Utility Bill PDF Template

Utility Bill PDF Template

The Utility Bill form is a crucial document used to verify a household's utility expenses, which can be essential for various applications, such as financial assistance or residency verification. By providing details about energy, water, and other utility services, this form helps establish a clear understanding of ongoing living costs. If you need to complete this form, please click the button below to get started.

Overview

The Utility Bill form plays a crucial role in managing household finances, helping residents keep track of their monthly expenses related to essential services such as water, electricity, and gas. When filling out this form, consumers should pay careful attention to key components, including account numbers, billing periods, and payment due dates. Various details, like usage statistics and rates charged, provide valuable insights into consumption patterns, enabling users to make informed decisions about their utility usage. Additionally, the form often features sections for payment methods and any applicable late fees, which can help individuals avoid unnecessary charges. Understanding the intricacies of the Utility Bill form empowers consumers to stay on top of their finances, ensuring they can manage their resources effectively while also taking advantage of any available discounts or assistance programs.

Utility Bill Preview

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

File Properties

Fact Name Description
Purpose The Utility Bill form is used to document and request payment for utility services such as water, gas, or electricity.
Common Utilities Utilities typically included are electricity, gas, water, and sometimes sewage or waste management services.
Billing Cycle Utility bills are usually issued on a monthly basis, allowing customers to see their usage and costs regularly.
Identification of Customer The form requires the customer's name and address to clearly identify the account holder responsible for payment.
Payment Instructions Instructions for payment methods, such as online payment, mail, or in-person, are often included on the form.
Late Fees Most utility bills outline consequences for late payments, including potential late fees or penalties.
State Regulations Each state may have specific laws governing utility service providers, such as the Public Utility Regulatory Policies Act (PURPA).
Estimated vs. Actual Usage Utility companies sometimes provide estimated usage based on past consumption, which can differ from actual usage.
Dispute Resolution Instructions for disputing charges or addressing service issues are normally included in the utility bill documentation.
Accessibility Utility bills must be accessible to all customers, including provisions for those with disabilities, as mandated by the Americans with Disabilities Act (ADA).

Instructions on Utilizing Utility Bill

Filling out the Utility Bill form is a straightforward process. By providing accurate information, you can ensure that your bill is processed promptly and correctly. Follow the steps outlined below to complete the form efficiently.

  1. Begin by reading the instructions on the top of the form to understand what information is needed.
  2. Write your full name in the designated field. Ensure that your name is spelled correctly.
  3. Provide your current address, including the street number, street name, city, state, and zip code.
  4. Enter your contact information, including your phone number and email address.
  5. Indicate the type of utility service you are applying for, such as water, gas, or electricity.
  6. Fill in your account number if you have one. If you do not, leave this section blank.
  7. Note the date of your last payment, providing specifics to avoid any discrepancies.
  8. List any changes in your account status, if applicable, such as a name change or transfer of service.
  9. Review all the information you have provided to ensure accuracy.
  10. Sign and date the form at the bottom to validate your application.

Important Facts about Utility Bill

What is the purpose of the Utility Bill form?

The Utility Bill form is typically used to request information or assistance related to utility services such as electricity, water, and gas. It may also be required for eligibility verification when applying for certain programs or benefits that require proof of utility payments or residency. By submitting this form, individuals can facilitate the processing of their requests with the utility provider or relevant authority.

Who needs to complete the Utility Bill form?

Individuals who need to provide proof of residency, apply for assistance programs, or dispute inaccuracies on their utility bills may be required to complete this form. This includes tenants, homeowners, and anyone who is responsible for paying utility bills. If utility service needs to be transferred or disconnected, the form might also be necessary.

What information is typically required on the Utility Bill form?

The form generally asks for personal details such as the name of the account holder, their address, and contact information. It might also require details about the utility provider, account number, and the specific service in question. Additionally, individuals may need to provide documentation like a recent utility bill for verification purposes.

How do I submit the Utility Bill form?

The submission process can vary by utility provider or relevant agency. Most entities will allow you to submit the form online through their website, via mail, or in-person at a customer service location. Always check the specific submission guidelines associated with the utility provider to ensure proper handling of your request.

What should I do if my Utility Bill form is rejected?

If the form is rejected, it is often due to incomplete information or errors in the submission. Review the rejection notice carefully for specific reasons. You may need to fill out the form again, correcting any issues noted. It is also helpful to contact customer service for further clarification and guidance on successfully resubmitting the form.

Can I appeal a decision made using the Utility Bill form?

If you receive an unfavorable decision related to your utility services, it may be possible to appeal. Check the utility provider's policies to see if an appeal process is available. This often involves submitting a written request for reconsideration, along with supporting documentation that illustrates why the original decision should be altered.

Are there any fees associated with submitting the Utility Bill form?

Typically, there are no fees for submitting the Utility Bill form itself. However, certain requests or changes to services may incur fees, depending on the utility provider’s policies. It is advisable to verify the specific costs associated with your situation, as different utility companies may have different pricing structures.

Common mistakes

When filling out the Utility Bill form, one common mistake is providing inaccurate personal information. Many people may overlook this. This includes incorrect names, addresses, or account numbers. Even a slight typo can lead to delays or issues with service. Always double-check that your information matches what is on your official documents.

Another frequent error is failing to include necessary account details. Some may forget to attach copies of prior bills or relevant documentation. This can result in the form being considered incomplete. It’s vital to gather all required information beforehand. Ensure you have all necessary documents before submission.

Additionally, some people neglect to read the instructions carefully. Each utility provider may have specific requirements. Ignoring these can lead to submitting the form improperly. Take the time to read through the guidelines provided with the application to avoid unnecessary setbacks.

Finally, many individuals may submit the form without reviewing it first. This simple oversight can lead to mistakes being missed. It is advisable to review all entries for accuracy and completeness. A thorough review can save time and prevent potential issues down the road.

Documents used along the form

A Utility Bill form is often required in various situations, such as applying for a loan, establishing service with a utility company, or verifying your identity. It serves as proof of residence and can be accompanied by other important forms and documents to provide a comprehensive understanding of your financial obligations or residency. Below is a list of other commonly used documents that might be needed alongside a Utility Bill form.

  • Identification Card or Driver’s License: This document is needed to verify your identity. It's typically required to establish that the name on the utility bill matches the name on your ID.
  • Lease Agreement: A lease agreement provides proof of residency. It outlines the terms and conditions of the rental arrangement, confirming where you live and the duration of your stay.
  • Bank Statements: Recent bank statements can serve as additional proof of your residence and provide insight into your financial stability. They may be requested to understand your financial history better.
  • Employment Verification Letter: This document confirms your employment status and may include your job title and salary. It's often requested by lenders to assess your ability to meet financial obligations.
  • Tax Return Documents: Tax returns provide a comprehensive overview of your income and financial information. Lenders may require these documents to evaluate your financial condition for loans or mortgages.
  • Social Security Card: Sometimes a social security card is required to verify your identity or eligibility for specific services or benefits associated with financial matters.
  • Proof of Insurance: Whether it's renters insurance or homeowners insurance, this document can demonstrate that you have financial protection for your residence, enhancing your credibility in financial transactions.
  • Credit Report: A credit report offers insight into your credit history and can be important when applying for loans. It helps lenders evaluate your creditworthiness.

Understanding these documents can make the process smoother when preparing to submit a Utility Bill form. Each one serves a specific purpose, contributing to a greater understanding of your identity, residency, and financial situation. Be prepared to gather these items to ensure a seamless experience in whatever process you are undertaking.

Similar forms

  • Lease Agreement: A lease agreement outlines the terms under which a tenant rents property from a landlord. Like a utility bill, it serves as proof of residence and may include details about associated costs, such as monthly rent. Both documents can also be required for identity verification in various settings.

  • Bank Statement: A bank statement provides a record of transactions within an account and may show deposits that include utility payments. Both the bank statement and utility bill are often used in financial assessments and can reflect an individual's financial habits.

  • Insurance Policy Document: An insurance policy document provides information about the coverage an individual has for various risks. Similarly to a utility bill, it contains personal information and may be required to verify residency and identity when obtaining other services.

  • Government Identification Card: A government identification card, such as a driver's license or state ID, proves one's identity and residence. Both this card and a utility bill often act as necessary documents for accessing services that require verification of one’s address.

Dos and Don'ts

When filling out a Utility Bill form, attention to detail is essential. Below is a list of things to do and avoid.

  • Do: Read all instructions carefully before beginning.
  • Do: Use clear and legible handwriting or type your information.
  • Do: Double-check all personal information for accuracy.
  • Do: Include your account number and billing address.
  • Do: Submit the form by the deadline to avoid late fees.
  • Don't: Leave any sections blank unless instructed.
  • Don't: Use incorrect or outdated information.
  • Don't: Forget to sign and date the form where required.
  • Don't: Submit the form without making copies for your records.

Taking these steps can ensure a smooth process in managing your utility bill. Accurate and complete information helps avoid potential issues with your service provider.

Misconceptions

Understanding the Utility Bill form can sometimes be tricky. Below are common misconceptions that can lead to confusion, along with clarifications to clear up any misunderstandings.

  1. Utility Bills Are Always Accurate: Many people believe that utility bills are free from errors. However, mistakes can happen due to billing system glitches or meter reading errors. Always review your bill thoroughly.
  2. Payment Amount Is Fixed: Some individuals think they will always pay the same amount each month. In reality, utility bills can fluctuate based on usage, seasonal changes, or rate adjustments.
  3. Late Fees Are Automatically Applied: It is a common belief that late fees are always charged if the bill is unpaid by the due date. While this can be true, some utility companies offer grace periods or alternative payment arrangements.
  4. All Utilities Are Billed the Same Way: Not everyone realizes that different types of utilities (electricity, gas, water) may have distinct billing structures. Each utility might include varying fees and charges, which can affect the total amount owed.
  5. Your Utility Provider Can Disconnect Service Without Notice: There is a concern that utility services can be cut off without warning. However, most utility companies are required to provide notice before disconnecting service, allowing customers time to address the situation.
  6. You Must Always Use the Form Provided by the Utility Company: Some believe that only the official form provided can be used for addressing utility issues. While using the provided form can simplify the process, customers often have the option to submit inquiries or disputes in a written format of their choice.
  7. Your Payment History Does Not Impact Future Bill Amounts: It’s a misconception that previous payment habits have no effect on future bills. In some cases, consistent late payments or payment plans may lead to higher rates or fees, so it’s essential to maintain good paying practices.

By addressing these misconceptions, individuals can better navigate the complexities of their utility bills and maintain clearer communication with their utility companies.

Key takeaways

Understanding how to fill out and use the Utility Bill form is crucial for effective management of your billing process. Here are some key takeaways to consider:

  • Ensure that all personal information is accurately completed, including name, address, and account number.
  • Attach any required documentation, such as proof of residence or account verification.
  • Review the form for any instructions specific to your utility provider; these can guide you through any unique requirements.
  • Double-check the payment options available, as methods can vary by provider.
  • Remember that submission deadlines vary; keep track of these dates to avoid late fees.
  • Addresses for submission should be confirmed to prevent any postal delays or misdirected forms.
  • Maintain copies of submitted forms and correspondence for your records, as this can be useful for future reference.

By focusing on these points, you can confidently navigate the process of completing and utilizing the Utility Bill form.

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