Summary. Seventeen documents. If there is a notice on the counter, use Templates 1 through 4 today.

How to use these

Templates 1–5 are for the day a disconnection notice arrives. All free, all doable in an afternoon.

Templates 6–11 are for a bill that is wrong.

Template 12 is the one nobody uses and the one that works.

Two habits: put everything in writing, and cite the tariff by section number. The tariff is public, it is on the utility's or the commission's website, and quoting it changes the conversation more than anything else you can do.

Template 1 — Disconnection notice audit

Most improper shutoffs are procedural failures. Work through this before you do anything else.

NOTICE AUDIT — [Utility], Account [], Notice dated []

Requirement Yes/No Evidence
Was it a written notice separate from the bill?
Does it state the amount owed?
Does it state the earliest disconnection date?
Does it state how to avoid disconnection?
Does it state how to dispute or seek assistance?
Has the required notice period elapsed? (tariff § ___ requires ___ days)
Was a second contact attempt made, if required?
Is the disconnection date a permitted day? (not Friday/weekend/holiday/day before)
Is it within permitted hours?
Was it sent to my current address?
Was a written dispute pending? Dated [ ]
Was an assistance application pending? Applied [ ]
Is a weather moratorium in effect?
Is a medical certificate on file?
Does the household include an infant, an elderly resident, or a person with a serious illness or disability?

Any "no" in the first ten rows, or any "yes" in the last five, is a basis to stop the disconnection. Call the utility, cite the row, and if they disagree, file the commission complaint (Template 12) the same day.

Template 2 — Medical certificate request to the utility

[Date] · Also call — but send this too

RE: Request for medical certificate protection — Account [], Service address []

A member of my household has a medical condition such that loss of [electric / gas / water] service would be dangerous to their health.

Please:

  1. Send me the medical certificate form immediately, by [email / fax] to [____]
  2. Confirm the fax number or email address to which my provider should return it
  3. Tell me the postponement period the certificate provides and whether it is renewable
  4. Place a hold on disconnection while the certificate is being obtained
  1. Tell me whether a payment agreement is required alongside the certificate, and send me those terms
  2. Confirm whether the household qualifies for a medical equipment rate or usage allowance

The condition involves: [ ] powered medical equipment [ ] refrigerated medication [ ] a condition made dangerous by extreme heat or cold [ ] other: ____

[Name] · [Account] · [Phone] · [Date]

Template 3 — Provider letter

Give this to the doctor's office if the utility's form is unavailable or as a supplement. Most offices complete these routinely.

[Provider letterhead] · [Date]

RE: [Patient name], DOB [____] — Utility service medical certification

To: [Utility], Customer Service / Medical Certificate Department Service address: [] · Account: []

[Patient name] is my patient and resides at the above address.

In my professional opinion, interruption or termination of [electric / gas / water] service at this residence would be dangerous to [patient]'s health, because:

[ ] [Patient] requires [oxygen concentrator / CPAP / BiPAP / nebulizer / ventilator / home dialysis / powered mobility device / feeding or infusion pump] which requires electrical power [state hours per day]. [ ] [Patient] requires refrigerated medication — [medication] — which must be maintained at [temperature]. [ ] [Patient] has a condition — [general description] — such that exposure to extreme [heat / cold] presents a serious risk to health. [ ] Other: ____

I certify this condition is expected to continue for at least [30 / 60 / 90] days and I anticipate it will require renewal certification thereafter.

Please contact my office at [phone] with any questions.

[Signature] · [Name, credentials, license number] · [Practice] · [Date]

Note. The certificate establishes a medical need, not a diagnosis. A general description of the functional risk is sufficient and preferable — do not disclose more than is required.

Template 4 — Payment agreement proposal

[Date]

RE: Account [____] — proposed deferred payment agreement

My account shows arrears of $______ as of [date]. I received a disconnection notice dated [date].

My circumstances. [My household income is $______ per month. / My income changed in (month) because . / I am on a fixed income of $__.] Household size: [ ]. [A household member has a medical condition; a certificate has been submitted.]

My proposal.

  1. I will pay $______ per month toward the arrears, in addition to current usage, beginning [date] — over [N] months.
  2. Please enroll me in budget billing for current usage so the amount is predictable.
  3. Please confirm that no disconnection will occur while I am current under this agreement.

This is an amount I can sustain. A defaulted agreement helps neither of us, and I would rather commit to a longer term at a lower payment than default on a shorter one.

Please also advise:

  • What is the longest term available under your tariff?
  • Does the agreement void entirely if one payment is missed, and is there a cure period?
  • Am I eligible for arrearage forgiveness, a percentage-of-income plan, or the low-income rate?

Please confirm acceptance in writing.

[Name] · [Account] · [Phone] · [Date]

Template 5 — Assistance pending notice

Send the day you apply. In many states a pending application independently bars disconnection.

[Date]

RE: Account [____] — energy assistance application pending

I applied for [LIHEAP / crisis assistance / (program)] on [date] through [agency name], [agency phone]. [My application or confirmation number is ____.]

Please note the account accordingly and confirm in writing that disconnection is stayed while the application is under review, as provided by [state rule / your tariff § ____].

The agency advises a determination is expected by approximately [date]. Please direct any verification request to them at [phone] — I have authorized release of information for this purpose.

[Name] · [Account] · [Service address] · [Phone] · [Date]

Template 6 — Program request letter

The three programs almost never volunteered, plus the rate check. One letter.

RE: Account [____] — program eligibility inquiry

Please advise, in writing, whether I am eligible for each of the following and how to apply:

  1. Arrearage forgiveness — a program forgiving a portion of past-due balance for on-time payments
  2. Percentage-of-income payment plan — a bill capped at a percentage of household income
  3. The company's hardship or fuel fund
  4. The low-income rate or discount rate, and whether I currently receive it
  5. Budget or levelized billing
  6. A medical equipment rate or usage allowance
  7. A senior discount, if one exists
  8. Free energy audit and any direct-install measures
  9. Weatherization referral

Household information: size [ ] · monthly income $______ · [any household member over ___ / under ___ / with a disability or serious illness].

Which rate am I currently billed on, and is a different available rate better for my usage pattern? [In a retail-choice state:] Who is my current supplier and at what rate, and what is the current default utility supply rate?

[Name] · [Account] · [Date]

Template 7 — Written bill dispute

Send before the due date, and use the word "dispute." That is what activates the protection.

[Date]

RE: Account [] — WRITTEN DISPUTE of bill dated [], amount $______

I dispute the above bill.

Amount disputed: $______ · Undisputed amount: $______ — payment enclosed / paid [date].

The basis for the dispute:

[ ] The amount is inconsistent with my usage history — [prior 12 months averaged $; this bill is $]. [ ] The bill appears to reflect estimated readings followed by a catch-up. [ ] I believe the meter is inaccurate. [ ] I believe I am billed on the wrong meter for this address. [ ] I believe I am billed on the wrong rate class. [ ] The bill includes charges for a period before I occupied this address — I took occupancy on [date]. [ ] The bill includes a back-billed amount exceeding the limitation in your tariff. [ ] Other: ____

Requests:

  1. Confirm in writing that service will not be discontinued over the disputed amount while this dispute is pending, per tariff § ____.
  2. Provide the account history for the past 24 months, showing for each period the read date, the reading, the usage, and whether the reading was ACTUAL or ESTIMATED.
  3. Perform a meter test. Advise whether the first test is free, the accuracy tolerance, and the rebilling adjustment if outside tolerance.
  4. Identify the tariff provision on which the disputed charge is based.
  5. Provide a written explanation of your determination.

[Name] · [Account] · [Service address] · [Phone] · [Date] Sent by [method] with proof of date. Copy retained.

Template 8 — Account history and meter test request

RE: Account [____] — request for records and meter test

Please provide:

  1. Account history, 24 months, showing for each billing period: read date · meter reading · usage · actual or estimated · amount billed · payments and credits
  2. Interval usage data for [date range], if the meter provides it
  3. The meter number serving [unit/address] and confirmation it is the meter assigned to my account
  4. The date the meter was installed and the date it was last tested
  5. My rate schedule and its effective date
  6. All deposits posted, the dates, and any interest accrued

I request a meter test. Please advise: whether the first test is free · the accuracy tolerance under your tariff · what happens if the meter tests outside tolerance · whether I may witness the test or obtain the results.

[Name] · [Account] · [Date]

Template 9 — Back billing challenge

RE: Account [] — bill dated [] covering [period]

The above bill includes charges for service rendered from [date] to [date] — a period of [N] months — apparently as a correction for prior undercharging.

Please advise:

  1. The cause of the undercharge — [estimated readings / a meter that failed / a billing error / a wrong rate class / other]
  2. The tariff provision limiting how far back the company may bill for an undercharge, and how it applies here
  3. The payment terms your tariff requires for a back-billed amount — many require a period at least as long as the period back-billed
  4. Whether any portion falls outside the limitation period and should be removed
  5. Whether late fees or interest were applied to the back-billed amount, and on what authority

I dispute any portion of this charge that exceeds the tariff's back billing limitation, and I request an extended payment arrangement for whatever remains properly billed. Service should not be discontinued over the disputed portion while this is pending.

[Name] · [Account] · [Date]

Template 10 — Leak adjustment request

Most water utilities have a policy. Almost none mention it.

RE: Account [____] — request for leak adjustment

My bill for [period] was $______, against a twelve-month average of $______.

The cause was a leak, which has been repaired:

  • Location: [ ] · Discovered: [date] · Repaired: [date]
  • Repaired by: [plumber name, license number] — invoice enclosed
  • The leak was not visible and could not reasonably have been discovered earlier
  • Photographs enclosed

Please advise whether the company has a leak adjustment policy, and consider this a request under it. If a form is required, please send it.

Please also confirm whether the leak was on the customer side or the utility side of the meter — if the latter, the loss is the company's.

Please also provide the account history for 24 months so the excess consumption attributable to the leak can be identified.

[Name] · [Account] · [Date]

Template 11 — Deposit refund demand

RE: Account [____] — request for deposit refund

I posted a deposit of $______ on [date] when service was established.

Please advise, in writing:

  1. The tariff provision governing deposit refunds and the period of satisfactory payment history required
  2. Whether I have satisfied that requirement — my payment history is [describe]
  3. Whether the deposit accrues interest, at what rate, and the amount accrued
  4. Whether the deposit will be refunded or credited to the account, and when

If I am eligible, please apply or refund it now. If I am not yet eligible, please state the date on which I will become eligible and confirm the refund will be issued automatically at that time.

[Name] · [Account] · [Date]

Template 12 — Informal commission complaint

Free. Twenty minutes. Service generally protected while pending. Most complaints resolve in days. Almost nobody files one.

INFORMAL COMPLAINT — [State] Public Utility Commission, Consumer Affairs Division

Complainant: [Name] · [Mailing address] · [Phone] · [Email] Utility: [Name] · Account: [] · Service address: [] Type of service: [electric / gas / water / telephone]

What I am asking the Commission to do: [ ] Order service restored [ ] Prevent a scheduled disconnection [ ] Correct the bill [ ] Order a payment arrangement over ___ months [ ] Waive the reconnection fee [ ] Order a meter test [ ] Refund my deposit [ ] Other: ____

Chronology:

Date What happened
Bill dated [ ] for $______ received
I disputed in writing / requested [ ]
Spoke with [name] at [phone]; was told [quote]
Disconnection notice dated [ ] received
Service disconnected at [time]

What I asked the utility for and what they said: [Specifically, with names and dates.]

The rule I believe was violated: [Tariff § ____ / Commission rule ____ ] provides: "[quote]." [Explain the mismatch in one or two sentences.]

Household circumstances: [size · income · any member who is elderly, an infant, or has a serious illness or disability · any medical equipment · any medical certificate on file]

Assistance applied for: [program, agency, date, status]

Enclosures: the disputed bill(s) · the disconnection notice · my written dispute · correspondence · the medical certificate · proof of assistance application.

[Signature] · [Date]

Template 13 — Municipal utility or cooperative appeal

Where the commission has no jurisdiction.

RE: [Account ____] — request for review and hearing

To: [City Council / Utility Board / Cooperative Board of Directors] cc: [Mayor / City Manager] · [State Attorney General, Consumer Protection Division]

I am a customer of [municipal utility / cooperative] at [address]. I am requesting review of the following:

[Chronology, as in Template 12.]

The rule at issue. [Cite the utility's own rules, ordinance, or bylaws. "Section ___ of the utility's Rules and Regulations provides: '[quote].'"]

Due process. [If a municipal utility:] As a municipal provider terminating an essential service, the utility is a government actor and owes notice and an opportunity to be heard before termination. I was not provided [notice meeting the requirements / an opportunity to contest the charge before disconnection].

Requests:

  1. Immediate restoration of service [/ suspension of the scheduled disconnection]
  2. A hearing before the [board / council] on the disputed charge
  3. Waiver of the reconnection fee
  4. A payment arrangement over [N] months
  5. A copy of the utility's rules, rate schedule, and written procedures for disputes and disconnection

[Name] · [Account] · [Contact] · [Date]

Template 14 — Landlord shutoff letter

[Date] · Delivered by [method] with proof

RE: Interruption of utility service at [unit address]

Dear [Landlord]:

On [date] at approximately [time], [electric / gas / water] service to my unit was interrupted. [The utility has confirmed the interruption was at your direction / that the account in your name was closed or unpaid.]

Interruption of essential services to a tenant is an unlawful self-help eviction under [state] law, and it is a breach of the implied warranty of habitability and of the covenant of quiet enjoyment.

I demand immediate restoration of service.

I have documented the interruption with photographs dated [date] and I am recording my damages, which to date include: [spoiled food $______ · alternative lodging $______ · lost wages $______ · alternative heating $______].

I have contacted [the utility] · [code enforcement / the housing agency] · [legal aid].

[If applicable:] I am advised that under [state] law I may place the utility account in my own name and deduct the amounts paid from rent. I intend to do so if service is not restored by [date/time].

[Name] · [Unit] · [Phone] · [Date] cc: [Utility] · [Code enforcement] · [Legal aid]

Template 15 — Submetering calculation request

RE: Utility charges billed by landlord — [Unit address]

You bill me $______ per month for [water / electric / gas]. Please provide in writing:

  1. How my usage is measured — an individual submeter, an allocation formula, or a flat rate. If a formula, describe it in full.
  2. If submetered: the meter number, the readings used for each of the last twelve bills, and when the meter was last tested or calibrated
  3. The rate you charge me per unit, and the rate the utility charges you for the same period
  4. Whether any common-area usage — hallways, laundry, irrigation, pool, office — is included in what tenants are billed, and how it is allocated
  5. Any administrative or service fee included, and the lease or statutory authority for it
  6. Copies of the master utility bills for the past twelve months

Many states prohibit a landlord from charging tenants more than the utility's own rate and require disclosure of the billing method. Please respond within fourteen days.

[Name] · [Unit] · [Date]

Template 16 — Collections validation

RE: Alleged utility account [], service address [], amount $______

I dispute this debt and request validation. Please provide:

  1. An itemized statement of the alleged debt
  2. The name and address of the original utility
  3. The service address and the exact dates of service claimed
  4. Documentation of your right to collect — the assignment or bill of sale, with the full chain of title
  5. A complete accounting: charges, payments, credits, any deposit posted and how it was applied, fees, and interest
  6. The date of first delinquency

Note: I [did not occupy that address during the dates claimed — I took occupancy on ____ / previously posted a deposit of $______ which does not appear to have been applied].

[If applicable:] I believe this debt is beyond [state]'s statute of limitations. I am not acknowledging the debt, and nothing in this letter should be construed as a promise to pay or as reviving any limitations period.

Until validation is provided, please cease collection. If you report this account, it must be reported as disputed.

[Name] · [Date] · Sent with proof of mailing

Template 17 — Assistance application prep

BEFORE CALLING THE COMMUNITY ACTION AGENCY

Say first: "I have a disconnection notice" — that opens expedited crisis processing.

Have ready ✓
Utility account number and service address ☐
The disconnection notice ☐
Most recent 2–3 utility bills ☐
Photo ID for the applicant ☐
Proof of address (lease, deed, or a utility bill) ☐
Social Security numbers for all household members ☐
Proof of income for ALL household members, last 30 days — pay stubs, benefit letters, SSA/SSI award, unemployment, child support, pension ☐
Proof of zero income, if applicable ☐
Household size and the ages of all members ☐
Documentation of disability or medical need, if any ☐

Ask about, in one call: LIHEAP regular · LIHEAP crisis · weatherization · the utility's hardship fund · local emergency funds · percentage-of-income plans · Lifeline (phone/broadband) · and anything else the household qualifies for.

Then: send Template 5 to the utility the same day.

The short version

  • Audit the notice — most improper shutoffs are procedural.
  • Get the medical certificate. A doctor's office can do it in ninety minutes.
  • Propose a payment amount you will certainly make.
  • Tell the utility in writing that an assistance application is pending.
  • Ask by name for arrearage forgiveness, a percentage-of-income plan, and the hardship fund.
  • Dispute in writing before the due date, and pay the undisputed portion.
  • Ask how many of the last twelve reads were estimated.
  • Cite the tariff by section number.
  • File the commission complaint — free, twenty minutes, service protected.
  • A landlord shutoff is an unlawful eviction, not a utility problem.

Related documents

Educational only, not legal advice. Adapt every template to your state's rules and your utility's tariff. Municipal utilities and cooperatives are frequently outside commission jurisdiction — confirm before filing.