8
VERIFICATION
AND
SWORN STATEMENT
RESIDENTIAL REVENUE
INTRASTATE REVENUES ONLY
STATE OF ARIZONA
I, THE UNDERSIGNED
OF THE
DO SAY THAT THIS ANNUAL UTILITY REPORT TO THE ARIZONA CORPORATION COMMISSION
FOR THE YEAR ENDING
HAS BEEN PREPARED UNDER MY DIRECTION, FROM THE ORIGINAL BOOKS,
PAPERS AND RECORDS OF SAID UTILITY; THAT I HAVE CAREFULLY EXAMINED
THE SAME, AND DECLARE THE SAME TO BE A COMPLETE AND CORRECT
STATEMENT OF BUSINESS AND AFFAIRS OF SAID UTILITY FOR THE PERIOD
COVERED BY THIS REPORT IN RESPECT TO EACH AND EVERY MATTER AND
THING SET FORTH, TO THE BEST OF MY KNOWLEDGE, INFORMATION AND
BELIEF.
SWORN STATEMENT
IN ACCORDANCE WITH THE REQUIREMENTS OF TITLE 40, ARTICLE 8, SECTION 40-
401.01, ARIZONA REVISED STATUTES, IT IS HEREIN REPORTED THAT THE GROSS
OPERATING REVENUE OF SAID UTILITY DERIVED FROM ARIZONA INTRASTATE
UTILITY OPERATIONS RECEIVED FROM RESIDENTIAL CUSTOMERS DURING
CALENDAR YEAR 2020 WAS:
(THE AMOUNT IN BOX AT LEFT
INCLUDES $_____________________________
IN SALES TAXES BILLED, OR COLLECTED)
*RESIDENTIAL REVENUE REPORTED ON THIS PAGE
MUST INCLUDE SALES TAXES BILLED.
SIGNATURE OF OWNER OR OFFICIAL
TELEPHONE NUMBER
SUBSCRIBED AND SWORN TO BEFORE ME
A NOTARY PUBLIC IN AND FOR THE COUNTY OF
THIS DAY OF
(SEAL)
MY COMMISSION EXPIRES SIGNATURE OF NOTARY PUBLIC