Details for: PGE AL 3973-G-A_5287-E-A.pdf

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Erik Jacobson
Regulatory Relations

Pacific Gas and Electric Company
77 Beale St., Mail Code B13U
P.O. Box 770000
San Francisco, CA 94177
Fax: 415-973-3582

May 11, 2018

Advice 3973-G-A/5287-E-A
(Pacific Gas and Electric Company ID U 39 M)

Public Utilities Commission of the State of California

Supplemental: Clean-Up Filing for Medical Baseline Allowance SelfCertification Request Form (Form 61-0502)

Pacific Gas and Electric Company (PG&E) submitted a Tier 1 Advice 3973-G/5287-E on
May 3, 2018 to make minor modification to PG&E’s Gas and Electric Sample Form 610502 - Medical Baseline Allowance Self-Certification Request Form.
PG&E respectfully submits this supplemental advice letter in which PG&E provides
additional background information regarding the online presentment of the Medical
Baseline Allowance Self-Certification Request Form. This advice letter supplements
Advice 3973-G/5287-E and does not change the original integrity of that submittal.
As stated in Advice 3973-G/5287-E, the advice letter was submitted to enable PG&E to
present the Medical Baseline Allowance Self-Certification Request Form (Form 61-0502)
online on Having the form available online provides customers a hassle-free
and environmentally friendly means to complete and submit the form to PG&E.
In Step 4 of the CPUC approved version of Form 61-0502, the form requires a customer’s
signature and that it be dated. With the online presentment of the form, the customer’s
signature block will be replaced by a “submit” button and the date will be computer
generated based on the date that the form is submitted and appear on the confirmation
page, but will not be displayed as an input field. PG&E will follow its Security and Privacy
Policy and will require verification of a customer’s identity either through the sign-in
process to their online account on or through a one-time sign-in process to
access the form directly. The “submit” button acts as the “click” or electronic signature1
for the customer during the online presentment of the form. The Terms and Conditions

CA Civil Code Section 1633.1 et seq. – authorizes the use of electronic transactions/signatures
to satisfy laws requiring records to be in writing.


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Advice 3973-G-A/5287-E-A -2- May 11, 2018 of the form remains the same whether it is presented on paper or online and only the signature block on the paper version is being replaced by a “submit” button during the online presentment of the Medical Baseline Allowance Self-Certification Request Form. In addition, the online presentment of the Medical Baseline Allowance Self-Certification Request Form will include an affirmative checkbox that states that the customer understands the terms and conditions of the form. This box is not present on the approved version of the form (paper version), but as part of the online presentment, this box has to be checked to verify the customer’s acknowledgment of the terms and conditions prior to clicking the submit button on the online application. Protests Pursuant to CPUC General Order 96-B, Section 7.5.1, PG&E hereby requests the protest period be waived. Effective Date PG&E requests that this supplemental Tier 1 advice submittal become effective upon date of submittal of the original Advice 3973-G/5287-E, which is May 3, 2018. Notice In accordance with General Order 96-B, Section IV, a copy of this advice letter is being sent electronically and via U.S. mail to parties shown on the attached list and the parties on the service list for R.01-05-047. Address changes to the General Order 96-B service list should be directed to PG&E at email address For changes to any other service list, please contact the Commission’s Process Office at (415) 703-2021 or at Send all electronic approvals to Advice letter submittals can also be accessed electronically at: /S/ Erik Jacobson Director, Regulatory Relations Attachments cc: Service List R.01-05-047
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CALIFORNIA PUBLIC UTILITIES COMMISSION ADVICE LETTER SUBMITTAL SUMMARY ENERGY UTILITY MUST BE COMPLETED BY UTILITY (Attach additional pages as needed) Company name/CPUC Utility No. Pacific Gas and Electric Company (ID U39 M) Utility type: Contact Person: Annie Ho  ELC  GAS  PLC  HEAT Phone #: (415) 973-8794  WATER E-mail: and EXPLANATION OF UTILITY TYPE ELC = Electric PLC = Pipeline GAS = Gas HEAT = Heat (Date Submitted/ Received Stamp by CPUC) WATER = Water Advice Letter (AL) #: 3973-G-A/5287-E-A Tier: 1 Subject of AL: Supplemental: Clean-Up filing for Medical Baseline Allowance Self-Certification Request Form (Form 61-0502) Keywords (choose from CPUC listing): Compliance, Forms AL submittal type:  Monthly  Quarterly  Annual  One-Time  Other _____________________________ If AL submitted in compliance with a Commission order, indicate relevant Decision/Resolution #: D.12-03-054 Does AL replace a withdrawn or rejected AL? If so, identify the prior AL: No Summarize differences between the AL and the prior withdrawn or rejected AL: ____________________ Is AL requesting confidential treatment? If so, what information is the utility seeking confidential treatment for: No Confidential information will be made available to those who have executed a nondisclosure agreement: N/A Name(s) and contact information of the person(s) who will provide the nondisclosure agreement and access to the confidential information: __________________________________________________________________________________________________ Resolution Required? Yes No Requested effective date: May 3, 2018 N No. of tariff sheets: N/A Estimated system annual revenue effect (%): N/A Estimated system average rate effect (%): N/A When rates are affected by AL, include attachment in AL showing average rate effects on customer classes (residential, small commercial, large C/I, agricultural, lighting). Tariff schedules affected: N/A Service affected and changes proposed: N/A Pending advice letters that revise the same tariff sheets: N/A Pursuant to CPUC General Order 96-B, Section 7.5.1, PG&E hereby requests the protest period be waived. California Public Utilities Commission Energy Division EDTariffUnit 505 Van Ness Ave., 4th Flr. San Francisco, CA 94102 E-mail: Pacific Gas and Electric Company Attn: Erik Jacobson Director, Regulatory Relations c/o Megan Lawson 77 Beale Street, Mail Code B13U P.O. Box 770000 San Francisco, CA 94177 E-mail:
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PG&E Gas and Electric Advice Filing List General Order 96-B, Section IV AT&T Albion Power Company Alcantar & Kahl LLP Anderson & Poole Atlas ReFuel BART Barkovich & Yap, Inc. Braun Blaising Smith Wynne P.C. CalCom Solar California Cotton Ginners & Growers Assn California Energy Commission California Public Utilities Commission California State Association of Counties Calpine Casner, Steve Cenergy Power Center for Biological Diversity City of Palo Alto City of San Jose Clean Power Research Coast Economic Consulting Commercial Energy County of Tehama - Department of Public Works Crossborder Energy Crown Road Energy, LLC Davis Wright Tremaine LLP Day Carter Murphy Dept of General Services Don Pickett & Associates, Inc. Douglass & Liddell Downey & Brand Ellison Schneider & Harris LLP Energy Management Service Evaluation + Strategy for Social Innovation GenOn Energy, Inc. Goodin, MacBride, Squeri, Schlotz & Ritchie Green Charge Networks Green Power Institute Hanna & Morton ICF International Power Technology Intestate Gas Services, Inc. Kelly Group Ken Bohn Consulting Keyes & Fox LLP Leviton Manufacturing Co., Inc. Linde Los Angeles County Integrated Waste Management Task Force Los Angeles Dept of Water & Power MRW & Associates Manatt Phelps Phillips Marin Energy Authority McKenzie & Associates Modesto Irrigation District Morgan Stanley NLine Energy, Inc. NRG Solar Office of Ratepayer Advocates OnGrid Solar Pacific Gas and Electric Company Pioneer Community Energy Praxair Regulatory & Cogeneration Service, Inc. SCD Energy Solutions SCE SDG&E and SoCalGas SPURR San Francisco Water Power and Sewer Seattle City Light Sempra Utilities Southern California Edison Company Southern California Gas Company Spark Energy Sun Light & Power Sunshine Design Tecogen, Inc. TerraVerde Renewable Partners Tiger Natural Gas, Inc. TransCanada Troutman Sanders LLP Utility Cost Management Utility Power Solutions Utility Specialists Verizon Water and Energy Consulting Wellhead Electric Company Western Manufactured Housing Communities Association (WMA) Yep Energy
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