Data Protection Commissioner
Data Protection Commissioner

Notification of personal data security breach

for providers of publicly available electronic communications networks or services in accordance with Commission Regulation (EU) 611/2013


Section 1

Identification of the Provider

1

2 Identity and contact details of the data protection officer or other contact point where more information can be obtained

3 Is it a first or second notification?

Initial information on the personal data breach
(for completion in later notifications, where applicable)

4 Date and time of incident (if known; where necessary an estimate can be made)and of detection of incident

4a

4b

5
(e.g. loss, theft copying)

6

7

8

Section 2

ODPC Ref Number (if advised)

Further information on the personal data breach

9

10

11

12

Possible additional notification to subscribers or individuals

13

14

15

Possible Cross-border issues

16Yes No

17Yes No


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