Form 79-1095 is a legally binding PG&E document that allows the customer of record to authorize a third party to access specific account information or conduct transactions on their behalf. Authorized actions include requesting billing records, investigating disputed charges, requesting rate analysis, and making rate change requests.
The authorization period can be set for a one-time action or for a period of up to three years. Both Energy Service Providers and general third parties can use this form. Completed forms must be submitted to PG&E as directed by the form instructions, and both parties should retain a copy for their records.
The form includes a release of account information clause and an indemnity clause that both parties must acknowledge before the authorization takes effect. These legal provisions ensure that both the customer and the third party understand their rights and accept responsibility for the designated actions.
| Question | Answer |
|---|---|
| Form Name | 79 1095 Form |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min |
| Other names | pge form 79 1095, covered ca form 1095 a, 1095 receive, form 79 1095 |