Homepage Blank Utility Bill Form
Outline

The Utility Bill form serves as a crucial document for individuals and businesses alike, providing a clear outline of energy and water consumption, as well as the associated costs. Typically issued on a monthly basis, this form includes essential details such as the account holder's name, billing period, and the total amount due. It often breaks down charges into categories, allowing users to understand their usage patterns and identify areas for potential savings. Additionally, the form may feature information on payment options, due dates, and any applicable late fees, ensuring that recipients are well-informed about their financial obligations. By presenting a comprehensive view of utility expenses, the Utility Bill form not only aids in budgeting but also encourages responsible consumption of resources. Understanding its components can empower individuals to take control of their utility usage and expenses, ultimately leading to more sustainable living practices.

Sample - Utility Bill Form

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 [email protected]

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 Information

Fact Name Description
Purpose The Utility Bill form is used to document and request information regarding utility services, such as electricity, water, and gas.
State-Specific Variations Different states may have unique requirements or formats for the Utility Bill form, reflecting local regulations.
Governing Laws In California, for instance, the form is governed by the California Public Utilities Code, while in Texas, it falls under the Texas Utilities Code.
Submission Process Typically, the completed Utility Bill form must be submitted to the relevant utility company or regulatory body for processing.
Importance of Accuracy Providing accurate information on the form is crucial, as errors can lead to delays or complications in service provision.

Detailed Guide for Filling Out Utility Bill

Filling out the Utility Bill form is an important step in managing your household expenses. Completing this form accurately ensures that your utility services are processed without delays. Follow the steps below to fill out the form correctly.

  1. Begin by entering your full name in the designated field. Make sure to use the name that matches your utility account.
  2. Next, provide your current address. This should include the street number, street name, city, state, and zip code.
  3. In the following section, input your utility account number. This number is usually found on previous utility bills.
  4. Indicate the type of utility service you are applying for, such as electricity, water, or gas.
  5. Fill in the date on which you are submitting the form. This helps in tracking your application timeline.
  6. Lastly, review all the information you have entered to ensure it is accurate and complete. Make any necessary corrections before submitting the form.

Obtain Answers on Utility Bill

  1. What is the Utility Bill form used for?

    The Utility Bill form serves as a formal document that provides evidence of a household's utility services. This may include services such as electricity, water, gas, and internet. It is often required for various purposes, such as verifying residency, applying for government assistance, or establishing a new account with a service provider. Having an accurate and up-to-date utility bill can facilitate these processes and ensure that all necessary information is readily available.

  2. What information do I need to provide on the Utility Bill form?

    When filling out the Utility Bill form, you will typically need to include the following information:

    • Your full name
    • The address of the property where the utilities are provided
    • The name of the utility company
    • Your account number with the utility company
    • The billing period covered by the bill
    • The total amount due or paid

    Make sure to double-check all entries for accuracy, as any discrepancies could lead to delays in processing your request.

  3. How recent does the Utility Bill need to be?

    Generally, it is advisable to provide a utility bill that is no more than 30 days old. Many organizations and agencies require recent documentation to ensure that the information reflects your current residency status. If you submit an older bill, it may not be accepted, leading to potential complications in your application or request.

  4. What should I do if I cannot find my Utility Bill?

    If you are unable to locate your utility bill, there are several steps you can take:

    • Check your email for any digital copies, as many utility companies send bills electronically.
    • Visit the utility company's website; they often provide options to view or download your bill after logging into your account.
    • Contact customer service for the utility company directly. They can assist you in obtaining a copy of your bill.

    It is important to act promptly, especially if you need the bill for an upcoming deadline or application.

Common mistakes

When filling out a Utility Bill form, individuals often overlook important details that can lead to delays or complications. One common mistake is providing incomplete information. It’s crucial to ensure that all required fields are filled out completely. Missing even one piece of information can result in the form being returned for correction.

Another frequent error is failing to double-check personal information. Names, addresses, and account numbers must be accurate. A simple typo can lead to billing issues or miscommunication with the utility provider.

Many people also neglect to read the instructions carefully. Each utility company may have specific guidelines regarding how to fill out the form. Ignoring these instructions can lead to errors that could have been easily avoided.

Additionally, some individuals forget to sign the form. A signature is often required to validate the submission. Without it, the form may be considered incomplete, causing delays in processing.

Another mistake occurs when people use outdated forms. Utility companies may update their forms periodically. Always ensure that you are using the most current version to avoid any discrepancies.

It's also common for individuals to submit the form without keeping a copy for their records. Having a copy can be helpful in case of disputes or if the utility company requires further information later on.

Some people may rush through the process and fail to review their work before submission. Taking a moment to go over the completed form can help catch any errors that may have been overlooked initially.

Finally, individuals often forget to check the submission method. Whether submitting online, by mail, or in person, it’s important to follow the correct procedure to ensure that the form reaches the appropriate department without any issues.

Documents used along the form

When dealing with utility services, several forms and documents often accompany the Utility Bill form. Each of these documents serves a specific purpose, helping to clarify or support the information presented in the utility bill. Here are a few common forms that may be used alongside the Utility Bill form:

  • Service Agreement: This document outlines the terms and conditions between the utility provider and the customer. It details the services provided, payment terms, and any obligations of both parties.
  • Change of Address Form: When a customer moves, this form is necessary to update the utility provider with the new address. It ensures that future bills and correspondence are sent to the correct location.
  • Payment Plan Agreement: For customers who may struggle to pay their bills in full, this document establishes a payment plan. It specifies the amount due, the payment schedule, and any applicable fees.
  • Dispute Resolution Form: If there are discrepancies in the bill, this form allows customers to formally dispute charges. It provides a structured way to communicate concerns and seek resolution.

Understanding these documents can help customers navigate their utility services more effectively. Each form plays a crucial role in ensuring clear communication and proper management of utility accounts.

Similar forms

The Utility Bill form serves a specific purpose in verifying residency and identity. However, several other documents share similar functions. Here are four documents that are comparable to the Utility Bill form:

  • Lease Agreement: This document outlines the terms between a landlord and tenant. Like a utility bill, it confirms residency at a specific address.
  • Bank Statement: A bank statement provides proof of identity and address. It often includes the account holder's name and address, similar to how a utility bill does.
  • Government-Issued ID: IDs such as a driver's license or state ID confirm identity and often include the holder's address. This is akin to the identification purpose of a utility bill.
  • Pay Stub: A pay stub shows employment details and typically includes the employee's address. This serves a similar role in verifying identity and residency.

Dos and Don'ts

When filling out the Utility Bill form, it’s important to be thorough and accurate. Here are some guidelines to help you navigate the process effectively.

  • Do double-check your personal information for accuracy.
  • Do ensure that you enter the correct account number.
  • Do read all instructions carefully before starting.
  • Do keep a copy of the completed form for your records.
  • Do submit the form by the specified deadline.
  • Don't rush through the form; take your time to avoid mistakes.
  • Don't leave any required fields blank.
  • Don't use illegible handwriting if filling out a paper form.
  • Don't forget to sign and date the form if required.
  • Don't submit the form without reviewing it first.

By following these guidelines, you can ensure that your Utility Bill form is completed correctly and submitted on time. Taking these steps will help avoid any delays or issues with your utility services.

Misconceptions

Misconceptions about the Utility Bill form can lead to confusion and errors in processing. Here are six common misunderstandings:

  1. Utility Bill forms are only for low-income households.

    This is incorrect. Utility Bill forms can be used by any household seeking assistance with their utility payments, regardless of income level. Programs may have different eligibility criteria, but the form itself is not limited to low-income applicants.

  2. Filling out the Utility Bill form guarantees assistance.

    While submitting the form is a necessary step, it does not guarantee that assistance will be granted. Each application is reviewed based on specific criteria and available funding.

  3. Only certain utilities can be included on the form.

    This is a misconception. Most Utility Bill forms allow for a variety of utilities to be included, such as electricity, gas, water, and sometimes internet services. It is essential to check the specific form for details.

  4. Utility Bill forms must be submitted in person.

    Many programs now allow for online submission of Utility Bill forms. While some may still require in-person applications, it is increasingly common to have digital options available.

  5. Once submitted, the Utility Bill form cannot be updated.

    This is not true. Applicants can often update their information if circumstances change. It is advisable to contact the relevant agency to understand their specific policies regarding updates.

  6. The Utility Bill form is the same across all states.

    This misconception overlooks the fact that different states and localities may have their own forms and requirements. It is important to use the correct form for the specific area in which assistance is being sought.

Key takeaways

When filling out and using the Utility Bill form, keep these important points in mind:

  1. Provide Accurate Information: Ensure that all details, such as your name, address, and account number, are correct. Mistakes can lead to delays or issues with your bill.
  2. Include All Required Documents: Attach any necessary documents, such as identification or proof of residence, as specified on the form.
  3. Submit Before the Deadline: Make sure to send in the form by the due date to avoid late fees or service interruptions.
  4. Keep a Copy: Always keep a copy of the completed form for your records. This can help if there are any questions or disputes later.
  5. Contact Customer Service for Help: If you have any questions while filling out the form, don’t hesitate to reach out to customer service for assistance.