Intake form

Help us serve you better

Name *

Email address *

What type of cryptocurrency was stolen?

Please select at least one option.

Bitcoin

Ethereum

Litecoin

Ripple

When did the theft occur?

Have you reported the theft to the authorities?

What is the estimated value of the stolen cryptocurrency?

Please provide any relevant transaction IDs or wallet addresses.

How did you first become aware of the theft?

Additional questions or comments

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Retake LLC