---
title: Cryptocurrency Exchange Security Breach Report Form Template | Paperform
description: Professional security breach reporting form for crypto exchanges with asset loss calculations, customer notification tracking, and regulatory disclosure management. SOC 2 compliant and customizable.
url: "https://paperform.co/templates/cryptocurrency-exchange-security-breach-report"
type: static
generatedAt: "2026-03-28T00:43:34.517Z"
---

[← Back to free form templates](/templates/)    ![Cryptocurrency Exchange Security Breach Report](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/cryptocurrency-exchange-security-breach-report.png)
    [Preview](https://_preview.paperform.co/ai-template/cryptocurrency-exchange-security-breach-report) [Use this template for free](/create?ai-template=cryptocurrency-exchange-security-breach-report)    [Emergency & Crisis Forms](/templates/category/emergency-crisis/)[Reporting & Incident Forms](/templates/category/reporting/)[Legal & Compliance Forms](/templates/category/legal/)[Financial & Accounting Forms](/templates/category/financial/)[Industry-Specific Forms](/templates/category/industry-specific/) [Software & SaaS](/templates/industry/software-saas/)[Cryptocurrency & Blockchain](/templates/industry/cryptocurrency/)[Cybersecurity](/templates/industry/cybersecurity/) [Executive](/templates/role/executive/)[IT Professional](/templates/role/it-professional/)[Compliance Officer](/templates/role/compliance-officer/)[CTO](/templates/role/cto/)     About this free form template
When a cryptocurrency exchange faces a security breach, rapid and accurate reporting is critical. This **Cryptocurrency Exchange Security Breach Report** template helps exchanges document incidents in detail, calculate asset losses, coordinate customer notifications, and meet regulatory disclosure requirements—all in one streamlined form.

Built for crypto platforms, blockchain companies, and digital asset custodians, this template captures everything from the initial breach discovery and affected assets to customer impact assessment and regulatory filing needs. With built-in calculations for loss assessment and conditional logic for incident severity, teams can respond faster while maintaining compliance with financial regulators and data protection authorities.

**Paperform makes crisis reporting more reliable.** Use conditional logic to show relevant fields based on breach type and severity, embed secure file uploads for forensic evidence, and trigger immediate notifications to your security and legal teams via **Stepper** workflows. Connect submissions to your incident management tools, CRM, or compliance dashboards to keep every stakeholder informed in real-time.

Whether you're managing a hot wallet compromise, a phishing attack, or a smart contract exploit, this template ensures your exchange captures the right information at the right time—helping you protect customers, satisfy regulators, and maintain trust during critical moments.

Trusted by blockchain companies worldwide, Paperform is SOC 2 Type II compliant and designed for businesses that need professional, secure forms without coding. Start with this template and customize it to match your exchange's incident response protocols and regulatory requirements.
       Built for growing businesses, trusted by bigger ones.   Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.     ![Capterra - 4.8 out of 5](/images/capterra-st.jpg)
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