Blackmail application form

Filling out this application means, I own you and you are my blackmail doggie, you must fully understand that I have the right to exploit you using the information you have provided  until you decide you no longer want to be my puppy..

You must fill out this application form as much as you can with the correct information.

You must also send an initial tribute of $50 with a message stating who you are, how much you are willing to tribute and how regular you can tribute. You must also state what safety word you wish to use. once filled out email the contract to me via Twitter or here. 

Also know that I do taxes : these will be taxes for when you are a bad puppy! 

I hereby agree and in fact wish to provide Mistress Lexxi with my personal information for the purpose of being consensually blackmailed. By filling out this form I agree that I do this of my own free will. I provide the following information freely and voluntarily. I have not been coerced or defrauded into providing such information and understand that release of this information by Mistress Lara will be of her own discretion. Once this document is filled out and signed, all information is sole property of Mistress Lara
 and she can do with it as she wishes unless I pay my get out fee or use the safety

(fields marked * are mandotory, unmarked will be to your discretion) 

Personal information:

*First name:

*Last name:

Address:

Home telephone no.

Mobile no.

*Email:

Employment

Job title:

Company name:

Company address:

Work phone number:

Name of your boss:

Monthly income:

Wife/Girl friend info

Name:

Mobile number:

Email address

Other personal info: 

Facebook user and password:

Twitter user and password:

Email user and password:

Online banking details:

Bank card details:

Paypal user and password:

Initial requirements

1. A picture of you holding up a sign that says “Mistress Lexxi's slave”

2. $50 tribute to amazon in gift card form 

By giving this information you give your full consent for Mistress Lexxi to fulfill your financial blackmail fetish. Any information you give is voluntary and of your own free will. You agree that the information you have supplied will be used accordingly for the purpose of consensual financial blackmail and give me full permission to use the information and any pictures I request as I see fit for the purpose of this fetish. You understand that there is a ‘get out fee’ if you no longer wish to pursue this and the fee to pay is 100$ Your personal details and any pictures I have in my possession will be destroyed with no further contact from me.

Name:

Date: