Name of Firm
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Primary Contact Name
*
First Name
Last Name
Phone Number
*
(###)
###
####
Email Address
*
Total # of Non-Attorney Staff
*
Does the firm currently have a Cyber Liability Insurance policy in place?
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Yes
No
If yes, what date does your current Cyber Liability Insurance policy expire?
MM
DD
YYYY
Does the firm currently have a Legal Malpractice Insurance policy in place?
*
Yes
No
If yes, what is the next Renewal Date for your current Legal Malpractice Insurance policy?
MM
DD
YYYY
If yes, what is the Retroactive Date on your current Legal Malpractice Insurance policy?
The carriers we work with will backdate Cyber Liability coverage to match your firm's Legal Malpractice Insurance policy's Retroactive Date.
MM
DD
YYYY
How many biometric information records or data (i.e fingerprints, retinal scans, etc.) does the firm collect, process, store, transmit, or have access to that can be used to uniquely identify a person?
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No records
< 100K
100K - 250K
250K - 500K
500K - 1M
> 1M
I don't know
Does the firm keep offline backups for all critical data that are disconnected from its network or store backups with a cloud service provider?
*
Yes
No
I don't know
Does the firm implement encryption on laptop computers, desktop computers, and other portable media devices for all sensitive information?
*
Yes
No
I don't know
What is the estimated annual volume of payment card transactions (credit cards, debit cards, etc.)?
*
No payment card transactions
< 100K
100K - 500K
500K - 1M
> 1M
I don't know
Does the firm require a secondary means of communication to validate the authenticity of funds transfers (ACH, wire, etc.) requests by at least 2 employees?
*
Yes
No
I don't know
Does the firm enforce procedures to remove content (including third party content) that may infringe or violate any intellectual property or privacy right?
*
Yes
No
I don't know
Additional Information (optional)
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