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Your information is valuable to us. Please answer the questions to the best of your ability and if you don't know the answer leave it blank.

Name (suspect)

Any other name

Is this person in Canada?

Yes

Province

City

Contact information of suspect

Tel#

Home Address

Social media handle

What is their immigration status in Canada?

Is the suspect a member or associate of the IRGC?

Yes

Please explain

What does the suspect do for work & where?

Is the suspect a member or associate of the Khamenei regime?

Yes

Please explain

Who are the suspect’s family members?

If the suspect has any business activity, please provide us with as much detail as you can on the name, location, and nature of the business.

Please write your full report here. Give as much information and detail as you can about the persons you are reporting and what they are doing in Canada.

Is there more evidence or documentation that may be available to prove the above information?

In order for our own report to the authorities to be stronger, we would like to discuss your report with you further. Your identity will remain confidential. Please indicate if you consent to our contacting you.

Yes

Contact info (reporter)

Preferred method of contact

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