European Data Protection Supervisor
European Data Protection Supervisor

Personal data breach notification form

Personal data breach notification form

  1. English
  2. English
 
1 General 2 Data Breach Information 3 Preview 4 Complete

A. Type of notification

Please read the user guide on how to notify a Personal Data Breach before filling out this form.
Please also read the specific data protection notice.
Select 'comprehensive' when this is a complete notification. Select 'in phases' when this is an initial, incomplete, notification, further information to follow (Art. 34(4) of the Regulation 2018/1725)
Follow-up: The is a follow-up to initial notification Conclusive: This is the final information for the incident
In case of a follow-up or conclusive type of notification, please indicate if available the Case File number provided by the EDPS.
Art 34(6) of the Regulation 2018/1725

B. Data Controller EUI

C. Data Processor