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Cybercrime Report Template

The document is a Cybercrime Report Template that outlines the necessary information to report an incident, including details about the victim, the incident, and the attacker. It includes sections for personal information, incident specifics, and any evidence gathered, as well as guidance on reporting to law enforcement. The template aims to facilitate the reporting process for individuals affected by cybercrime.

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preimyt08
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38 views4 pages

Cybercrime Report Template

The document is a Cybercrime Report Template that outlines the necessary information to report an incident, including details about the victim, the incident, and the attacker. It includes sections for personal information, incident specifics, and any evidence gathered, as well as guidance on reporting to law enforcement. The template aims to facilitate the reporting process for individuals affected by cybercrime.

Uploaded by

preimyt08
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Cybercrime Report Template

To report an incident, please provide the following information

Type of report * End-user/Reseller

Incident reported by Amit Pal


First Name Last Name

Email address brog4434@gmail.com

Victim information
Fill in your contact details

Report anonymously

First & Last Name * Amit Pal Pal


First Name Middle Name Last Name

Address * Street 209 odhav


Street Address

Ahmedabad
Street Address Line 2

Gujrat Ahmedabad
City State / Province

382417 India
Postal / Zip Code Country

Phone or mobile 91 - 9313486179


number * Country Code Phone Number

Email address * brog4434@gmail.com


Business Name

Attack(er) information
Fill in any and all data or information you have obtained

Do you know when the Yes No


incident occured? *

Date and time when 06 - 05 - 2025 9 : 20 PM


the incident occurred Hour Minutes
Month Day Year

Do you know how the Yes No


incident occurred? *

Infection vector (how Spam/Phishing/Spear Phishing


did the malware or
attacker enter the Phone scam (eg.: Fake Microsoft call)
system)
Chat room (eg.: IRC/Forum/Newsgroup/Reddit/...)

Social Networking (Facebook, Instagram, Twitter, Linkedin, ...)

Physically (eg.: physical burglary, lost or stolen USB-drive or machine,


...)
Server remotely controlled (RDP) or hacked/Password guessed

Online: any or unknown website

Online: specific website (specify in incident description below)

Other social engineering means: "lost" USB-drive, new "job seeker",


etc.
Mobwik wallet

How did you learn Device showing strange or inappropriate behavior


about the incident? *
My Internet Service Provider (ISP)

My antivirus/antimalware software/hardware (UTM, firewall,


IPS/IDS...)
Unauthorized money transfer from bank/credit card/PayPal/...

Alerted by my company's administrator

Alerted by a friend/colleague/security researcher

Other
Do you have Yes No
knowledge of any
other
victims/witnesses
involved in the attack?
*

Do you have Yes No


knowledge of the
actors behind this
attack? (ie. the
cybercriminals) *

d d ot s a e a y pe so a o a ca o at o .
Fill in any and all
information you have I am attaching screenshots of the conversation as
already gathered proof.
about the
cybercriminals. The intent seemed to be to steal money or personal
data through fake offers

op e e tt e o sca g ot e s, a
Describe the reporting this incident. I also told them that I am
incident * reporting them to Cyber Crime to scare them off. I
am attaching the screenshots and details of their
Telegram ID @workison0930 for further
investigation.

Try to be specific and include as many details possible

Did you experience Yes No


any monetary loss? *

Have you already Yes No


reported this incident
to law enforcement or
government agencies?
*

Please refer to the following websites if you would also like to report this seperately:

Report Cybercrime Online (EU)

IC3 Complaint Referral Form (US)

In case you do not want to report this to a specific law enforcement agency seperately, just finish
up this form. If you are willing, it is possible to share any information through Criminal Intelligence
teams - this can be completely anonymous, similar to this form.

Be sure to contact your CERT or local police department to ask if they have such a team or
anonymous reporting possiblity (see also links above).

You can find a list of CERTs here:


CERTs by Country - Interactive Map

List of National CSIRTs

APCERT team members

Add any other


information you deem
relevant

Reset form Print form

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