IT Security Incident Report Template

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IT Security Incident Report Template

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Last updated September 8th, 2025

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An IT security incident report documents the particulars of a cyber attack on an organization’s networks, systems, or data. The report describes how and when the issue was found, the nature and extent of the breach, and the actions that were taken in response to the threat. After being completed, the report is kept in the company’s internal records for future reference.

AKA

  • Cybersecurity Incident Report
  • Databreach Incident Report
  • Cyber Attack Incident Report

Reporting a Cybercrime

Victims of internet-based fraud, scams, and other cybercrimes can file complaints with the Internet Crime Complaint Center (IC3). Ongoing crimes, threats to life, or terrorist threats attacks can be reported to the FBI by filling out an Online Tip Form or contacting a local field office.

If Protected Health Information (PHI) was compromised in a cybersecurity breach, the incident must be reported to the HSS.

Incident Examples

  • Data or information breach
  • Malware, ransomware, and denial-of-service (DDoS)
  • Unauthorized access
  • Phishing attacks

Sample

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IT SECURITY INCIDENT REPORT FORM
INDIVIDUAL FILING REPORT

Full Name: [FULL NAME] Title/Role: [TITLE/ROLE]
Signature:                                                           Date: [MM/DD/YYYY]

INCIDENT DETAILS
Date of Incident: [DATE OF INCIDENT]      Time: [TIME] ☐ AM ☐ PM

Location: [LOCATION]

How was the incident discovered? [DESCRIBE DISCOVERY OF INCIDENT]

Incident Severity: ☐ 0 ☐ 1 ☐ 2 ☐ 3 ☐ 4 ☐ 5 ☐ 6 ☐ 7 ☐ 8 ☐ 9 ☐ 10

Describe the Incident: [DESCRIBE THE INCIDENT]

NOTIFICATION
Were other personnel notified? ☐ Yes ☐ No

If yes, enter: [LIST CONTACTED PERSONNEL]

CONTAINMENT
Were any containment measures made? ☐ Yes ☐ No

If yes, describe: [DESCRIBE CONTAINMENT MEASURES]

IMPACTED SERVICES
Were any services permanently impacted? ☐ Yes ☐ No

If yes, describe: [DESCRIBE IMPACTED SERVICES]

ATTACK VECTOR
Do you know how the attack was made? ☐ Yes ☐ No

If yes, describe: [DESCRIBE ATTACK]

INFORMATION IMPACT

Was there any breach of data, records, or information? ☐ Yes ☐ No

If yes, describe: [DESCRIBE BREACHES]

ADDITIONAL INFORMATION

Is there any other information that should be provided? ☐ Yes ☐ No

If yes, describe: [DESCRIBE ADDITIONAL INFORMATION]