Subject

Give a brief summary of the incident that you are reporting.

Phone Number

I. General Information

Describe the Device including the type of Device (e.g., desktop computer, laptop, mobile phone, thumb drive, etc.), name, manufacturer, model and year of purchase or acquisition:

Was the Device purchased by Oakland University or an Oakland University employee?

Yes

No

Was the Device purchased with Oakland University funds (directly or via reimbursement) or funds from a grant or contract administered by Oakland University?

Yes

No

When was a compromise first suspected and what raised this suspicion?

Have you report the potential compromise to anyone else at Oakland University and, if so, when did you make the report and to whom did you make the report?

Yes

No

Not Sure

If yes, please describe.

Was the suspected compromise reported to Oakland University Police Department or any other police department? If so, when did you make the report and provide any applicable information such as the case number? If yes, please describe.

Was the Device used by more than one individual?

Yes

No

Not Sure

If yes, name the other user(s):

Was the Device password or passcode protected?

Yes

No

Not Sure

If yes, describe the password protection (e.g., number of digits, etc.):

Have you been able to remotely lock down the Device and/or delete any information or data stored on the Device?

Yes

No

Not Sure

If yes, what was done and when was it done?

What was the Device primarily used for (e.g., personal, work, etc.)?

Was the Device used to check Oakland University email?

Yes

No

Not Sure

If yes, was the Oakland University email accessed through a web browser (e.g., webmail.oakland.edu) or an application/app?

Was the Device used to access Oakland University’s network?

Yes

No

Not Sure

What software data, and/or information was accessed?

Was the Device registered to use on the OU network?

Yes

No

Not Sure

What software, data, and/or information was accessed?

II. Data and Information Stored on the Device or Accessible Using the Device

What data or information was stored or maintained on the Device:

What data or information was accessible using the Device (e.g., data or information stored in a cloud account) and, if accessible, would a user need a username and/or password to access the information?

Was any of the data or information stored or maintained on the Device encrypted or otherwise protected?

Yes

No

Not Sure

If yes, please describe the encryption method:

Do you have any backups of the data or information stored on the Device (e.g., external hard drive, cloud account, etc.)?

Yes

No

Not Sure

If yes, where was the data or information stored?

Oakland University defines Confidential Data as data that are specifically restricted from open disclosure to the public (see OU Administrative Policy #860). Confidential Data requires a high level of protection against unauthorized disclosure, modification, transmission, destruction, and use. Please indicate whether any of the following categories of Confidential Data were stored on the Device and/or accessible using the Device:

Student Data, including without limitation Social Security Numbers, student numbers (e.g., Grizzly ID numbers), grades, email addresses, education records, tests, papers, research.

Yes

No

Not Sure

If yes, please identify each student whose student data was stored on or accessible using the Device and describe in detail all such information for each student:

Medical Data other than your own personal medical data, including without limitation any data relating in any way to the past, present, or future physical or mental health or condition of any individual, the provision of health care to an individual, or the past, present, or future payment for the provision of health care to an individual.

Does the above statement apply?

Yes

No

Not Sure

If yes, please identify each individual whose medical data was stored on or accessible using the Device and describe in detail all such medical information for each individual:

Information Access Security Data, including without limitation login passwords,

Yes

No

Not Sure

If yes, describe in detail the Information Access Security Data and the data or information that is accessible using such Information Access Security Data:

Financial Data other than your own personal financial information, including without limitation primary account numbers, cardholder data, credit card numbers, payment card information, banking information, employer or taxpayer identification number, demand deposit account number, savings account number, financial transaction device account number, account password, stock or other security certificate or account number.

Does the above statement apply?

Yes

No

Not Sure

If yes, please identify each individual whose financial data was stored on or accessible using the Device and describe in detail all such financial data for each individual:

Personnel/Employment Data other than your own personal personnel/employment information, including without limitation employment records, payroll records, leave records and disciplinary records.

Yes

No

Not Sure

If yes, please identify each individual whose personnel/employment data was stored on or accessible using the Device and describe in detail all such personnel/employment data for each individual:

Library Data other than your own personal library data, including without limitation any data retained by a library that contains information that personally identifies a library patron, including the patron's name, address, or telephone number, or that identifies a person as having requested or obtained specific materials from a library.

Does the above statement apply?

Yes

No

Not Sure

If yes, please identify each individual whose library data was stored on or accessible using the Device and describe in detail all such library data for each individual:

Identification Data other than your own personal identification data, including without limitation drivers’ license numbers, state personal identification card numbers, Social Security Numbers, employee identification numbers, government passport numbers, and other similar identification data.

Does the above statement apply?

Yes

No

Not Sure

If yes, please identify each individual whose identification data was stored on or accessible using the Device and describe in detail all such identification data for each individual:

Research Data (please respond separately for each of the categories below):

Intellectual Property (yours or others’)

Yes

No

Not Sure

If yes, identify each individual whose intellectual property was stored on or accessible using the Device and describe in detail all such intellectual property for each person:

Unpublished Data (e.g., proposals, manuscripts, databases, research results)

Yes

No

Not Sure

If yes, identify each individual whose unpublished data was stored on or accessible using the Device and describe in detail all such unpublished data for each person:

Identifiable human subjects data (including medical data)

Yes

No

Not Sure

If yes, identify each individual whose human subjects data was stored on or accessible using the Device and describe in detail all such identifiable human subjects data for each person:

Other confidential or sensitive research data or documents

Yes

No

Not Sure

If yes, identify individual whose confidential or sensitive research data or documents was stored on or accessible using the Device and describe in detail all such confidential or sensitive research data or documents:

III. Other Technical, Confidential or Proprietary Data

Please indicate whether any of the following categories of technical, confidential or proprietary data were stored on the Device and/or accessible using the Device:

Research data or source code that was not already in the public domain (e.g. publication, internet)?

Yes

No

Not Sure

If yes, describe in detail all such research data or source code and identify any passwords, encryption or other security measures that were applied to such data or source code:

* Information or data that is or was subject to a confidentiality provision in a grant, sponsored research, non-disclosure or other contract or agreement.

Yes

No

Not Sure

If yes, identify the parties to each such contract or agreement, describe all information or data that was covered by a confidentiality provision in the contract or agreement, and identify any passwords, encryption or other security measures that were applied to such data or source code:

Research or technical data protected by a Technology Control Plan?

Yes

No

Not Sure

If yes, describe all of the research or technical data covered by each Technology Control Plan and identify any passwords, encryption or other security measures that were applied to such research or technical data and describe all of the research or technical data covered by each Technology Control Plan and identify any passwords, encryption or other security measures that were applied to such research or technical data:

Please describe if applicable:

Research or technical data that resulted from work under a contract that prohibited publication?

Yes

No

Not Sure

If yes, identify the parties to each such contract or agreement, describe all information or data that was covered by prohibition upon publication, and identify any passwords, encryption or other security measures that were applied to such data or source code:

For each of the following, consider any possible information or data access or exposure. Provide information or data regarding any of the following and, if yes, describe in detail the relevant information and data and identify any passwords, encryption or other security measures that were applied to such information or data:
- Artillery Projectors
- Ammunition
- Launch vehicles, guided missiles, ballistic missiles, rockets, torpedoes, bombs or mines
- Explosives, propellants, incendiary agents or their constituents
- Vessels of war and special naval equipment
- Tanks and military vehicles
- Aircraft, spacecraft and associated equipment
- Military training equipment
- Protective personnel equipment
- Military electronics
- Fire control, range finder, optical and guidance or control equipment
- Auxiliary military equipment
- Toxicological agents and equipment and radiological equipment
- Spacecraft systems and associated equipment
- Nuclear weapons design and test equipment
- Classified articles, technical data and defense services
- Submersible vessels, oceanographic or associated equipment
- Any other articles that have substantial military applicability and which have been specifically designed or modified for military purposes

Does the above statement apply?

Yes

No

Not Sure

If yes, please explain.

Owner Agreement must be accepted.

Accept Agreement

Your name

Your email address

Verification Code

Report a Compromised Device

I. General Information

II. Data and Information Stored on the Device or Accessible Using the Device

Research Data (please respond separately for each of the categories below):

III. Other Technical, Confidential or Proprietary Data

Please indicate whether any of the following categories of technical, confidential or proprietary data were stored on the Device and/or accessible using the Device:

Other Fields