Reporting breaches under PIPEDA

Privacy Breach Incident Report Form

You can view this form in:

  • RTF format: This form can be opened in MS Word or WordPerfect. You might need to save the form on your computer before completing.
  • PDF format: You might need to save the form on your computer before completing.

The purpose of the incident report form is to assist organizations in notifying OPC of any material breaches.

Privacy breach incidents can be reported as follows:

  • By e-mail: notification@priv.gc.ca;
  • By phone: (819) 994-5444; Toll-free: 1-800-282-1376; or,
  • By mail:

    Notification Officer
    Office of the Privacy Commissioner of Canada
    30 Victoria Street
    Gatineau, Quebec
    K1A 1H3