If you're able to log in
If you're able to log in to the Cobalt Network, then you don't need to fill out this form. You likely can appeal in-game by typing /appeal and following the instructions.
If you're NOT able to log in
If you see a brown, dirt-textured screen when trying to log in to Cobalt, then you may be banned. At the bottom of the message, you should see a code labeled "Ban ID". Type that into the text box behind this message.