Reconsideration Request FormTitle (required)Author(s): (required)Publisher (if known):Request Initiated by: (required)Telephone: (required)Address: (required)City: (required)Zip: (required)Is complainant representing self or representing an organization: (required)Representing selfRepresenting organizationOrganization's name, if complainant is representing an organization:Did you read/view/listen to the entire work? (required)Yes, I read/view/listen to the entire workNo, I did not read/view/listen to the entire workWhat concerns do you have about this work? Please be specific (i.e. cite pages, timestamps for AV materials, scenes, lyrics, etc.) (required)What action would you like to see taken regarding this work? (required)In its place, what work of equal quality would you recommend to convey of the subject treated? (required)If you have any supporting documents to your claim, upload them in a .pdf formatYour Signature (required)Confirm e-SignatureReview Electronic Records and Signatures Policy (required)Read our Electronic Record and Signature Disclosure I agree to use electronic records and signaturesThere was a problem saving your submission. Please try again later.Please wait while your submission is being saved...Submitting...SubmitThank you, your submission has been received.