Notification form: Data breach
Contact details
Last name *
First name *
Email address *
Phone number (only to contact you related to this data breach) *
Staff member of UAntwerpen *
yes
no
Description of the data breach and involved individuals
Description data breach *
Involved individuals *
Members of staff
Students
Purveyors
Other:
Timeline
Determination
Moment of determination *
Is the data breach still going on? *
yes
no
Start date
End date
Estimated time of day (this can be periods) *
Type of incident
Reading of data
Copying of data
Change of data
Deletion or destruction of data
Theft/loss of data (purchasing or legal service)
Other:
Categories of data
General data
General personal data (name, address, place of residence)
Phone number, email address
Access data (passwords, login usernames)
Financial data
Identification data
Duplicate copies of one of the above
Gender, date of birth and/or age
Other
Sensitive data:
Submit
The Data Protection Office collects this personal data in order to process the incident report. Under no circumstances will this data be transfered on to third parties. For incidents without legal guidelines, the Data Protection Office will never keep the personal data longer than necessary for the completion of the incident. For incidents where the University of Antwerp is bound by legal provisions, the personal data will be kept until these provisions are met. For questions you can always contact
privacy@uantwerpen.be
. More info about our privacy policy:
www.uantwerpen.be/disclaimer
.