Data Breach Questionnaire Full Name *Date Of Birth *Your email *Contact Number*House Number *Postcode *What date did the breach occur? When were you made aware of the breach? How were you made aware of it? What information was disclosed? How was the information disclosed? (Post, email etc.) Who disclosed the information of the breach? Are you aware of how many people had access of the information and for how long?Have you reported the breach to the company, ICO or the Police? Have you contacted the company? Have you contacted any other Solicitors or legal professionals Are you subject to a debt relief order or claimed bankruptcy? Are you happy for us to correspond with you via email? If you have any evidence of the breach, ie email confirming the breach, please upload here:We will contact you as soon as possible