General Information
1 Incident number (to be assigned by MyCERT).................:
2 Reporting site information
2.1 Name of Organization... ..................................................:
2.2 Name of Domain (e.g., mycert.mimos.my).......................:
Contact Information
1 Your contact information
1.1 Name..........................................................................:
1.2 E-mail address.............................................................:
1.3 Telephone number......................................................:
1.4 FAX number...............................................................:
Incident Categories
1 Please indicate the incident catagories
1.1 Nework Abuse
1.1.1 Intrusion......................................................:
1.1.2 Destruction.................................................:
1.1.3 Denial of service attack..............................:
1.1.4 Hack Threat................................................:
1.1.5 Probe/Scan.................................................:
1.1.6 Spoofing.....................................................:
1.2 Email Abuse (please provide the full header)
1.1.1 Mailbomb...................................................:
1.1.2 Virus...........................................................:
1.1.3 Email Forgery.............................................:
1.1.4 Harrassment................................................:
1.1.5 Spamming...................................................:
1.1.6 Others.................................(please specify):
Detail description of the incident
1 Please complete in as much detail as possible
1.1 Suspected date and time of attack.............................:
1.2 Suspected method of intrusion (e.g., name of virus,
name of exploit script, etc.).....................................:
1.3 How you discovered the incident...............................:
1.4 The source of the attack (if known)............................:
1.5 Steps taken to address the incident (e.g.,
binaries reinstalled, patches applied)........................:
1.6 Planned steps to address the incident (if any)............:
2 Please append any log information or directory listings
and time zone information relative to GMT to the end of
this document...................................................................:
Other information
1 What assistance would you like from MyCERT...............:
2 Would you allow MyCERT to reveal your contact info...:
3 Any additional information................................................: