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The Utility Bill form plays a crucial role in managing household expenses and ensuring that essential services like water, electricity, and gas are delivered without interruption. This form typically includes vital information such as the account holder's name, service address, and account number, which helps utility companies track payments and usage. Additionally, it outlines the billing period, due date, and the total amount owed, providing a clear snapshot of financial obligations. Understanding the components of the Utility Bill form is essential for effective budgeting and timely payments, as it can prevent late fees and service disruptions. Furthermore, being familiar with this form can empower individuals to address discrepancies and communicate effectively with utility providers. As households navigate their monthly expenses, the Utility Bill form stands as an important document that reflects both consumption and responsibility.

Key takeaways

When filling out and using the Utility Bill form, consider these key takeaways:

  1. Accurate Information: Ensure all personal details, including your name, address, and account number, are filled out accurately. Mistakes can lead to processing delays.
  2. Submission Method: Know the preferred method for submitting the form. Some utility companies allow online submissions, while others may require mailing or in-person delivery.
  3. Documentation: Attach any necessary documentation that may be required. This could include proof of identity or prior utility bills.
  4. Deadlines: Be aware of any deadlines for submission. Late submissions can result in penalties or service interruptions.
  5. Follow Up: After submitting the form, follow up with the utility company to confirm receipt and ensure your request is being processed.

Dos and Don'ts

When filling out the Utility Bill form, it’s important to be thorough and accurate. Here’s a list of things you should and shouldn’t do:

  • Do double-check your account number for accuracy.
  • Do provide your current address, ensuring it matches official records.
  • Do include your contact information, such as a phone number or email.
  • Do review the form for any errors before submitting.
  • Don't leave any required fields blank; incomplete forms can delay processing.
  • Don't use nicknames or abbreviations for your name or address.
  • Don't forget to sign and date the form, if necessary.

Documents used along the form

When dealing with utility services, several forms and documents are commonly required alongside the Utility Bill form. Each of these documents serves a specific purpose and helps streamline processes related to utilities.

  • Application for Service: This form is used to request utility services for a new address. It typically requires personal information and details about the desired services.
  • Change of Address Form: When moving, this form updates your utility provider with your new address. It ensures that your bills and communications reach you at the correct location.
  • Payment Agreement Form: If you are unable to pay your bill in full, this form allows you to set up a payment plan with your utility provider. It outlines the terms of repayment.
  • Deposit Request Form: Some utility companies require a deposit before starting service. This form is used to request the deposit amount and outline the conditions for its return.
  • Authorization for Automatic Payments: This document allows you to set up automatic deductions from your bank account for your utility bills, ensuring timely payments.
  • Trailer Bill of Sale: When selling a trailer in New York, it is crucial to complete the Fast PDF Templates to ensure a smooth transaction and compliance with state regulations.
  • Service Disconnection Notice: If you need to disconnect your service, this form notifies the utility provider of your intention to stop service at a specific date.
  • Emergency Contact Form: This form provides your utility company with emergency contact information. It is crucial for situations where immediate action may be needed.
  • Billing Dispute Form: If you believe there is an error in your bill, this form allows you to formally dispute the charges and seek resolution from your utility provider.

These documents are essential for managing utility services effectively. Understanding each form's purpose can help you navigate the process more smoothly and ensure that your utility needs are met efficiently.

Things to Know About This Form

What is the Utility Bill form?

The Utility Bill form is a document used to provide proof of residency or to verify a person’s address. It typically includes information such as the name of the account holder, the service address, and the billing period. This form is often required for various applications, such as opening a bank account or applying for government assistance programs.

Who needs to fill out the Utility Bill form?

Individuals who need to prove their residency may be required to fill out this form. This can include:

  • New residents applying for a driver's license.
  • Students enrolling in schools.
  • Individuals applying for social services.

In some cases, landlords may also request a completed Utility Bill form from prospective tenants to confirm their address history.

What information do I need to provide on the Utility Bill form?

When filling out the Utility Bill form, you will typically need to provide:

  1. Your full name.
  2. Your current address.
  3. The name of the utility company.
  4. The account number associated with the utility service.
  5. The billing period for the utility bill.

Make sure all information is accurate to avoid any delays in processing your application.

How do I obtain a copy of my utility bill?

You can obtain a copy of your utility bill in several ways:

  • Log in to your online account with the utility provider.
  • Contact customer service and request a copy.
  • Visit a local office of the utility company.

Most companies provide digital copies, which can be printed for your records.

Is there a fee for requesting a copy of my utility bill?

Generally, utility companies do not charge a fee for providing a copy of your bill. However, if you request a printed copy to be mailed, some companies might charge a small fee. It’s best to check with your specific utility provider for their policies.

Can I use a past utility bill for the form?

Yes, you can use a past utility bill as long as it is recent enough to prove your current residency. Most organizations prefer bills from the last 30 to 90 days. Always check the specific requirements of the organization requesting the Utility Bill form.

What if my name is not on the utility bill?

If your name does not appear on the utility bill, you may still be able to use it as proof of residency. In such cases, you might need to provide additional documentation, such as:

  • A lease agreement.
  • A letter from the person whose name is on the bill, stating that you reside at the address.

Always confirm with the requesting party what documentation is acceptable.

How long does it take to process the Utility Bill form?

The processing time for the Utility Bill form can vary based on the organization reviewing it. Typically, you can expect a response within a few days to a couple of weeks. If you need it processed quickly, consider reaching out to the organization to inquire about expedited options.

Preview - Utility Bill Form

ENERGY STATEMENT

Account No:

1234567890-1

Statement Date:

09/07/2019

www.pge.com/MyEnergy

Due Date:

09/28/2019

 

 

Service For:

SPARKY JOULE 12345 ENERG'( CT

Questions about your bill?

Monday-Friday 7 a.m.-9 p.m. Saturday 8 a.m.-6 p.m. Phone: 1-800-743-5000 www.pge.com/MyEnergy

Ways To Pay

www.pge.com/waystopay

Your Account Summary

Amount Due on Previous Statement

$91.57

Payment(s) Received Since Last Statement

-91.57

Previous Unpaid Balance

$0.00

Current PG&E Electric Delivery Charges

$55.66

Silicon Valley Clean Energy Electric Generation Charges

$32.48

I Total Amount Due by 08/28/2019

$88.14

Monthly Billing History

 

 

 

 

Daily Usage Comparison

$200

 

 

 

 

 

 

 

1 Year

Last

Current

 

 

 

 

 

 

 

Ago

Period

Period

$150

 

 

 

 

 

 

 

12.50

12.16

12.67

$100

 

 

 

 

 

 

 

■ ■ ■

$50

 

 

 

 

 

 

 

Electric kWh / Day

 

 

 

 

 

 

 

 

 

 

$0

-+-----'-r-"-------

"'r�---

'-r"-----'-r-"

-----'-r�---

'-r"-----'-r"----'-r�---

'--r"------'-r"------i

0.12

0.16

0.17

2018 8/07

9/06 10/04 11/06 12/06 1/08 2/06

3/07 4/08

5/09 6/06

7/10 8/07 2019-�c____<=----

=::,__---l

 

 

 

Electric

D

Gas

 

Gas Therms/ Day

Visit www.pge.com/MyEnergy for a detailed bill comparison

Important Messages

The Family Electric Rate Assistance (FERA) Program provides a monthly discount on electric bills for income-qualified households of three or more persons. To see if you qualify, please call 1-800-PGE-5000 or apply online at www.pge.com/fera.

El Programa FERA ofrece ahorros mensuales solo en las facturas de electricidad a hogares de ingresos econ6micos bajos y medianos con tres o mas personas. Para determinar si califica, por favor llame al 1-800-PGE-5000 o puede aplicar a traves de nuestra pagina web www.pge.com/fera.

Continued on page 6

Please return this portion with your payment. No staples or paper clips. Do not fold. Thank you.

®

Account Number:

Due Date:

Total Amount Due:

Amount Enclosed:

123456789-1

09/28/2019

$88.14

$

PG&E

BOX 997300

SACRAMENTO, CA 95899-7300

Page 1 of 6

ENERGY STATEMENT

Account No:

1234567890-1

Statement Date:

09/07/2019

www.pge.com/MyEnergy

Due Date:

09/28/2019

 

 

Important Phone Numbers - Monday-Friday 7 a.m.-9 p.m., Saturday 8 a.m.-6 p.m. Customer Service (All Languages; Relay Calls Accepted) 1-800-743-5000

TTY 7-1-1

Servicio al Cliente en Espanol (Spanish) -��.P�IHf (Chinese)

1-800-660-6789

Djch VI) khach tieng Vi�t (Vietnamese)

1-800-298-8438

1-800-893-9555

Business Customer Service

1-800-468-4743

Rules and rates

You may be eligible for a lower rate. To learn more about optional rates or view a complete list of rules and rates, visit www.pge.com or call 1-800-743-5000.

If you believe there is an error on your bill, please call 1-800-743-5000 to speak with a representative. If you are not satisfied with our response, contact the California Public Utilities Commission (CPUC), Consumer Affairs Branch (CAB), 505 Van Ness Avenue, Room 2003, San Francisco, CA 94102, 1-800-649-7570 or 7-1-1 (8:30 AM to 4:30 PM, Monday through Friday) or by visiting www.cpuc.ca.gov/complaints/.

To avoid having service turned off while you wait for the outcome of a complaint to the CPUC specifically regarding the accuracy of your bill, please contact CAB for assistance. If your case meets the eligibility criteria, CAB will provide you with instructions on how to mail a check or money order to be impounded pending resolution of your case. You must continue to pay your current charges while your complaint is under review to keep your service turned on.

If you are not able to pay your bill, call PG&E to discuss how we can help. You may qualify for reduced rates under PG&E's CARE program or other special programs and agencies may be available to assist you. You may qualify for PG&E's Energy Savings Assistance Program which is an energy efficiency program for income-qualified residential customers.

Important definitions

Rotating outage blocks are subject to change without advance notice due to operational conditions.

Tier 1/Baseline allowance: Some residential rates are given a Tier 1/Baseline allowance - a CPUC approved percentage of average customer usage during summer and winter months. Your Tier 1/Baseline allowance provides for basic needs at an affordable price and encourages conservation. Your allowance is assigned based on the climate where you live, the season and your heat source. As you use more energy, you pay more for usage. Any usage over your baseline allowance will be charged at a higher price.

High Usage: An increased price per kWh whenever electricity usage exceeds four times the Baseline Allowance (Tier 1) in a billing period. This charge does not apply to Time-of-Use rate plans.

DWR bond charge: Recovers the cost of bonds issued by the Department of Water Resources (DWR) to purchase power to serve electric customers during the California energy crisis. DWR bond charges are collected on behalf of DWR and do not belong to PG&E.

Power Charge Indifference Adjustment (PCIA): Ensures that non-exempt customers under PG&E's GT and ECR rate schedules or who purchase electricity (generation) from non-PG&E suppliers pay their share of generation costs.

Gas Public Purpose Program (PPP) Surcharge. Used to fund state-mandated gas assistance programs for low-income customers, energy efficiency programs, and public-interest research and development.

Visit www.pge.com/billexplanation for more definitions. To view most recent bill inserts including legal or mandated notices, visit www.pge.com/billinserts.

Your Electric Charges Breakdown

Conservation Incentive

-$9.50

Transmission

12.42

Distribution

35.08

Electric Public Purpose Programs

4.71

Nuclear Decommissioning

0.33

DWR Bond Charge

1.91

Competition Transition Charges (CTC)

0.42

Energy Cost Recovery Amount

-0.22

PCIA

10.26

Taxes and Other

0.25

Total Electric Charges

$55.66

"PG&E" refers to Pacific Gas and Electric Company, a subsidiary of PG&E Corporation. © 2019 Pacific Gas and Electric Company. All rights reserved. Please do not mark in box. For system use only.

Update My Information (English Only)

Please allow 1-2 billing cycles for changes to take effect

Account Number: 1234567890-1

Change my mailing address to: ________________

City _____________ State

ZIP code ____

Primary

Primary

 

Phone#--------- Email --------------

Ways To Pay

Online via web or mobile at www.pge.com/waystopay

By mail: Send your payment along with this payment stub in the envelope provided.

By debit card, Visa, MasterCard, American Express, or Discover: Call

877-704-8470 at any time. (Our independent service provider charges a fee per transaction.)

At a PG&E payment center or local office: To find a payment center or local office near you, please visit www.pge.com or call 800-743-5000. Please bring a copy of your bill with you.

Page 2 of 6

ENERGY STATEMENT

Details of PG&E Electric Delivery Charges

Service For: 12345 ENERGY CT

Service Agreement ID: 111111111

Rate Schedule: E1 X Residential Service

07/02/2019 - 07/31/2019 Your Tier Usagel�-1��-2

Tier 1 Allowance

297.00

kWh

(30 days x 9.9 kWh/day)

Tier 1 Usage

297.000000

kWh

@$0.22376

$66.46

Tier 2 Usage

83.000000

kWh

@$0.28159

23.37

Generation Credit

 

 

 

-44.68

Power Charge Indifference Adjustment

 

 

10.26

Franchise Fee Surcharge

 

 

 

0.25

Total PG&E Electric Delivery Charges

$55.66

Electric Usage This Period: 380.000000 kWh, 30 billing days

30kWh

 

 

 

 

----- =

Average Daily Usage 12.67 I

24

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

 

 

 

 

 

 

12

---------

------------�•--·--- - ------

----

--

- -

6

 

 

 

 

 

 

 

 

 

 

0

--+------"P.__.,.___.,._.,.__.,.___.,._.,.__.,.___.,._.,.__.,.__.,._.,.__.,.__.,._.,._.,.__.,._.,._.,.__.,._.,._.,.__.,._.,._.,.__.,._.,._.,.____.,.___,

 

7/2

7/5

7/8

7/11

7/14

7/17

7/20

7/23

7/26

7/29

Due Date:

09/28/2019

Service Information

1111111111

Meter#

Current Meter Reading

37,710

Prior Meter Reading

37,330

Total Usage

380.000000 kWh

Baseline Territory

X

Heat Source

B - Not Electric

Serial

G

Rotating Outage Block

50

Visit www.pge.com/MyEnergy for a detailed bill comparison.

Page 3 of 6

 

ENERGY STATEMENT

www.pge.com/MyEnergy

Details of Silicon Valley Clean Energy Electric Generation Charges

08/02/2019 - 08/31/2019 (30 billing days)

Service For: 12345 ENERGY CT

Service Agreement ID: 11111111

07/02/2019 - 07/31/2019

Rate Schedule:

E-1

$32.37

Generation - Total

380.000000 kWh @$0.08519

 

Net Charges 32.37

0. 11

Energy Commission Surcharge

Customers receive clean electricity and save money with SVCE. Please see updated

SVCE electric rates and comparisons to PG&E at www.svcleanenergy.com/rates

Total Silicon Valley Clean Energy

$32.48

Electric Generation Charges

Account No:

1234567890-1

Statement Date:

09/07/2019

Due Date:

09/28/2019

Service Information

 

Total Usage

380.000000 kWh

For questions regarding charges on this page, please contact:

SILICON VALLEY CLEAN ENERGY 1-844-474-7823 customerservice@SVCleanEnergy.org

Additional Messages

About Silicon Valley Clean Energy (SVCE) Serving 13 Santa Clara County communities, SVCE is a locally-controlled, public agency providing residents and businesses with electricity from renewable and hydroelectric sources.

Understanding SVCE Charges

PG&E continues to provide and bill for electric delivery. SVCE replaces PG&E generation charges. Under PG&E Electric Delivery Charges, note the Generation Credit. This is what PG&E would have charged for power, and now credits back to you. The Power Charge Indifference Adjustment and Franchise Fee are factored into SVCE rates. Learn more:

https://www.svcleanenergy.orgies/your-bi11/.

SVCE is committed to protecting customer privacy.

Learn about our privacy policy at www.svcleanenergy.org/customer-confidenti ality

Visit www.pge.com/MyEnergy for a detailed bill comparison.

Page 4 of 6

 

ENERGY STATEMENT

www.pge.com/MyEnergy

Details of Gas Charges

08/02/2019 - 08/31/2019 (30 billing days)

Service For: 12345 ENERGY CT

Service Agreement ID: 1111111111

Rate Schedule: G1 X Residential Service

07/02/2019 - 07/31/2019

Your Tier Usagel�-1��-2

 

 

 

 

 

Tier 1 Allowance

17.70 Therms (30 days x

0.59 Therms/day)

 

 

Tier 1 Usage

5.000000Therms @$ 1.28395

$6.42

Gas PPP Surcharge ($0.09047 /Therm)

0.45

Total Gas Charges

 

 

$6.87

Account No: 1234567890-1

Statement Date: 09/07/2019

Due Date: 09/28/2019

Service Information

Meter#

11111111

Current Meter Reading

2,588

Prior Meter Reading

2,583

Difference

5

Multiplier

1.031647

Total Usage

5.000000 Therms

Baseline Territory

X

Serial

G

Gas Procurement Costs ($/Therm)

07/02/2019 - 07/31/2019$0.28462

Gas Usage This Period: 5.000000 Therms, 30 billing days

Therms

 

 

 

 

 

= Average Daily Usage 0. 17 I

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

7/2

7/5

7/8

7/11

7/14

7/17

7/20

7/23

7/26

7/29

 

Visit www.pge.com/MyEnergy for a detailed bill comparison.

Page 5 of 6

 

ENERGY STATEMENT

Statement Date:

 

09/07/2019

 

Account No:

1234567890-1

www.pge.com/MyEnergy

Due Date:

09/28/2019

 

Important Messages (continued from page 1)

CARE Program. You may qualify for a monthly discount with the California Alternate Rates for Energy (CARE) Program. To find out more and apply online, visit www.pge.com/care.

Usted podría reunir los requisitos de un descuento mensual con el California Alternate Rates for Energy Program (CARE). Para obtener más información y hacer su solicitud en Internet, visite www.pge.com/espanol/care.

Electric power line safety PG&E cares about your safety. Be aware of your surroundings and keep yourself, tools, equipment and antennas at least 10 feet away from overhead power lines. If you see an electric power line fall to the ground, keep yourself and others away. Call 9-1-1.

Call 811 before you dig. A common cause of pipeline accidents is damage from digging. If you plan on doing any digging, such as planting a tree or installing a fence, please call 811 at least two working days before you dig. One free call will notify underground utilities to mark the location of underground lines, helping you to plan a safe project.

Visit www.pge.com/MyEnergy for a detailed bill comparison.

Page 6 of 6

Document Specifics

Fact Name Description
Purpose The Utility Bill form is used to document and request payment for services such as electricity, water, gas, and other utilities.
Information Required Typically, the form requires the account holder's name, address, account number, billing period, and the amount due.
Submission Methods Forms can usually be submitted online, by mail, or in person, depending on the utility company’s policies.
State-Specific Regulations In many states, utility billing practices are governed by the Public Utility Commission, which ensures fair pricing and service standards.
Payment Options Most utility companies offer various payment options, including online payments, automatic bank drafts, and traditional checks.
Late Fees Failure to pay the utility bill by the due date may result in late fees, which vary by utility provider and state regulations.

How to Fill Out Utility Bill

After you have gathered all necessary information, you are ready to fill out the Utility Bill form. This process is straightforward and will help ensure that your bill is processed correctly.

  1. Start by writing your full name in the designated section at the top of the form.
  2. Provide your current address, including the street name, city, state, and zip code.
  3. Enter your account number, which can usually be found on previous utility bills.
  4. Fill in the billing period dates, indicating the start and end dates for the bill you are addressing.
  5. List the total amount due, ensuring that you double-check for accuracy.
  6. Include any additional notes or comments in the space provided, if necessary.
  7. Sign and date the form at the bottom to validate your submission.

Once you have completed these steps, review the form for any errors before submitting it to the appropriate utility company. Make sure to keep a copy for your records.