Fill Out a Valid Utility Bill Template
Form Specs
| Fact Name | Description |
|---|---|
| Purpose | The Utility Bill form is used to request a utility service connection or to update existing service information. |
| Common Utilities | This form typically applies to water, gas, and electricity providers. |
| Required Information | Users must provide personal identification, service address, and billing information. |
| State Variations | Each state may have its own version of the Utility Bill form, reflecting local laws and regulations. |
| Governing Law | In California, for example, the form is governed by the California Public Utilities Code. |
| Submission Methods | The form can often be submitted online, via mail, or in person at utility offices. |
| Processing Time | Utility companies usually process requests within a few business days, depending on their workload. |
| Fees | Some utility companies may charge a fee for processing new service requests. |
| Emergency Services | In cases of emergency, customers should contact the utility provider directly instead of using the form. |
| Contact Information | Customers should ensure they have updated contact information for any correspondence regarding their utility service. |
Dos and Don'ts
When filling out a Utility Bill form, it’s essential to follow certain guidelines to ensure accuracy and efficiency. Here are seven things you should and shouldn't do:
- Do read the instructions carefully before starting.
- Do provide accurate information, including your account number and address.
- Do double-check your entries for any typos or errors.
- Do keep a copy of the completed form for your records.
- Don't leave any required fields blank; this may delay processing.
- Don't use abbreviations unless specified in the instructions.
- Don't forget to sign and date the form before submission.
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Common mistakes
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Inaccurate account number: Many individuals fail to double-check their utility account number, leading to delays in processing.
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Incorrect billing address: Providing an outdated or incorrect address can result in miscommunication and potential service interruptions.
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Missing signature: Some people forget to sign the form, which is essential for validation and processing.
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Failure to include payment information: Not specifying the payment method can cause delays in processing the bill.
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Omitting contact information: Without a phone number or email, utility companies may struggle to reach out for clarification.
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Not reading the instructions: Skipping the instructions can lead to misunderstandings about the requirements for filling out the form.
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Using incorrect dates: Entering the wrong billing cycle dates can create confusion and lead to billing errors.
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Neglecting to keep a copy: Failing to make a copy of the completed form can complicate follow-ups or disputes.
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Assuming all fields are optional: Some individuals mistakenly believe that they can skip certain fields, which may be mandatory.
Documents used along the form
When submitting a Utility Bill form, several other documents may be required to support the application or request. These documents help provide additional information and context, ensuring that the process runs smoothly. Below is a list of commonly used forms and documents.
- Identification Proof: This document verifies the identity of the individual or entity submitting the Utility Bill form. It may include a government-issued ID, such as a driver's license or passport.
- Hold Harmless Agreement: This document is vital for outlining the liability protections in various agreements. For more information, you can refer to californiadocsonline.com/hold-harmless-agreement-form.
- Proof of Residence: This document confirms the applicant's current address. It can be another utility bill, a lease agreement, or any official correspondence that displays the name and address of the individual.
- Income Verification: This document provides evidence of the applicant's income. It may include recent pay stubs, tax returns, or bank statements, which help determine eligibility for certain programs or assistance.
- Application Form: This is a standard form that may be required to accompany the Utility Bill form. It typically collects basic information about the applicant and the purpose of the request.
Gathering these documents in advance can facilitate a quicker processing time for your Utility Bill form. Ensuring that all necessary information is included will help avoid delays and ensure that the application is reviewed efficiently.
Misconceptions
When dealing with the Utility Bill form, several misconceptions can lead to confusion among users. Understanding these misconceptions is crucial for ensuring accurate submissions and avoiding unnecessary delays. Below are four common misunderstandings:
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Utility Bill forms are only for low-income households.
This is not true. The Utility Bill form is available to all households, regardless of income level. Its purpose is to assist individuals and families in managing their utility expenses, not to limit assistance to specific income brackets.
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Filling out the Utility Bill form guarantees assistance.
While completing the form is an important step in the process, it does not automatically guarantee that assistance will be provided. Each application is reviewed based on eligibility criteria, funding availability, and specific circumstances.
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Only past due bills can be submitted.
Another misconception is that only overdue bills are eligible for assistance. In reality, the Utility Bill form can be used for current bills as well. This helps individuals manage their expenses proactively rather than reactively.
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The Utility Bill form must be submitted in person.
Many believe that in-person submission is the only option. However, most jurisdictions allow for online submissions, mail-in options, or even faxing the completed form. This flexibility helps ensure that more individuals can access the assistance they need.
Preview - Utility Bill Form
ENERGY STATEMENT |
Account No: |
|
Statement Date: |
09/07/2019 |
|
www.pge.com/MyEnergy |
Due Date: |
09/28/2019 |
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Service For:
SPARKY JOULE 12345 ENERG'( CT
Questions about your bill?
Ways To Pay
www.pge.com/waystopay
Your Account Summary
Amount Due on Previous Statement |
$91.57 |
Payment(s) Received Since Last Statement |
|
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 |
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Daily Usage Comparison |
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$200 |
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1 Year |
Last |
Current |
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Ago |
Period |
Period |
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$150 |
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12.50 |
12.16 |
12.67 |
$100 |
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■ ■ ■ |
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$50 |
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Electric kWh / Day |
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$0 |
0.12 |
0.16 |
0.17 |
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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 |
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■ |
Electric |
D |
Gas |
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Gas Therms/ Day |
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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
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
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: |
|
09/28/2019 |
$88.14 |
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$ |
PG&E
BOX 997300
SACRAMENTO, CA
Page 1 of 6
ENERGY STATEMENT |
Account No: |
|
Statement Date: |
09/07/2019 |
|
www.pge.com/MyEnergy |
Due Date: |
09/28/2019 |
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Important Phone Numbers -
TTY
Servicio al Cliente en Espanol (Spanish)
Djch VI) khach tieng Vi�t (Vietnamese) |
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Business Customer Service |
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
If you believe there is an error on your bill, please call
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
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
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
Gas Public Purpose Program (PPP) Surcharge. Used to fund
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 |
|
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 |
|
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
Account Number:
Change my mailing address to: ________________
City _____________ State |
ZIP code ____ |
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Primary |
Primary |
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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
•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
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
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 |
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Power Charge Indifference Adjustment |
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10.26 |
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Franchise Fee Surcharge |
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0.25 |
Total PG&E Electric Delivery Charges |
$55.66 |
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Electric Usage This Period: 380.000000 kWh, 30 billing days |
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30kWh |
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Average Daily Usage 12.67 I |
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24 |
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18 |
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12 |
- - |
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6 |
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0 |
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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 |
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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: |
$32.37 |
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Generation - Total |
380.000000 kWh @$0.08519 |
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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 |
$32.48 |
|
Electric Generation Charges |
||
Account No: |
|
Statement Date: |
09/07/2019 |
Due Date: |
09/28/2019 |
Service Information |
|
Total Usage |
380.000000 kWh |
For questions regarding charges on this page, please contact:
SILICON VALLEY CLEAN ENERGY
Additional Messages
About Silicon Valley Clean Energy (SVCE) Serving 13 Santa Clara County communities, SVCE is a
Understanding SVCE Charges
PG&E continues to provide and bill for electric delivery. SVCE replaces PG&E generation charges. Under PG&E Electric Delivery Charges, note the Generation Credit. This is what PG&E would have charged for power, and now credits back to you. The Power Charge Indifference Adjustment and Franchise Fee are factored into SVCE rates. Learn more:
SVCE is committed to protecting customer privacy.
Learn about our privacy policy at
Visit www.pge.com/MyEnergy for a detailed bill comparison. |
Page 4 of 6 |
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ENERGY STATEMENT
www.pge.com/MyEnergy
Details of Gas Charges
08/02/2019 - 08/31/2019 (30 billing days)
Service For: 12345 ENERGY CT
Service Agreement ID: 1111111111
Rate Schedule: G1 X Residential Service
07/02/2019 - 07/31/2019 |
Your Tier |
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Tier 1 Allowance |
17.70 Therms (30 days x |
0.59 Therms/day) |
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Tier 1 Usage |
5.000000Therms @$ 1.28395 |
$6.42 |
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Gas PPP Surcharge ($0.09047 /Therm) |
0.45 |
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Total Gas Charges |
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$6.87 |
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Account No:
Statement Date: 09/07/2019
Due Date: 09/28/2019
Service Information
Meter# |
11111111 |
Current Meter Reading |
2,588 |
Prior Meter Reading |
2,583 |
Difference |
5 |
Multiplier |
1.031647 |
Total Usage |
5.000000 Therms |
Baseline Territory |
X |
Serial |
G |
Gas Procurement Costs ($/Therm)
07/02/2019 - 07/31/2019$0.28462
Gas Usage This Period: 5.000000 Therms, 30 billing days
Therms |
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= Average Daily Usage 0. 17 I |
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7/2 |
7/5 |
7/8 |
7/11 |
7/14 |
7/17 |
7/20 |
7/23 |
7/26 |
7/29 |
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Visit www.pge.com/MyEnergy for a detailed bill comparison. |
Page 5 of 6 |
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ENERGY STATEMENT |
Statement Date: |
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09/07/2019 |
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Account No: |
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www.pge.com/MyEnergy |
Due Date: |
09/28/2019 |
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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
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
Key takeaways
When filling out and using the Utility Bill form, consider the following key takeaways:
- Ensure all personal information is accurate. Double-check names, addresses, and account numbers.
- Provide complete details about your utility usage. This information helps in assessing your needs effectively.
- Submit the form by the specified deadline. Late submissions may delay processing or result in penalties.
- Keep a copy of the completed form for your records. This can be helpful for future reference.
- Contact customer service if you have questions or need assistance. They can provide guidance on the process.
- Review the form for any errors before submission. Mistakes can lead to complications in your utility service.
Similar forms
- Bank Statement: Like a utility bill, a bank statement provides a record of transactions and can verify an individual’s address. Both documents are commonly used for identification purposes.
- Non-disclosure Agreement: A Washington Non-disclosure Agreement (NDA) serves to protect sensitive information shared between parties, ensuring privacy and confidentiality, much like how a Utility Bill safeguards vital transaction details. For more information, visit Forms Washington.
- Lease Agreement: A lease agreement outlines the terms of renting a property and includes the tenant’s name and address. This document serves a similar purpose in confirming residency.
- Credit Card Statement: This document shows recent transactions and includes the cardholder's name and address. It is often used in the same way as a utility bill for proof of residence.
- Government-Issued ID: A government-issued ID, such as a driver’s license, contains personal information including the address. Both documents serve to verify identity and residency.
- Tax Return: A tax return includes personal information and can confirm residency through reported addresses. It functions similarly to a utility bill in providing verification for various applications.
- Insurance Policy Document: This document outlines coverage and includes the policyholder’s name and address. It can be used in the same context as a utility bill for proof of residence.
- Pay Stub: A pay stub provides evidence of employment and includes the employee's address. It is often accepted as a valid form of identification alongside a utility bill.