Please note: this form is intended for use by Queensland Government agencies. If you are not an agency and you wish to notify the Office of the Information Commissioner (OIC) of a privacy breach please contact OIC’s Enquiries Service at email@example.com or call us on (07) 3234 7373 or 1800 642 753.
It is not mandatory under the IP Act for Queensland Government agencies to notify OIC or affected individuals in the event of a privacy breach.
Read the Privacy breach management and notification guideline, for further information including additional factors that may be relevant to your circumstances. For detailed guidance, seek legal advice.
A PDF version of this form is also available Report a privacy breach to OIC (PDF, 454.55 KB)
Completing this form will:
- provide your agency with a summary document for the breach and the steps taken to address it.
- enable your agency to request OIC contact your agency concerning the breach and/or its consequent management.
- assist OIC to respond to community enquiries about the privacy breach including the appropriate person in the agency to whom enquiries can be directed (agency contact person).
The personal information you provide on this form will be used to deliver these outcomes. OIC will respect the confidence of provided commercially or operationally sensitive information and will only disclose this information after consulting with you or where required by law.
For more information, please refer to: how the OIC handles and manages personal information.
Please enter preferred agency contact details