Data Breach Complaint Generator

Forum Type *

Where do you want to file? *

Your Information (Plaintiff)

Full Legal Name *

Email Address

Email that was potentially compromised

Phone Number

Date of Birth

If personal information was involved

Address *

Template Type

Auto (based on selected data types)

Standard (PII complaint)

PHI / HIPAA (healthcare breach)

Choose PHI / HIPAA to force the healthcare breach template even if PHI is not selected below. Auto will switch to PHI when you select “Protected Health Information (PHI)” or “Medical Records”.

Company Information (Defendant)

Company Name *

Company Type

Industry

Business Description

Company Address

Data Breach Information

Breach Type

Date of Breach Discovery *

When you learned about the breach

Notification Date

When the company notified you

How were you notified?

Email notification Physical letter Media report Company website Credit monitoring offer Phone call No notification received Other

Types of Data Compromised

Personal ID Information (Name, SSN, DOB)

Financial Information (Credit cards, bank accounts)

Protected Health Information (PHI) — HIPAA-covered

Medical Records

Login Credentials/Passwords

Other Sensitive Data

Select PHI or Medical Records to include HIPAA-specific allegations and formatting.

Breach Description

Remedial Actions Offered by Company

Credit monitoring service Identity theft protection Identity theft insurance Refund or reimbursement Apology letter Password reset assistance Dedicated support hotline No remedial action offered

Damages and Impact

Damages Suffered

Identity theft

Direct financial losses

Credit monitoring costs

Time spent addressing breach

Anxiety and emotional distress

Estimated Financial Impact

Include credit monitoring, identity theft losses, etc.

Impact Description

⚖️ Legal Disclaimer

WE ARE NOT YOUR LAWYER. This service provides document generation assistance only and does not constitute legal advice.

It is your responsibility to:

Comply with all local court rules, filing requirements, and procedural deadlines
Verify that all facts and legal claims in your complaint are accurate and supported by law
Review, edit, and customize the generated document before filing
Properly serve the complaint on all defendants according to applicable rules
Handle all aspects of litigating your case, including discovery, motions, hearings, and trial
Meet all statutory deadlines and statutes of limitations

By using this service, you acknowledge that you understand these limitations and assume full responsibility for your legal filings and litigation.

⚠️ Important Disclaimer

This is an experimental feature, and its products should not be assumed to be ready to file. These generated complaints are meant to serve as a starting point for your pro se litigation. These complaints are generated with AI, and AI can make mistakes. Be sure to check that the facts described here are correct.

📊 Data Breach Complaint Generator