UPL Reporting Form

UPL Reporting Form

RELANC has a committee of attorney members who are compiling this information. Please fill out as much as you know, and let us know if we may contact you for more details. This form does NOT publish to the internet, it sends a confidential email to the committee chairperson.
Situation Category

Title Entity Attorney Other
Name of Entity, Attorney or Party
Address of the Entity (not your address) This can come from settlement documents you may have obtained, or from your own personal observation.

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Describe the Organization and People Involved. *
Your Name (optional)

First Name Last Name
Your E-mail (optional)
Do you have a preferred phone number at which we may contact you? (optional)

Area Code Phone Number
Should be Empty: