Data Breach Notifications

Entity Information

  • Type of Organization: Other Commercial
  • Entity Name: x
  • Street Address: x
  • City: x
  • State, or Country if outside the US: x
  • Zip Code: x

Submitted By

  • Name: x
  • Title: x
  • Firm name (if different than entity):
  • Telephone Number: x
  • Email Address: x
  • Relationship to entity whose information was compromised: x

Breach Information

  • Total number of persons affected (including residents): x
  • Total number of Maine residents affected: x
  • If the number of Maine residents exceeds 1,000, have the consumer reporting agencies been notified:
  • Date(s) Breach Occured: x
  • Date Breach Discovered: x
  • Description of the Breach:
    • Other
  • Information Acquired - Name or other personal identifier in combination with: Social Security Number

Notification and Protection Services

  • Type of Notification: Written
  • Date(s) of consumer notification: x
  • Copy of notice to affected Maine residents:
  • Date of any previous (within 12 months) breach notifications:
  • Were identity theft protection services offered: Yes
  • If yes, please provide the duration, the provider of the service and a brief description of the service: