Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Damage Report - 2019-10 PG&E Power Shutoff

  1. 1. Where in Humboldt County do you live?

  2. 5. How were you notified that you would lose power?

    Check all that apply

  3. 6. How did the outage affect your work?

  4. 7. Please select all that apply to your household:

  5. 8. If you own or run a business, how was it impacted?

    Select all that apply

  6. For items 9 through 13, please indicate business revenue, personal income, and other financial losses or outage-related expenses below.

  7. 14. What emergency supplies did you have before the outage was announced?

  8. 15. What communications and data systems were unavailable to you during the outage? (Check all that apply.)

  9. 16. Please select the most accurate statement about your household’s disaster preparedness.

  10. 17. Please select all that apply:

  11. Sign up for Humboldt Alert

    If you have not already done so, please sign up for Humboldt Alert to receive emergency messages targeted for your area.

  12. Leave This Blank:

  13. This field is not part of the form submission.