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Contents

The Utility Bill form serves as an essential document for individuals and businesses alike, facilitating the management of utility services such as electricity, water, gas, and internet. It typically includes crucial information such as the account holder's name, service address, and billing details, which together help ensure accurate and timely payments. This form may also outline payment options, due dates, and any applicable late fees, making it a vital resource for maintaining good standing with utility providers. Moreover, users can often find sections dedicated to reporting issues or requesting service changes, allowing for a streamlined communication process with utility companies. Understanding the components of the Utility Bill form can empower consumers to take control of their utility expenses, avoid service interruptions, and effectively manage their household or business budgets.

Similar forms

  • Lease Agreement: A lease agreement outlines the terms under which a tenant rents property from a landlord. Like a utility bill, it provides essential information about the parties involved and details of the agreement, such as payment terms and duration.

  • Bank Statement: A bank statement summarizes account activity over a specific period. Similar to a utility bill, it includes account holder information, transaction details, and balances, serving as proof of financial activity.

  • Pay Stub: A pay stub details an employee's earnings and deductions for a pay period. It shares similarities with a utility bill in that it provides information about financial transactions and serves as a record of income.

  • Boat Bill of Sale: The New York Boat Bill of Sale form is a crucial document to ensure the transfer of boat ownership is legitimate and properly recorded, and can be accessed here: https://nypdfforms.com/boat-bill-of-sale-form.

  • Credit Card Statement: A credit card statement lists transactions made with a credit card over a billing cycle. Like a utility bill, it includes account details, payment due dates, and outstanding balances, helping users track their expenses.

Document Example

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

Form Specs

Fact Name Description
Purpose The Utility Bill form is used to request utility services or to report issues related to utility billing.
Common Utilities This form typically applies to electricity, water, gas, and sewage services.
Eligibility Residents and businesses within the service area can use this form.
Required Information Users must provide personal information, service address, and account details.
Submission Method The form can often be submitted online, via mail, or in person at local utility offices.
State-Specific Forms Each state may have its own version of the Utility Bill form, governed by state utility regulations.
Governing Laws In California, for example, the form is governed by the Public Utilities Code.
Processing Time Utility companies usually process requests within a few business days, depending on the nature of the request.

Crucial Questions on This Form

What is the Utility Bill form used for?

The Utility Bill form is designed to document and verify utility expenses. This form is often required for various applications, such as housing assistance, financial aid, or other programs that require proof of residency and financial obligations. By providing accurate information, applicants can ensure their eligibility for assistance or benefits.

Who needs to fill out the Utility Bill form?

Individuals who are applying for programs that require proof of utility expenses should complete the Utility Bill form. This includes:

  • Residents applying for housing assistance
  • Students seeking financial aid
  • Anyone needing to verify residency for legal or financial purposes

It is important that the form is filled out accurately to avoid any delays in processing applications.

What information is required on the Utility Bill form?

The Utility Bill form typically requires the following information:

  1. Name of the utility provider
  2. Account number
  3. Billing address
  4. Amount due
  5. Due date
  6. Signature of the account holder

Providing complete and accurate details is essential to ensure that the form is accepted without issues.

How do I submit the Utility Bill form?

Submission methods for the Utility Bill form may vary depending on the specific program or organization requesting it. Common submission options include:

  • Online submission through a designated portal
  • Mailing a physical copy to the appropriate office
  • Delivering the form in person

Always check the specific instructions provided by the organization to ensure proper submission and avoid any delays.

Documents used along the form

When dealing with utility services, several forms and documents may be required alongside the Utility Bill form. These documents help establish identity, verify residency, or provide necessary information for service connections. Below is a list of commonly used documents.

  • Proof of Identity: This document can include a government-issued ID, such as a driver's license or passport. It confirms the identity of the individual applying for services.
  • Lease Agreement: A lease agreement outlines the terms of rental for a property. This document serves as proof of residency and may be needed to establish eligibility for utility services.
  • Social Security Number: Providing a Social Security number may be necessary for identification purposes. It helps utility companies verify the applicant's identity and credit history.
  • Operating Agreement: This critical document governs the operations and management of an LLC, detailing ownership and financial arrangements. For more information, see the All Ohio Forms.
  • Application for Service: This form is required to initiate utility services. It collects essential information about the customer and the service requested.
  • Previous Utility Bill: A recent utility bill from another provider may be requested to verify payment history and establish creditworthiness for new service applications.
  • Authorization Form: If someone is applying for service on behalf of another person, an authorization form may be needed. This document grants permission for the representative to act on behalf of the account holder.

These documents work together to facilitate the establishment of utility services. Having them ready can streamline the process and help avoid delays.

Misconceptions

Understanding the Utility Bill form can be challenging due to various misconceptions. Here are ten common misunderstandings, along with clarifications to help you navigate the process more effectively.

  1. Utility Bill forms are only for low-income households. Many people believe these forms are exclusively for those with limited financial resources. In reality, anyone can use the Utility Bill form to apply for assistance, regardless of income level.
  2. Filling out the form is too complicated. While the form may seem daunting at first, it is designed to be user-friendly. Clear instructions are often provided, making it easier for individuals to complete the application.
  3. Assistance is only available for electricity bills. Some individuals think that help is limited to electricity expenses. However, many programs cover a variety of utility bills, including water, gas, and heating costs.
  4. You must be behind on payments to qualify. It is a common belief that applicants must be in arrears to receive assistance. Many programs offer support even if you are current on your bills, as long as you demonstrate a need for help.
  5. Only homeowners can apply. This misconception leads many renters to believe they are ineligible. In fact, renters can also apply for assistance, provided they meet the program's requirements.
  6. Submitting the form guarantees assistance. While completing the form is a crucial step, approval is not guaranteed. Each application is reviewed based on specific criteria, and funding availability may vary.
  7. All utility companies participate in the assistance program. Some individuals assume that every utility provider is involved in assistance programs. However, participation can differ by region and provider, so it is essential to check with your local utility company.
  8. You can only apply once per year. Many believe that applications are limited to a single submission annually. In reality, some programs allow multiple applications throughout the year, depending on individual circumstances.
  9. Assistance is only for emergencies. While many people think that help is reserved for urgent situations, assistance programs often provide support for ongoing utility costs, not just emergencies.
  10. All information on the form is shared with third parties. Privacy concerns often lead to the belief that personal information will be widely shared. Most programs have strict confidentiality policies to protect applicants' information.

By addressing these misconceptions, individuals can better understand the Utility Bill form and the assistance available to them. Seeking help is a proactive step towards managing utility expenses and ensuring stability.