Incident Report - PARSOL - Pennsylvania Assoc for Rational Sex Offense Laws (PA Megan's Law Resources)

Name

First Name

Last Name

Phone

Address

City

State/Province

Zip/Postal

Address

County

Checkboxes

Please check if you or an immediate family is a member of the military or a veteran.

Please check if you are at age 60 or older.

Please check if you are forced to register on PA Megan’s Law.

Choose ANY that Apply:

I am under county parole/probation supervision

I am under state parole/probation supervision

I am under federal parole/probation supervision

I believe the information contained in the PA Megan’s Law Database was used unlawfully

I am a PA Megan’s Law Registrant

I am a family member of a registrant

Incident/Scam Method

Telephone to Registrant

Telephone to Registrant’s workplace

Telephone to Registrant’s family member or cohabitant

Email to Registrant

Email to Registrant work email

Email to to Registrant’s family member or cohabitant

Text Message

Social Media Message

In-Person Incident

Please provide any information you have on the scammer’s identity or whereabouts:

Business Name (if known) Stated by the Caller or Email

“Name” of Person to whom you spoke

Phone Number Displayed on Caller ID

Choose all that apply:

The call began with a recorded message.

The Scammer contacted you by text message.

The Scammer refused to identify themselves or a company.

I have asked the Scammer to stop calling you.

I am on the Pennsylvania Do Not Call List.

I am on the Federal Do Not Call List.

Date the scammer first contacted you

How Much Did the Scammer Ask You To Pay?

How Much Did You Actually Pay?

What Form of Payment Did The Scammer Ask You To Use? What Form of Payment Did The Scammer Ask You To Use?

Complaint Summary

Please explain your complaint: Try to be brief, but be sure to tell WHAT happened, WHEN it happened, WHERE it happened HOW MANY time it happened. Be specific about any oral statements the Scammer made to you, ESPECIALLY those that influenced you to deal with the Scammer. Describe events in the order in which they happened, and provide any other information you have about the Scammer (address, other phone numbers, alternative names, etc). Tell us if you have contacted the payment processor or bank to determine exactly where your funds were received, and tell us whether you reported this loss to any law enforcement agency.

Were there any other collateral consequences?

Upload

Maximum file size: 67.11MB

If possible, please upload your contract, proof of payment, and other documentation to help us better understand your complaint. Accepted file types include jpg, gif, png, pdf, doc, docx. If you do not have a scanner, please upload photo of the documents. Please include any relevant emails or screen shots of text messages, or call log screenshots.

Please check these boxes to proceed.

I understand that PARSOL will keep this information as part of its database of scams in order to help protect others.

I understand that my report will be copied to PARSOL’s contact at the PA Attorney General’s office, but that I should submit a report directly with the Bureau of Consumer Protection as well.

If you are human, leave this field blank.