NJCCIC Cyber Incident Report Form

If you would like to report an incident, please complete the form below. The below fields are designed to assist the New Jersey Cybersecurity & Communications Integration Cell (NJCCIC) with the timely handling of cyber incidents.

Point of Contact

Full Name:
Organization:
Email:
Telephone:
Extension:
Zipcode:

Incident Details

Date of Incident:
Time of Incident:
What type of entity is reporting?
Type of Report?
Current status of the incident?
Incident Details:

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