[TEMPLATE] Claim Rollback Request

[3XJ]

In order for our and your convenience, please copy paste this template and fill in the information when making your rollback request topic.
For your topic name, use [Claim Rollback Request]*YourName*

Your Name:  
Coordinates: (use format xyz: 1845 64 2374)
Time/Date (Post a time/date when everything was fine)(day/month/year): 
Description of Issue: 
Screenshots (Optional):