OMB APPROVAL NO.: 3084-0171
EXPIRATION DATE: 12/31/2026
The Safeguards Rule requires covered financial institutions to report to the FTC security events affecting 500 or more people. Your report may be made public. If law enforcement has requested a delay in making this report public, please check the appropriate box below.
Third party entities (such as attorneys or service providers) may submit reports on behalf of the financial institution(s) affected by the security event. If you are a third party submitting a single report on behalf of multiple financial institutions, you may wish to check the box below for “Request Secure File Transfer Link” to provide that additional information. You should receive a reply email within two business days with instructions for the secure electronic submission of encrypted documents.
Paperwork Reduction Act Statement: An agency may not conduct or sponsor an information collection and a person is not required to respond to this information unless it displays a current valid OMB control number and an expiration date. The control number for this collection is 3084-0171. The estimated average time to read the instructions, gather the information, and complete this form is 5 hours. If you have any comments regarding the burden estimate you can write to Federal Trade Commission; Assoc. Director - DPIP; DPIP; 600 Pennsylvania Ave. N.W.; Washington, D.C. 20580.
