Application Form

Lost Money Claims

Please answer as accurately and honestly as you can. Fields marked with * are required - everything else is optional, but the more detail you can provide, the faster your claim can be reviewed and verified.

Contact Information

First Name *

Last Name *

Mobile Number *

ID Number at the Time of Loss — helps a lot

Current City

City at the Time of Loss

Current Country

Country at the Time of Loss

Current Age

Age at the Time of Loss

The Company You Lost Money With

Company Name *

Registration Fees (if any)

Total Loss (USD) — helps a lot

Names of Any Management People

Names of Any Shareholders

Any Local Management You Dealt With

Sponsor Information

Sponsor's Name — helps a lot

Sponsor's Phone Number — helps a lot

Sponsor's City — helps a lot

Sponsor's Country — helps a lot

Your Story

In your own words, how did you lose your money, and why do you believe you lost it? — helps a lot

Reason You Joined the Business (Your Favorite Part) — helps a lot

Timeline From Paying Money and Joining to When You Lost the Money — helps a lot

Reason for the Loss of Money — helps a lot

The Part of the Business/Product You Liked the Best

The Part of the Business You Disliked the Most

Business & Financial Details

Product You Bought (if any) — helps a lot

Cost of the Product — helps a lot

Product You Chose or Received

Payment Method (Visa, MC, AMEX, Cash, Bank Transfer, Check, Apple Pay, PayPal, Crypto, Other) — helps a lot

Any Earnings You Made With the Company Prior to the Loss — helps a lot

Number of Profit Centers or Teams You Were On?

Number of Profit Centers or Teams You Made From?

Any Board Earnings? (Total How Much) — helps a lot

Boards You Lost From? (Total How Much) — helps a lot

Number of People You Introduced to the Business and You Made a Sale — helps a lot

At What Price Did You Sell to Them? — helps a lot

People & Meetings

3 or 4 People You Knew in the Business at That Time — helps a lot

Any of Your Teammates at That Time

Copy of Teams You Were On — optional, good to know

Upload a photo/screenshot — up to 5.

Venues You Attended — helps a lot

Any Meetings You Had or Hosted (at Home, a Restaurant, Hotel, Rented Room, etc.) — Approximate Month/Year and Location