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Run: Unauthorized Records Disposition Incident Report

Report the unauthorized removal, destruction, or loss of federal records in one structured form. Capture the facts needed for internal review, containment, a...

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Report Overview

Date the incident was discovered (required)

Date reported (required)

Reporter name (required)

Reporter email (required)

Reporter phone

Reporting office or program (required)

Type of incident (required)

Brief summary of what happened (required)

Describe the incident factually. Avoid speculation and include only information needed for records management review.

Affected Records

Record series title (required)

Record series number or identifier

Record category (required)

Record format (required)

Approximate volume affected

Enter the best estimate available, such as number of folders, boxes, files, or records.

Retention schedule reference

Does the affected material contain sensitive information?

Select any that apply. Do not include full identifiers or unnecessary PII in the description.

Yes No N/A

Incident Details

Where did the incident occur? (required)

How was the incident discovered? (required)

Known or estimated timeframe of the incident

Provide the best available estimate if the exact time is unknown.

Suspected cause (required)

Describe other cause

Detailed incident narrative (required)

Describe what happened, who was involved if known, what records were affected, and any observed evidence. Do not include unnecessary PII.

Immediate Containment and Notifications

Immediate actions taken (required)

Describe other immediate action

Date notifications were made

If multiple notifications were made on different dates, include the earliest date here and provide details in the narrative.

Who was notified? (required)

Evidence preserved? (required)

Evidence preservation details

Assessment, Review, and Submission

Estimated impact (required)

Corrective actions recommended or already taken

Upload supporting documents

Attach any relevant logs, screenshots, emails, inventories, or other supporting records. Do not upload files containing unnecessary PII.

I certify that the information provided is accurate to the best of my knowledge. (required)

Yes No N/A

Additional notes for the records officer

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