
I may be contacted by the following methods (include all): [physical address, telephone number, and email address];
I hereby request that you remove or disable access to this material as it appears on your service in as expedient a fashion as possible. Thank you.
[your full legal name]