Skip to main content
Security Breach Report Form Concepts
What's Included
$19 Template
$89 Pack
$199 Pro
This single static template
180 contract template library
Starter proposal template library
Novice quoting software
340 contract templates
700 proposal layouts
200 completed sample proposals
110 project templates
Expert quoting software
Document branding features

How to write your Security Breach Report Form

We include this 6 page template with IT/Software/Hardware Contract Pack and the Proposal Kit Professional. You will get more content and software automation for data merging, managing client documents, and creating proposals with line item quoting with a Contract Pack or the Professional.

Use the Security Breach Report Form to file a report about a security breach either involving a physical breach or a computer breach.
Document Length: 6 Pages
Quote Logo What Our Clients Say

Before I used the Web Freelancer Contract Pack, I would often find myself forgetting to include items in my agreements with clients that lead to frustration, usually on my part. This contract pack has allowed me to keep a consistent look to my client documents, and helped me be more proactive and helpful to my clients, by covering all of the bases I need to cover."

Richard Pelzar
Webbit Media LLC.

1. Get IT/Software/Hardware Contract Pack or the single template that includes this business contract document.

We include this Security Breach Report Form in editable Word format that can be customized using your office software.

2. Download and install after ordering.

Once you have ordered and downloaded your template or pack, you will have all the content you need to get started.

3. Customize the contract template with your information.

You can customize the contract document as much as you need. If you get a Contract Pack or Professional Bundle, you can also use the included Wizard software to automate name/address data merging.

Security Breach Report Form

How do you write a Security Breach Report Form document?

Incident Report: Security Date Reported: Current Date. Employee: First Last Department: Department Supervisor: Supervisor Date / Time of Injury: Insert Incident Date and Time. Point of Contact (POC) Information Name: Phone: Job title of signator, authorized signature or signer. Point of Contact must complete the following form and file it with the Security Department as well as the Human Resources Department.

The following is a high-level description of the incident for summary purposes only. Distribution of this report is limited to the following departments on a NEED-TO-KNOW basis only. If you have any questions related to this summary, please contact at method for more information.

Description of Incident / Intrusion Describe the injury as well as the events or what happened to cause this incident. Attach additional pages if necessary. Witnesses Did anyone witness the incident or evidence of the incident after it occurred?

Yes ? No ? Name(s) of Witnesses:

Type of Intrusion (Please check all that apply) Intrusion ? Data Breach ? Theft ? Malware/Trojan/Virus ? Compromised System ? Physical Intrusion ? Other ?

Intrusion Location and Information: (Name, Address, Phone if applicable) Notes:

Effect of Intrusion (Please check all that apply. Loss of Data ? Unauthorized Access of Data ? Theft ? Degradation of Service(s) ? Interruption of Service ?

Physical Damage to System(s) ? Unauthorized Escalation of Privileges ? Physical Intrusion ? Other ?

Additional Information:

Systems Affected

Insert the systems this intrusion affected.

Intrusion Discovery

Describe how, where, and by whom this intrusion was first detected.

Communication / Notification

Describe the notifications and communication that were carried out at every step. Also describe any initial notification, follow-up, resolutions and communication(s) that still need to be made at this stage.

Evidence and Documentation

Describe the evidence and documentation, logging, files, etc., that have been gathered at each step, and indicate by whom they were gathered. Attach additional sheets if necessary.

Incident Response

Describe the work flow of the incident response, including personnel involved at each stage and all actions taken. Attach additional sheets if necessary. Corrective Action(s) Taken and Incident Resolution. Describe the corrective actions taken, including names of parties responsible for those actions, to address each system impacted by the intrusion.

Attach additional sheets if necessary.

Conclusion and Findings

Insert conclusions reached at this stage. Attach additional sheets if necessary.

Conclusions may include:

The root or proximate cause of this incident. Precautions that could have prevented this. The direct and indirect impact on the Company and its systems, customers, users, employees, etc.

The estimated cost to investigate, respond to, and correct the intrusion. The steps that have been taken to prevent the incident from happening again and to limit further interruption. The additional actions, research or communication that need to happen.

The complete Security Breach Report Form - with the actual formatting and layout - is available as a single template or as part of a library of related templates in a Contract Pack or the Professional Bundle.
Security Breach Report Form
Product name:
Security Breach Report Form
Produced by:
Proposal Kit
Software › Computer Software › Business & Productivity Software
$19 USD
Proposal Kit Reviews Logo4.7 stars, based on 839 reviews
Related documents may be used in conjunction with this document depending on your situation. Many related documents are intended for use as part of a contract management system.

Related Documents:

Key Takeaways

  • The Security Breach Report Form is available as a ready-to-edit template.
  • The Contract Packs and Professional Bundle include many related agreements and documents.
  • You can automate financials and data merging into contracts using a Contract Pack or Professional Bundle.
  • You can also create business proposals and integrate your contracts using the Professional Bundle.
  • There are no ongoing subscription fees. You get lifetime unlimited use.
Proposal Kit LogoPublished by Proposal Kit, Inc.


Proposal Kit, Inc. makes no warranty and accepts no responsibility for the suitability of any materials to the licensee's business. Proposal Kit, Inc. assumes no responsibility or liability for errors or inaccuracies. Licensee accepts all responsibility for the results obtained. The information included is not legal advice. Names in use cases have been fictionalized. Your use of the Security Breach Report Form template and any purchased packages constitutes acceptance and understanding of these disclaimers and terms and conditions.

© 1997 - 2024, Proposal Kit, Inc. All rights reserved. Privacy Policy.