Copyright Infringement Counter Notification Form

If a subscriber receives notice that, in response to a notification of claimed infringement under the Digital Millennium Copyright Act, an OSP has removed or disabled access to material that the subscriber placed on the Internet, the Act permits the subscriber, in certain circumstances, to file a counter notification.

A counter notification under the Act must be submitted to the OSP’s Designated Agent and must substantially conform to the requirements set forth below:

17 U.S.C § 512(g)(3) Contents of Counter Notification

To be effective under this subsection, a counter notification must be a written communication provided to the service provider's designated agent that includes substantially the following:

1. A physical or electronic signature of the subscriber.
   
   
2. Identification of the material that has been removed or to which access has been disabled and the location at which the material appeared before it was removed or access to it was disabled.
   
   
3. A statement under penalty of perjury that the subscriber has a good faith belief that the material was removed or disabled as a result of mistake or misidentification of the material to be removed or disabled.
   
   
4. The subscriber's name, address, and telephone number, and a statement that the subscriber consents to the jurisdiction of Federal District Court for the judicial district in which the address is located, or if the subscriber's address is outside of the United States, for any judicial district in which the service provider may be found, and that the subscriber will accept service of process from the person who provided notification under subsection (c)(1)(C) or an agent of such person.

Contact information for Qwest's Designated Agent is as follows. You may notify Qwest's Designated Agent by mail or by submitting the form below.

Qwest Security
600 Stinson Blvd., #3N
Minneapolis, MN 55413
Telephone: 612-664-4382
Fax: 612-664-4868
Email: infring@qwest.com

Please provide the following information regarding the alleged copyright infringement in dispute:

		Contact Information Name of Subscriber: Mailing Address: E-mail Address: Daytime Phone Number: Fax Number: Identification of the material that has been removed or to which access has been disabled and a description of where the material appeared, i.e., full URL(s): Explanation of why you have a good faith belief that the material was removed or disabled as a result of mistake or misidentification: