Incident Report Form

Title

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First Name✱

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Last Name✱

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Position / Designation✱

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Telephone✱

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Email✱

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Ongoing Incident✱

Yes

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Date and Time of Incident✱

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Type of Incident✱

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Criticality/Impact✱

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Affected Platform✱

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Incident Details✱

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Please include as much detail about the incident as possible, including the IP addresses involved, ports and any other item of interest.

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Incident Reporting Form