Cybercrime Report Template

Do you know when the incident occured? *

Yes No

Date and time when the incident occurred

Month Day Year Hour Minutes AM/PM Option

Do you know how the incident occurred? *

Yes No

Infection vector (how did the malware or attacker enter the system)

How did you learn about the incident? *

Device showing strange or inappropriate behavior My Internet Service Provider (ISP) My antivirus/antimalware software/hardware (UTM, firewall, IPS/IDS...) Unauthorized money transfer from bank/credit card/PayPal/... Alerted by my company's administrator Alerted by a friend/colleague/security researcher

Do you have knowledge of any other victims/witnesses involved in the attack? *

Yes No

Indicate other victims or witnesses. Please provide name(s) and email address(es), or website/other contact means

	Name	Email	Website	Other (phone number, ...)
Person #1
Person #2
Person #3

Do you have knowledge of the actors behind this attack? (ie. the cybercriminals) *

Yes No

Fill in any and all information you have already gathered about the cybercriminals.

Describe the incident *

Try to be specific and include as many details possible

Did you experience any monetary loss? *

Yes No

Monetary loss ($/€/£/...)

Means of payment you used

Cash/Cashier's Check Check/Debit Card Credit Card Money Order Wire Transfer Online Payment (PayPal, uKash, MoneyPak, ...)

Have you already reported this incident to law enforcement or government agencies? *

Yes No

Please refer to the following websites if you would also like to report this seperately:

Report Cybercrime Online (EU)

IC3 Complaint Referral Form (US)

In case you do not want to report this to a specific law enforcement agency seperately, just finish up this form. If you are willing, it is possible to share any information through Criminal Intelligence teams - this can be completely anonymous, similar to this form.

Be sure to contact your CERT or local police department to ask if they have such a team or anonymous reporting possiblity (see also links above).

You can find a list of CERTs here:
CERTs by Country - Interactive Map

List of National CSIRTs

APCERT team members

Indicate the organizations or individuals that you contacted

Local police department Country CERT Lawyer/attorney Local computer store/Antivirus vendor/Hardware provider Means of payment organisation (bank, card service, PayPal, ...) External company (please specify in "Other")

Add any other information you deem relevant

Cybercrime Report Template

Victim information

Attack(er) information