Fill Your Utility Bill Template

Fill Your Utility Bill Template

The Utility Bill form is a document used to verify a person’s residency and utility payment history. This form is often required for various applications, such as opening a bank account or applying for government assistance. Understanding how to fill out this form correctly can streamline the process and ensure that you provide the necessary information.

Ready to get started? Fill out the Utility Bill form by clicking the button below.

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When managing household expenses, keeping track of utility bills is essential for budgeting and financial planning. The Utility Bill form serves as a vital tool for documenting and organizing these expenses. Typically, this form captures key details such as the account holder's name, service address, and billing period. It also includes information about the utility provider, the total amount due, and any applicable late fees. Understanding the components of the Utility Bill form helps individuals ensure accurate record-keeping and timely payments, preventing service interruptions. Additionally, this form can be useful when applying for financial assistance programs or disputing charges. By familiarizing yourself with the Utility Bill form, you can take proactive steps in managing your utility expenses effectively.

Documents used along the form

When dealing with utility services, various forms and documents may be required alongside the Utility Bill form. Each of these documents serves a specific purpose in ensuring that all necessary information is accurately captured and processed. Below is a list of commonly used forms that complement the Utility Bill form.

  • Application for Utility Service: This form is typically the first step in establishing a new utility account. It collects essential information about the customer, including their name, address, and contact details.
  • Vehicle Transfer Form: A crucial document for the transfer and reassignment of vehicle ownership, it must accompany the title or an application for a duplicate title. To get started on your vehicle transfer, fill out the form by visiting californiapdfforms.com/california-fotm-reg-262-form.
  • Change of Address Form: If a customer moves or needs to update their address, this form is used to ensure that their utility service reflects the correct location for billing and service purposes.
  • Authorization for Automatic Payments: This document allows customers to authorize the utility company to automatically deduct payments from their bank account, ensuring timely payment and avoiding late fees.
  • Disconnection Notice: In cases where payment has not been received, this notice informs the customer of impending disconnection of service due to non-payment, providing them with an opportunity to rectify the situation.
  • Payment Arrangement Request: Customers facing financial difficulties can use this form to request a payment plan, allowing them to pay their bill in installments rather than all at once.
  • Customer Complaint Form: This document enables customers to formally express concerns or issues they may have regarding their utility service, ensuring that their voices are heard and addressed by the company.
  • Service Termination Request: If a customer wishes to end their utility service, this form is necessary to formally request the termination and ensure that all final billing is handled appropriately.

Understanding these forms can help customers navigate their utility services more effectively. Each document plays a vital role in ensuring smooth communication and service management between the utility provider and the customer.

Document Preview 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

Guidelines on How to Fill Out Utility Bill

Filling out the Utility Bill form is a straightforward process. This form will require some basic information about your utility account and personal details. Follow the steps below to complete the form accurately.

  1. Start by writing your name in the designated area. Make sure to include your first and last name.
  2. Next, enter your current address. This should match the address associated with your utility account.
  3. Provide your utility account number. This can usually be found on your previous utility bills.
  4. Fill in the date of the bill you are referencing. This is typically the date the bill was issued.
  5. Indicate the total amount due on the bill. Be sure to double-check this figure for accuracy.
  6. Lastly, sign and date the form at the bottom. Your signature confirms that the information you provided is correct.

Once you have completed these steps, review the form to ensure all information is accurate before submitting it as instructed.

Similar forms

A lease agreement is a document that outlines the terms under which one party agrees to rent property owned by another party. Similar to a utility bill, it provides essential information regarding the address of the property, the parties involved, and the duration of the agreement. Both documents serve as proof of residence and can be used to verify identity or address for various purposes, such as applying for loans or government services. The lease agreement often includes financial obligations, much like the utility bill details the costs associated with services provided to the property.

For those dealing with various legal documents, understanding the nuances of each is vital; one such important document is the Release of Liability form. This form is important in numerous contexts, especially for events or activities where individuals may face risks. To ensure clarity on this significant legal paperwork, visit legalpdf.org, which provides invaluable resources and guidance.

A bank statement is another document that shares similarities with a utility bill. It provides a detailed account of transactions over a specific period, including deposits, withdrawals, and fees. Like a utility bill, a bank statement contains the account holder's name and address, establishing proof of residency. Both documents are used to verify financial stability and identity in various situations, such as applying for credit or renting an apartment. Each serves as a snapshot of an individual’s financial responsibilities and history.

A pay stub, or paycheck, is a document issued by an employer that details an employee’s earnings for a specific pay period. It includes information such as gross pay, deductions, and net pay. Similar to a utility bill, a pay stub can be used to establish proof of income and residency. It often includes the employee’s name and address, which helps verify identity. Both documents may be required when applying for loans or housing, as they provide insight into an individual’s financial situation.

An insurance policy document is another relevant comparison. This document outlines the terms and coverage provided by an insurance company to the policyholder. Like a utility bill, it includes the policyholder's name and address, serving as proof of residence. Both documents are often required when applying for loans or services, as they demonstrate responsibility and commitment to financial obligations. The insurance policy also details the financial protections in place, similar to how a utility bill outlines the costs associated with essential services.

Consider Common Documents

Misconceptions

Understanding the Utility Bill form is essential for many individuals and businesses. However, several misconceptions often arise. Here are ten common misunderstandings:

  1. It is only for residential customers. Many believe the Utility Bill form is exclusive to homeowners. In reality, both residential and commercial customers can use this form.
  2. Filling it out is complicated. Some think the form is overly complex. In truth, it is designed to be straightforward, with clear instructions to guide users.
  3. Utility companies don’t care about the form. Many assume that utility companies overlook the form. However, it is crucial for processing and ensuring accurate billing.
  4. You can skip sections if you’re unsure. Some individuals believe they can leave parts of the form blank. In fact, incomplete forms can lead to delays or errors in processing.
  5. It only needs to be submitted once. A common misconception is that the Utility Bill form is a one-time submission. Depending on changes in service or account information, it may need to be updated regularly.
  6. It does not affect your credit score. Many people think submitting this form has no impact on their credit. However, accurate billing and payment records can influence credit ratings.
  7. Only the account holder can fill it out. Some believe only the account holder is allowed to complete the form. In fact, authorized representatives can also submit it on behalf of the account holder.
  8. It is only necessary for new accounts. Some think the form is only needed when opening a new account. It is also important for updating existing account information.
  9. There is no deadline for submission. Many assume they can submit the form at any time. However, there are often specific deadlines that must be met to avoid service interruptions.
  10. It is not important for service continuity. Some underestimate the importance of the form. In reality, it plays a vital role in maintaining uninterrupted utility services.

By addressing these misconceptions, individuals can better navigate the Utility Bill form and ensure their utility services run smoothly.

File Features

Fact Name Description
Purpose The Utility Bill form is used to document charges for services such as electricity, water, and gas.
Required Information Typically includes the account holder's name, service address, billing period, and total amount due.
Frequency of Issuance Utility bills are usually issued monthly, though some companies may have different billing cycles.
Payment Methods Payments can often be made online, by mail, or in person, depending on the utility provider.
State-Specific Forms Some states may have specific forms or requirements based on local regulations.
Governing Laws Utility billing practices are often governed by state public utility commissions or similar regulatory bodies.
Dispute Resolution Customers may have the right to dispute charges; procedures for this are typically outlined on the bill or the utility's website.