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Data Breach Notifications
Entity Information
- Type of Organization: Healthcare
- Entity Name: Test 123
- Street Address: 122 Large Rd
- City: Washington
- State, or Country if outside the US: DC
- Zip Code: 20001
Submitted By
- Name: Will K
- Title: Test
- Firm name (if different than entity):
- Telephone Number: 9137087777
- Email Address: william.krouse@gmail.com
- Relationship to entity whose information was compromised: Test
Breach Information
- Total number of persons affected (including residents): 1
- Total number of Maine residents affected: 1
- If the number of Maine residents exceeds 1,000, have the consumer reporting agencies been notified: No
- Date(s) Breach Occured: 09/14/2020
- Date Breach Discovered: 09/14/2020
- Description of the Breach:
- Inadvertent disclosure, Internal system breach
- Information Acquired - Name or other personal identifier in combination with: Financial Account Number or Credit/Debit Card Number (in combination with security code, access code, password or PIN for the account)
Notification and Protection Services
- Type of Notification: Written
- Date(s) of consumer notification: 09/14/2020
- Copy of notice to affected Maine residents:
- Date of any previous (within 12 months) breach notifications:
- Were identity theft protection services offered: No
- If yes, please provide the duration, the provider of the service and a brief description of the service: