OBJECTION TO INFRINGEMENT REPORT

(Intellectual Property Claims)

I am aware that , (the “Reporting Party”), has

submitted a sworn infringement report alleging that the website or webpage located at
_______________ (the “Website”) infringes its intellectual property rights and that PayPal
payment services are being used to process payments in connection with sales of such items.

Therefore, I, the undersigned, CERTIFY UNDER PENALTY OF PERJURY that:

The Website does not advertise, sell, offer for sale or make available an item or items that
infringe, and the Website’s content does not itself infringe, upon the intellectual property rights of
the Reporting Party.

Please briefly explain why the Website does not infringe the intellectual property rights of the
Reporting Party, as alleged in the Reporting Party’s infringement report.

I agree that I will not offer for sale or sell any items using PayPal as the payment method that
infringe upon the intellectual property rights of the Reporting Party.

Indemnification. I agree to indemnify PayPal from and against any and all claims, losses,
liabilities, costs, and expenses, including reasonable attorneys’ fees, which PayPal may incur in
connection with the Website or the items offered therein.

False Statements. I understand that my knowing misrepresentation herein that the Website does
not infringe the Reporting Party’s intellectual property rights may expose me to legal liability for
damages, including costs and attorneys’ fees. I further understand that perjury is a felony which
may be punishable by imprisonment of not more than five years or a fine.

Legal Action. I understand that if the Reporting Party disagrees with this Objection, it may
choose to file a legal action against me.

PayPal’s Actions. I acknowledge that the submission of this Objection does not require PayPal
to allow me to continue to use PayPal as a payment means or to reinstate my account.

Contact Information. I certify that the following contact information is accurate and valid. I
acknowledge that PayPal will compare the contact information provided herein with the contact
information I provided in connection with my PayPal account, and my providing false or
fraudulent information will result in the restriction of my PayPal account(s).

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I may be contacted at:

Name:
Title and Company:
Street Address*:
_______________________________________________________________________
City, State, and Zip:
Email address:
Telephone:
Fax:

* Please provide the street address at which you reside; a Post Office (P.O.) Box or the like is not
sufficient.

Signature
UNDER SWORN PENALTY OF PERJURY

Date

Please fax your completed Objection to 1-402-537-5774 or email it to

infringementreport@paypal.com

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