Free Utility Bill PDF Template Open Utility Bill Editor Here

Free Utility Bill PDF Template

The Utility Bill form is a document used to provide proof of residency and verify utility services at a specific address. This form is often required for various applications, including opening bank accounts, applying for loans, or enrolling in school. To ensure your needs are met, consider filling out the form by clicking the button below.

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Key takeaways

Filling out and using the Utility Bill form is an important task that can affect various aspects of your daily life. Here are some key takeaways to keep in mind:

  1. Understand the Purpose: The Utility Bill form is used to establish or update your utility services, such as water, electricity, and gas.
  2. Gather Necessary Information: Before filling out the form, collect all relevant information, including your identification, address, and previous utility account details.
  3. Be Accurate: Ensure that all information provided is correct. Mistakes can lead to delays in service activation or billing issues.
  4. Check for Required Documentation: Some utility providers may require additional documents, such as proof of residency or identification. Verify what is needed before submission.
  5. Review the Form: Take a moment to review the completed form for any errors or omissions. This step is crucial to avoid complications later.
  6. Submit Promptly: Submit the form as soon as possible to ensure that your utility services are set up without unnecessary delays.
  7. Keep a Copy: Always retain a copy of the submitted form for your records. This can be helpful in case of disputes or inquiries.
  8. Follow Up: After submission, follow up with the utility provider to confirm that your application has been processed and services are active.
  9. Understand Billing Cycles: Familiarize yourself with the billing cycle for your utilities. Knowing when bills are due can help you manage your finances effectively.
  10. Seek Assistance if Needed: If you encounter difficulties while filling out the form, do not hesitate to reach out to customer service for guidance.

By keeping these takeaways in mind, you can navigate the process of filling out and using the Utility Bill form more effectively.

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

Similar forms

The first document similar to a Utility Bill form is a Lease Agreement. Both documents serve as proof of residency. A Lease Agreement outlines the terms of renting a property, including the duration of the lease and the responsibilities of both the tenant and landlord. Like a Utility Bill, it typically includes the tenant's name and the address of the property, making it useful for verifying residency when applying for services or benefits.

In addition to various financial obligations, understanding the legal aspects of purchasing a vehicle is essential. For anyone engaging in the sale or purchase of a vehicle, the utilization of a Vehicle Bill of Sale Forms can simplify the process and provide clarity. This form acts as a vital record, safeguarding the interests of both parties involved in the transaction, similar to how other financial documents maintain transparency and accountability.

Another comparable document is a Bank Statement. A Bank Statement provides a detailed account of transactions and balances for a specific period. It often includes the account holder's name and address, similar to a Utility Bill. Both documents can be used to confirm identity and residency, especially in situations where proof of financial stability is required.

A Government-Issued ID is also similar to a Utility Bill form. This document includes personal information such as name, address, and date of birth. While the primary purpose of an ID is to verify identity, it also serves as proof of residency when the address matches that on the Utility Bill. Both documents are often required in formal processes, such as applying for loans or government services.

Another document that shares similarities is a Pay Stub. A Pay Stub provides information about an employee's earnings and deductions over a specific period. It typically includes the employee's name and address, making it a valid form of residency verification. Like a Utility Bill, it demonstrates financial responsibility, which can be essential for various applications.

Lastly, a Mortgage Statement is akin to a Utility Bill. This document outlines the details of a mortgage account, including payment history and outstanding balance. It contains the homeowner's name and address, serving as proof of residency. Both documents can be used to establish a person's residence and financial obligations, particularly in applications for credit or housing assistance.

How to Use Utility Bill

After obtaining the Utility Bill form, you will need to fill it out accurately to ensure proper processing. Follow these steps carefully to complete the form correctly.

  1. Begin by entering your name in the designated field at the top of the form.
  2. Next, provide your current address, including the street number, street name, city, state, and zip code.
  3. In the following section, write down the account number associated with your utility service.
  4. Indicate the type of utility service you are referring to, such as water, electricity, or gas.
  5. Fill in the billing period by specifying the start and end dates.
  6. Next, enter the total amount due as stated on your most recent bill.
  7. If applicable, include any late fees or additional charges that may apply.
  8. Finally, sign and date the form at the bottom to certify that the information provided is accurate.

Documents used along the form

When managing household expenses or applying for various services, the Utility Bill form is often accompanied by several other important documents. These documents serve to verify identity, residency, and financial status. Below is a list of common forms and documents that are frequently used alongside the Utility Bill form.

  • Identification Card: This document verifies the identity of the individual submitting the Utility Bill. It may include a driver's license, state ID, or passport.
  • Lease Agreement: A lease agreement provides proof of residency. It outlines the terms of the rental arrangement between the tenant and the landlord.
  • Power of Attorney for a Child: To ensure your child's needs are addressed during your absence, consider using a formal Power of Attorney for a Child arrangement that legally designates another adult to make important decisions.
  • Pay Stubs: Recent pay stubs demonstrate income and financial stability. They are often required for applications related to loans or rental agreements.
  • Bank Statements: Bank statements offer a snapshot of an individual's financial situation. They can help establish proof of income and spending habits.
  • Social Security Card: This card may be requested to confirm the individual's Social Security number, which is often required for various applications.
  • Tax Returns: Recent tax returns provide a comprehensive view of an individual's financial history and can be used to verify income for loans or assistance programs.

Collecting these documents can streamline the process of verifying identity and financial status. Each document plays a crucial role in ensuring that applications are processed efficiently and accurately.

Common mistakes

  1. Incorrect Account Number: Many individuals mistakenly enter the wrong account number. This can lead to delays in processing the payment or even penalties for late payment.

  2. Missing Personal Information: Failing to provide complete personal information, such as the name or address, can result in the form being rejected.

  3. Inaccurate Payment Amount: Some people miscalculate the total due, which can cause issues with their account status.

  4. Neglecting to Sign: A common oversight is forgetting to sign the form. Without a signature, the form may not be valid.

  5. Using the Wrong Payment Method: Individuals sometimes choose a payment method that is not accepted, leading to confusion and delays.

  6. Submitting After the Deadline: Late submissions can incur extra fees. People often overlook the due date, which can affect their service.

  7. Not Keeping a Copy: Failing to make a copy of the submitted form can create problems if there are disputes or questions later.

  8. Ignoring Instructions: Some individuals do not read the instructions carefully. This can lead to mistakes that could have been easily avoided.

Dos and Don'ts

When filling out a Utility Bill form, it’s essential to ensure accuracy and clarity. Here’s a list of things you should and shouldn’t do to help you complete the form correctly.

  • Do double-check your account number to avoid any delays in processing.
  • Do provide your current address, ensuring it matches your utility service address.
  • Do include all required personal information, such as your name and contact details.
  • Do read the instructions carefully before starting to fill out the form.
  • Don't leave any fields blank unless specified; incomplete forms may be rejected.
  • Don't use abbreviations or shorthand that could lead to confusion.
  • Don't submit the form without reviewing it for any errors or typos.
  • Don't forget to sign and date the form, if required, to validate your submission.

By following these guidelines, you can help ensure that your Utility Bill form is processed smoothly and efficiently.