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Data Breach Enquiry.
  • 1

    The information given to us in this questionnaire will enable us to accurately assess your claim. 

    It is important that the information that you give is accurate to the best of your knowledge and where possible please ensure that you have up to date contact details for the company involved in the breach. 

    Please either upload or store safely any documents that you refer to in this questionnaire as we may need these from you at a later date. 

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  • 2
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  • 5
    You may be asked further information to assess your claim.
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  • 6
    The more information you can provide, the quicker and more accurately we can assess your claim.
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  • 7
    If you are unsure please give as close as possible
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  • 8
    If this is different from above
    Pick a Date
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  • 9
    Please enter as much contact information as you have about the company responsible for the breach. This information helps
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  • 12
    Breach Victim
    Pick a Date
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  • 13
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  • 14
    No = Documents being sent via post
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  • 15
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  • 16
    Any other relevant information
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  • 17
    ie. Correspondence, emails etc - This information will be kept secure.
    Drag and drop files here
    Select files to upload
    Max. file size: 10.6MB
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  • 18
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  • 20

    Your information will be reviewed by a Solicitor and in some cases a Barrister. By submitting your details you are agreeing to this. 

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Data Breach Enquiry.
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