Data Breach Report
Please fill in this form if you SUSPECT a breach of data controlled by OCA has occurred.
Email Address
In order for us to follow up this report with further questions, please provide your Email address here. (not essential)
Your answer
Date of Breach
MM
/
DD
/
YYYY
Time of Breach (if known)
Time
:
Location of the breach *
Your answer
Nature of the breach
Your answer
Number of affected individuals *
Approx. number of affected individuals
Your answer
Type of Data at Risk *
Immediate Action Taken *
Please describe any immediate actions taken to reduce the impact of this data breach, by yourself or any others. Check before submitting this form.
Your answer
Crime Reference Number (if applicable)
Your answer
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