1. Section
  2. First name*
  3. Last name*
  4. Company name*
  5. Ariba vendor number (if known or applicable)
  6. Company street address (100 Main St)*
  7. Address 2 (Apt, Suite, etc.)
  8. City*
  9. ZIP code*
  10. State
  11. Phone (4151234567)*
  12. Extension
  13. Email (john@smith.com)*
  14. Confirm email*
  16. First name
  17. Last name
  18. Phone (4151234567)
  19. Extension
  20. Email (john@smith.com)
  21. Confirm email
  23. Describe the incident or reason for notification*
  24. What equipment or service is affected by the incident?*
  26. What is your relationship with PG&E?*
  27. If other, please specify your relationship with PG&E
  28. Do you have an existing contract with PG&E*
  29. Who is your point of contact at PG&E?*
  30. Are you a manufacturer from whom we do not purchase directly?
  31. If so, who is the vendor we use to purchase your product?
  32. Please verify that you are not a robot. Select the check box and click submit to verify.*
  33. Submit

Contact for your internal Cyber Security team, if available

Details of the security incident or data breach

Relationship with PG&E