- Account Name (the name you log into the LoL client with):
- Summoner Name (the name your friends see in-game):
- The server you play on (NA, EU-West or EU-Nordic/East):
- When was the last time that you had access to the account (Month/Day/Year):
- Creation date of the account (Month and Year):
- Original email address used to register the account:
- Location where you registered the account (City and Country):
- List of locations that you have played on this account(City and Country):
- Last IP address used to play League of Legends -

- Internet Service Provider (ISP)/Internet Carrier when registering the account:
- Other people who have ever had access to the account:
- How did you first come into possession of the account:
If Applicable:
- Location of RP purchases (City and Country):
- Approximate dates of most recent RP purchases:
- Email address linked to PayPal account:
- Unique PayPal transaction IDs associated with purchase(s):
- Phone number(s), mobile provider, and country used for SMS transactions:
- Any PaySafe Card PIN/Transaction IDs:
- Any Prepaid RP card PINs:
- The last 4 digits and expiration date of any credit card(s) used to purchase RP:
- Any transaction or confirmation numbers received via email for this account: