Report a privacy breach at your federal institution

Federal institutions subject to the Privacy Act are required to notify the Office of the Privacy Commissioner of Canada (OPC) and the Treasury Board of Canada Secretariat of all material privacy breaches and of the mitigation measures being implemented, if the breach involves sensitive personal information and could reasonably be expected to cause serious injury to the individual.

This reporting form on this page outlines the information that should be provided to the OPC. Report the breach promptly rather than waiting to compile all the information requested in the form. Please note that the completed report is intended to provide detailed information about the breach itself but must not include personal information or protected/classified information.

The breach report will help determine the type of intervention required by the OPC, such as an informal discussion or an investigation.

Federal institutions should also refer to the Treasury Board’s Directive on Privacy Practices, Appendix B: Mandatory Procedures for Privacy Breaches. They may also wish to refer to our office’s private sector tips entitled, Tips for containing and reducing the risks of a privacy breach.

Privacy Act Breach Report Form for Government of Canada Institutions

This form is being offered to you as an on-line service and is available to you in Rich Text (RTF) and Portable Document (PDF) formats.

If you choose either the RTF format or the PDF format, you will have two options for completing the form:

1. Fill in the form on-screen, save it for submission by email or print it for submission by mail;
2. Print the form and fill in the fields by hand for submission by mail.

If you choose the PDF format, you might need a reader to view the form. Please go to the Adobe Acrobat Reader download page.

• RTF format: Please save the form on your computer before completing.
• PDF format: Please save the form on your computer before completing.

Please submit this form to the Office of the Privacy Commissioner of Canada and the Treasury Board of Canada Secretariat through one of the following means: