Notification of personal data security breach regarding Telecoms/ISP providers

Please note these requirements apply to telecommunications and internet service providers as defined by SI 336 of 2011 only.
For Data Controllers / Data Processors wishing to report a GDPR related personal data breach please click here

Part One

Identification of the Provider

Name of the Provider *

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

Full Name *

Your Phone number

Email Address *

Your Postal Address, including Eircode/Postal Code

Is it a first

second Notification

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

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

Date and time of incident *

Date and time of detection of the incident. *

Circumstances of the personal data breach*

Nature and content of the personal data concerned*

Technical and organisational measures applied (or to be applied) by the provider to the affected personal data*

Relevant use of other providers (where applicable)

Part Two

Data Protection Commission Ref Number (if advised)

Further information on the personal data breach

Summary of the incident that caused the personal data breach (including the physical location of the breach and the storage media involved):*

Number of subscribers or individuals concerned*

Potential consequences and potential adverse effects on subscribers or individuals*

Technical and organisational measures taken by the provider to mitigate against potential adverse effects*

Possible additional notification to subscribers or individuals

Content of notification

Means of communication used

Number of subscribers or individuals notified

Possible Cross-border issues

Personal data breach involving subscribers or individuals in other Member States*

Yes

Notification of other competent national authorities*

Yes

Other authorities notified