Cybercrime Report Template
To report an incident, please provide the following information
Type of report * Governmental
Incident reported by vikas sharma
First Name Last Name
Victim information
Fill in your contact details
Report anonymously
Whenever possible, person saying i am from jammu but we think
enter any victim- suspect is from amritsar ip address of the culprit
192.168.1.1
related information
here
Attack(er) information
Fill in any and all data or information you have obtained
Do you know when Yes No
the incident
occured? *
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Do you know how the Yes No
incident occurred? *
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? *
Indicate other victims or witnesses. Please provide name(s) and email address(es), or
website/other contact means
Name Email Website Other (phone number, ...)
Person
#1 himanshu
Person
#2 sujal
Person
#3
Do you have Yes No
knowledge of the
actors behind this
attack? (ie. the
cybercriminals) *
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Fill in any and all sakshi from jammu
information you have himanshu from amritsar
already gathered
about the
cybercriminals.
Describe the a person who used my pic on his profile and
incident * abused me on instagram she claims that her
name is sakshi and she is from jammu
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
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Add any other
information you
deem relevant
Reset form Print form
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