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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 Name Work Phone Home/Cell Phone E-mail Address Affected System Information: Affected System Location Name of Operator 1. 2. Nature of Incident: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Incident Response Team Members Assigned: 1. ___________________________________________________ 2. ___________________________________________________ 3. ___________________________________________________ Incident Response Coordinator (Signature): _________________________________ Info-Tech Advisor Solutions Bank documents are provided for the free and unrestricted use of subscribers to Info-Tech Research Group services. You can use this document either in whole, in part, or as a basis and guide for your own documents. To customize this document with your own corporate marks and titles, simply replace the Info-Tech Information in the Header and Footer fields of this document. Page 1 Info-Tech Research Group 2001
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