Device Data Decommissioning Form Decommissioning 2024 "*" indicates required fields 1. FirmCompany* Security Officer Name* Security Officer Email* 2. ComputerComputer Name* Computer Serial Number* Hard Drive Serial Number* Computer Owned by* Company Individual 3. If Computer is owned by Individual, fill this Section 3Computer Owned By (full name) Phone email Individual is still associated with the Company? Yes No 4. Decommissioning OptionsDecommission Request Date* MM slash DD slash YYYY Select one option* Option 1: Hard Disk Was Destroyed Option 2: Hard Disk Was Securely Wiped & Prepared for Reuse Option 3: Request to Remove Firm's Security Management Services (FCI Protectit) Option 4: Request to Lockdown Computer * Below, fill the Section that corresponds to the Option you selected aboveOption 1: Hard Disk Was DestroyedHard disk was encrypted before destruction? Yes No Destruction evidence was saved in your Cyber Folder? Yes No Notes Option 2: Hard Disk Was Securely Wiped & Prepared for ReuseThe hard disk was wiped/formatted/rebuilt with a process that overwrites the entire hard disk with zeros or random characters to render it unreadable? Yes No Notes Option 3: Request to Remove Firm's Security Management Services (FCI Protectit)Attestation Hard Disk was inspected by the Firm and NPI was removed from computer Firm got a signed attestation from computer owner confirming NPI was removed from computer and will not be restored on any computer (download the form below and have it signed) NPI retained by computer owner as per agreement with the Firm Broker is authorized to keep Guardian NPI Other (add explanation in the Notes field below) Download the attestation form The attestation signed by the computer owner must be attached to the decommissioning ticket email and sent to FCI. Notes Option 4: Request to Lockdown ComputerRequest FCI to put the computer in Lockdown Mode (which will make the computer unusable until the Recovery Key is entered) on: MM slash DD slash YYYY Notes
