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Incident Log - DOC


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									                                        Incident Log Form

Incident Number:           ______________________________________________________

Date of Notification: ______________________________________________________

Time of Notification: ______________________________________________________

First IT Contact (Name):           ________________________________________________

Contact Information:

                        Notifier                                  Notifier’s Supervisor
Work Phone
Home/Cell Phone
E-mail Address

Affected System Information:

Affected System                    Location                               Name of Operator

Nature of Incident:

Incident Response Team Members Assigned:

    1. ___________________________________________________
    2. ___________________________________________________
    3. ___________________________________________________

Incident Response Coordinator (Signature): _________________________________

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Info-Tech Research Group                                                                              2001

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