[b]In-game name:[/b]
[b]Account name:[/b]
[b]Date you where blacklisted:[/b]
[b]Your LEVEL(4/5):[/b]
[b]Why have you been blacklisted(Less than 20 words):[/b]
[b]Have 2 months (level 4) or 4 months (level 5) passed since you got added to the list (Yes/No):[/b]
[b]Your in-game name:[/b]
[b]In-game pseudonym and the account name of the person:[/b]
[b]Why should the person be added to the list:[/b]
[b]Evidence of the claim:[/b]