Customer Number Cust-2024-

Date

Name of the homeowner

Address
Bill To:

Name of the applicant

Lone Meter ID
Meter Details

Meter Reading Period [Start Date] to [End Date]

Previous Reading

Current Reading

Units Consumed
Billing Details
Base Charge

Usage Charge

Late Payment Fee (if applicable)

Total Amount Due

Payment Information
Payment Due Date

Payment Method
Payments received after the due date are subject to a late payment fee.
Invoice Notes
For any billing-related inquiries, contact us at DHE - HOAI #.
Customer Number Cust-2024-

Date

Name of the homeowner

Address
Bill To:

Name of the applicant

Lone Meter ID
Meter Details

Meter Reading Period [Start Date] to [End Date]

Previous Reading

Current Reading

Units Consumed
Billing Details
Base Charge

Usage Charge

Late Payment Fee (if applicable)

Total Amount Due

Payment Information
Payment Due Date

Payment Method
Payments received after the due date are subject to a late payment fee.
Invoice Notes
For any billing-related inquiries, contact us at DHE - HOAI #.
Requirements: Identification (ID) of the applicant

Proof of Billing
Proof of Ownership (If owner)

Proof of Authorization (If renter/Caretaker)

Photocopy of the homeowner(s) Identification card with 3 specimen signatures