Complaint Referral Form Internet Crime Complaint Center

Transcription

1 Complaint Referral Form Internet Crime Complaint Center Please review your complaint for accuracy, prior to submitting it to the IC3. The following information was provided by the victim and may be forwarded to the appropriate law enforcement or regulatory agencies. Your Personal Information * First Name: Thomas Middle Name: Peter * Last Name: Burgess Business Name: TrueValueMetrics * Age: Over 60 * Gender: M * Address: 204 Seaham Court Address (continued): Suite/Apt./Mail Stop: * City: Bushkill Do you live within the city limits?: County: Pennsylvania State: Pennsylvania * Country: United States * Zip Code / Route: * Phone Number: * E mail Address: peterbnyc@gmail.com Name of your local police or sheriff's office: State Police in Swiftwater PA Is the complaint you are filing related to the Internet or an online service? Do you have pertinent documents in paper form? Information about the Individual/Business that victimized you Business Name: Monster Energy Drink First Name: Tom Middle Name: 1/5

2 Last Name: Gender: Address: Address (continued): Suite/Apt./Mail Stop: City: State: Country: Zip Code / Route: Phone Number: E mail Address: Coyne U tdcoyne@hotmail.com Other Identifiers Web Site: IP Address: IRC Server: Chat Room Name: Usenet Newsgroup: Other: almadera@hotmail.com Monetary Loss * Please specify the total dollar amount of your loss from this incident: $ 2030 (US Dollars) Please indicate the means of payment (select all that apply) Cash Cashier's Check Check/Debit Card Credit Card Money Order Wire Transfer Other (Specify Other) Did you use a third party online payment service such as PayPal, BidPay, Escrow? Description of the Incident * Describe in your own words how you have been victimized. Be specific. Include date(s) of transaction(s), a description of any items that were not delivered or were counterfeited, any transaction numbers (from Ebay, Western Union, PayPal, etc.), and any other pertinent information that helps to explain how you were victimized. Also if you received anything by U.S. Mail, FedEx, or UPS, specifically describe the envelope, by the date, time, city and zip code shown on the stamp cancellation postmark. On January 3rd Tom Coyne <almadera@hotmail.com> contacted me by to ask if 2/5

3 I would like to &#39;wrap&#39; my car for $300 a week with the Monster Energy Drink advertisement. On January 5, I replied YES and then Tom Coyne now at <tdcoyne@hotmail.com> replied with some details. Tom Coyne described himself as the Hiring Manager, Monster Energy Drink. There were several exchanges during which he described what had to happen with the wrapping process and he also asked for information about my car. In essence they were going to pay me $300 a week in for the advertising associated with driving a wrapped car. The cost of wrapping the car was going to be paid by them. They would send me the cost of wrapping which I would pay to the graphic artist who did the work. The graphic artist who did the work was going to be someone local. On January 24 he advised that a check payment had been sent by USPS and on Monday January 26, I picked it up from my mail box. Tracking Number (Sent January 22) The mail was sent by a John Fields 6701 Columbia Lane Amarillo Texas according to the USPS label. Also on January 24 he advised me on how I should proceed with the check cashing and onward remittance of some of the proceeds to the graphic artist who would be doing the wrapping. At this point it was explained that the wrapping materials were made in China and the graphic artists were paid from the head office... quite plausible if one didn&#39;t think it through! The check was for $2330 drawn on General Electric Credit Union Reading Road Cincinnati Ohio The bank codes The instruction was for me to take $300 from this and forward the balance of $2030 to the following address by Western Union. NAME: HONGWEI DONG CITY: CHANGYANG STATE: BEIJING COUNTRY: CHINA When the check proceeds were posted to my account, (Tuesday, January 27) I withdrew $2030 plus WU fee for total of $2048 in cash and had this sent Western Union to China. The transmittal / tracking number being Today, January 29, I have been advised by the bank that the check was a fraud. Please indicate any medium used by the individual/business in the course of the incident. Bulletin board Chat room Fax In person Internet messaging Mail Newsgroup Telephone Web site Wire Other Please indicate the initial means of contact with the individual/business that victimized you. Was this initial means of contact unsolicited/uninvited? What was your relationship with the individual/business you are complaining about prior to 3/5

4 the incident you are reporting? no prior relationship Did you conduct any research on the individual/business prior to the incident? How much time has passed since you determined you were victimized? Less than 1 week Contact Information Are there witnesses or other victims to this crime? None to my knowledge... though it is likely there are others Have you reported this crime to any law enforcement or government agencies? Better Business Bureau Consumer protection agency Individual/business that victimized you Police/other law enforcement Private attorney Provide the specific name of each organization, contact name, contact phone number, address, date reported, and report number (if known). The only other organization that knows about this is my bank Wayne Bank Marianne Glamann Regional Manager 5165 Milford Road East Stroudsburg P.A Ph Fax: marianne.glamann@waynebank.com Digital Signature Read the following statement below, and confirm your agreement by typing your full name below in the box provided: By digitally signing this document, I affirm that the information I provided is true and accurate to the best of my knowledge. I have read the IC3's Privacy Policy, and understand that this information may be provided to law enforcement and regulatory agencies. If available, I will provide additional documentation not included in this complaint, such as correspondence, payment receipts, or electronic logs, upon request to the best of my ability. I authorize the dissemination of the complaint, or information in the complaint, to appropriate federal, state, local, tribal or international Law Enforcement Agencies (LEAs) for purposes of investigating the complaint. Digital Signature: Thomas Peter Burgess To confirm the submission of your complaint, please enter the following letters below. 4/5

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