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 * 

Description of the data breach and involved individuals

Description data breach * 


Involved individuals * 


Timeline

Determination
Moment of determination * 

Is the data breach still going on? * 

Start date  

End date  

Estimated time of day (this can be periods) * 

Type of incident






Categories of data

General data







Other
Sensitive data:

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.