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Vulnerability Coordination Assistance Request Form

Vulnerability Coordination Assistance Request Form

Contact information

Name *

Organization

Email *

Phone *

Alternate name

If we publish a document based on this report, we will credit you unless otherwise specified. We will use the name specified in this form unless you provide an alternate name here.

Please DO NOT acknowledge me by name in any published document about this vulnerability.

Coordination Status

What coordination actions have you taken so far? You must select at least one. *

I have not attempted to contact any other parties. I have contacted other vendors with the same issue. I have contacted a CERT or ISAC. None of these apply.

If you have contacted a CERT or ISAC, please specify name.

Vulnerability Description

What is the name of the affected product or software? *

What version number of the product or software is affected (if known)?

What is the vulnerability? *

How does an attacker exploit this vulnerability?

What does an attacker gain by exploiting this vulnerability? (i.e., what is the impact?)

How was the vulnerability discovered?

Is there evidence that this vulnerability is being actively exploited?

Yes No

Do you plan to publicly disclose this vulnerability yourself?

Yes No

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