Security Violation Reporting Form

This form is required for all suspected or actual privacy or security breaches. Please fill out to the best of your abilities. Stared fields are mandatory. Contact ITS Helpdesk if you have further questions. 580-774-7070

 

(Full Name)

 

(Today's Date)

 
mm/dd/yyyy
 

When did the incident happen?

 
mm/dd/yyyy
 

If known, select the type of security violation. If unsure, choose Other.

 
 
 
 
 
 
 
 

Hardware, software, sites etc. Please include SWOSU Tag Numbers.

 
 

Please include Building & Rm Number (SWOSU onsite) or street, city, state, zip (offsite)

 
 

Please include 3rd parties, local public health, other state agencies.

 
 

Impact on operations to include downtime, costs, other damages