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Meter Form -Form Fill

Section One
Q1

Account#
Q2

Invoice #
Q3

Mail Date

Date
Q4

after
Q5

Previous Balance
Q6

Late Payment Charge
Q7

Payment Received
Q8

Remaining Balance
Q9

Energy Charge
Q10

Storm Restoration Offset
Q11

Fuel Adjustment
Q12

Federal Mandated EAC Rider

Date
Q13

Municipal Franchise Fee
Q14

Total Metered Charges
Q15

Storm Restoration Charge
Q16

Current Month Energy Charges
Q17

Total Amount Due
Q18

Rate
Q19

Current Meter Reading
Q20

Previous Meter Reading
Q21

kWh Metered
Q22

Account
Q23

QPC
Q24

Invoice
Q25

Name

First Name
Q26

Name

Last Name