Hmm, Not to sure what specific form you would fill in, But try Complaint's. You will need to provide a lot of details if you don't remember your E-mail. Just ask them and they will tell you what you need. Most likely something along the lines of recent transaction ID's, When you made it, I.P or location of where you made it, Original Password, etc, etc. Good luck man. It's VERY hard to recover an account without knowing the original E-mail.