KSU will adhere to federal, state laws, rules, regulations, policies and procedures governing the confidentiality of data and notification of security breaches.
Appendix A: Security Incident Reporting Form
Date Submitted:___/___/___
| 1. Reported By Contact Information | |
| Full Name: | |
|---|---|
| Job Title: | |
| Department/College: | |
| Office Room Number: | |
| Work Phone Number: | |
| Cellphone Number: | |
| Email Address: | |
| Additional Contact Information: | |
2. Type of Incident (Check all that apply)
☐ Compromised/Stolen/Altered Data ☐ Theft and use of Others ID's ☐ Denial of Service ☐ Unauthorized Access ☐ Data Breach ☐ Social Engineering (e.g. Phishing, scams) ☐ Website Defacement or Redirection ☐ Reconnaissance (e.g. scans, probes) ☐ Malicious Code (e.g. worms, virus, Trojan) ☐ Computing Device Lost, Stolen or Damaged ☐ Violation of Security Policy or Policies ☐ Other or Unknown (Provide description below)