Incident Assessment Questionnaire Question Response/Comments When was the incident discovered? When did the incident occur (if different from date of discovery)? Who discovered the incident? What type of incident occurred? System/Data Compromise Network Attack/Malware/Virus Lost/Stolen Equipment Lost/Stolen Data Physical (e.g. Compromise of POS damage/tampering) UBC Policy Violation, e.g PCI DSS, email Other please describe __________________ – Was cardholder data involved? Card Number Credit Name No Cardholder Date Yes select what type of data is involved Expiration – None Was sensitive authentication data involved? Full Magnetic Stripe Data CVV PIN None What is the estimated number of people or None records impacted? 0-499 or above 500 Does the incident compromise business No operation continuity (availability)? Potentially Yes Unknown Is there a need for client/customer No notification? Potentially Yes What steps have been taken to resolve or rectify the incident?
Incident Assessment Questionnaire Question Response/Comments When was the incident discovered? When did the incident occur (if different from date of discovery)? Who discovered the incident? What type of incident occurred? System/Data Compromise Network Attack/Malware/Virus Lost/Stolen Equipment Lost/Stolen Data Physical Compromise of POS (e.g. damage/tampering) UBC Policy Violation, e.g PCI DSS, email Other – please describe __________________ Was cardholder data involved? No Yes – select what type of data is involved Credit Card Number Cardholder Name Expiration Date None Was sensitive authentication data involved? Full Magnetic Stripe Data CVV PIN None What is the estimated number of people or records impacted? None 0-499 500 or above Does the incident compromise business operation continuity (availability)? No Potentially Yes Unknown Is there a need for client/customer notification? No Potentially Yes What steps have been taken to resolve or rectify the incident?
Reporting_PCI_Incident_Procedures.docx