DigiCrime Survey

In order to provide better service to our customers, we are conducting a survey. We would greatly appreciate it if you would fill the following information:
Please answer a few simple questions:

Mother's maiden name:     
Social Security Number:   
Name of first male child: 
Bank account number:      
Bank name:                
Calling card number:      

  Credit Card type:   Master Card Visa American Express 
Credit Card Number: 
Expiration Date:    
Name on Card:       

Your address:        
State or Province:    
Postal Code: 
First Name:           
Init./Middle Name:   
Family Name:         
Tel (work) Number:   
Tel (home) Number:   
Fax Number:          
EMail address:       
Driver's license number: State: 
License plate number: 
Vehicle ID number (VIN): 
Number of sexual partners to date: 
Name of most recent partner: 
Their email address: 

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DigiCrime is comically hosted at Southwest Cyberport, in Albuquerque, New Mexico.