Myspace - Declaration of Ownership

Enter your legal First and Last name: *
Current email address you have access to: *

By signing the Electronic Signature box below and submitting this form, you are being duly sworn to hereby state the following:

I have created, and have maintained ownership of the Myspace account at this URL: *
If you are having trouble locating your URL, click here for help.

Please select your reason for submitting this Declaration of Ownership form:

Declaration Purpose: *

Did you request a password reset, and not receive an email?

I hereby authorize to change the log in email address for the aforementioned account to:

New Email:
DO NOT include an email address that is already assigned to another profile.

The following information should be used to verify my identity:
Email address associated with profile:*
Date of birth:*
Zip code listed on account:*
Name listed on account:*
City and State account was created:*
Artist genre listed on account (Artists only):

If you do not know any of the requested information above and have requested that your profile be deleted, please attach a digital image of your government issued ID. Please conceal all private information, but your name and photo.

Pursuant to this Attestation, I waive any claims against, indemnify and hold harmless Myspace, Inc., its affiliates, and their respective directors, officers, agents, and employees from and against any claims, damages or expenses relating to or arising from, in whole or in part, the disclosure of such information, records and data. I have not been promised anything in exchange for providing this consent and authorization.

By signing this, I swear under penalty of perjury that the information contained in this document is true and correct, and that the aforementioned Myspace account was created and maintained by me.

Electronic Signature: *

If you are under the age of 18, please print this page, have your parent or legal gardian sign it, scan and send the form to us as an attachment.

Myspace Member's Signature: ___________________________________

Guardian Signature: ___________________________________________

(Required if Myspace member is under the age of 18)

File Attachment: