Unauthorized Facial Recognition Incident Report Form
Use this form to report and document incidents involving unauthorized use of facial recognition technology. Please provide as much detail as possible.
Date and time of the incident
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Location of the incident
*
How did you become aware of the unauthorized facial recognition use?
*
Direct observation
Notified by another person
System alert/notification
Other
Describe the incident
*
Who was affected by the incident?
*
Employee(s)
Visitor(s)
Customer(s)
Other
Type of facial recognition system involved (if known)
Building security system
Retail surveillance
Public space monitoring
Unknown
What was the potential impact of the incident?
Privacy violation
Unauthorized data collection
Reputational damage
Other
Was this incident reported to any authorities?
*
Yes
No
Not sure
Please provide any evidence or supporting documents (optional)
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Your contact information (email or phone, for follow-up if needed)
Submit Report
Should be Empty: