Data breach notification form

A data breach has to be notified to the Data Protection Authority through an electronic form which, after being completed, must be submitted via an Internet portal. Notice that the forms submitted by e-mail will not be processed.

Notify a data breach in 3 steps:

✅ Download the electronic form

Complete the electronic form. A manual on the use of electronic forms is at your disposal.

Unfortunately, forms cannot be opened on mobile devices. You must open and fill in the forms on a computer or laptop.

Data breach notification form (Dutch)Data breach notification form (French)Manual electronic forms

These documents are only available in Dutch and French.

This form must be completed in one of the three national languages. The technical annexes to the application form may also be submitted in English, in addition to the three national languages (other languages are not accepted). If this language requirement is not respected, the application will be considered inadmissible.

✅ Complete the electronic form

Complete the uploaded form electronically (on your computer). Notice that it is not possible to submit a scanned form that was completed by hand.

You can keep a draft version with the "Save As" function, as for ordinary PDF documents. You can save the final version in the same way to a location of your choice.

✅ Submit the completed electronic form through the application

Submit the completed form via our e-forms web portal. If the submission was successful, you will receive an e-mail with a unique code that will be sent to the address you entered on this portal. Only the reception of this e-mail confirms that the information has been submitted successfully.

Eforms web portal

The portal is only available in Dutch and French.