Form for reporting an incident of personal data breach

Enter the name of the service concerned by the request:
Enter the e-mail address through which you will be able to correspond with us in the reported case:
Specify the time of the event as precisely as possible:
Describe as accurately as possible who breached the law, whose rights were violated, what were the circumstances of the violation of law:
Permitted formats: pdf, png, jpg, jpeg, zip, doc, docx, txt, gif, odt, csv, xlsx, xls, eml
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