Incident Reporting System

OMB Control No.: 1670-0037; Expiration Date: 12/31/2021

CISA Incident Reporting System

The CISA Incident Reporting System provides a secure web-enabled means of reporting computer security incidents to CISA. This system assists analysts in providing timely handling of your security incidents as well as the ability to conduct improved analysis. If you would like to report a computer security incident, please complete the following form. Please provide as much information as you can to answer the following questions to allow CISA to understand your incident. Do not copy and paste malicious code directly into this form. Fill out this incident report in detail. Then, provide the resulting CISA Incident ID number in the Open Incident ID field of the Malware Analysis Submission Form where you can submit a file containing the malicious code.

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Malware Submissions

Do not copy and paste malicious code directly into this form. Fill out this incident report in detail. Then, provide the resulting CISA Incident ID number in the Open Incident ID field of the Malware Analysis Submission Form where you can submit a file containing the malicious code.

I am:

MY CONTACT INFORMATION

Please provide your contact information so that we are able to contact you should we need to follow-up. Your contact information is not required to submit a report using this form. However, incomplete contact information may limit US-CERT's ability to process or act on your report.

MY ORGANIZATION

DATE AND TIME INFORMATION

When was this incident detected? * Required

INCIDENT DESCRIPTION

IMPACT DETAILS

Was the confidentiality, integrity, and/or availability of your organization's information systems potentially compromised? * Required

Privacy Act Statement

Authority: 5 U.S.C. § 301 and 44 U.S.C. § 3101 authorize the collection of this information.
Purpose: The primary purpose for the collection of this information is to allow the Department of Homeland Security to contact you about your request.
Routine Uses: The information collected may be disclosed as generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as amended. This includes using the information as necessary and authorized by the routine uses published in DHS/ALL-002 - Department of Homeland Security (DHS) Mailing and Other Lists System November 25, 2008, 73 FR 71659.
Disclosure: Some entities are regulatorily or statutorily required to submit incident reports to DHS, and those entities must provide information in this form as required by applicable statute, regulation, or similar mandate. Failure for provide this information may result in inaccurate record keeping of the entity’s compliance. For non-mandatory incident reporting, providing this information is voluntary. However, failure to provide this information will prevent DHS from contacting you in the event there are questions about your report.


Version: 3.0 | Report ID: 2021-USCERTv32LJJZS | Date: 202111200650
Email comments and feedback on the Incident Reporting Form