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Get Ca 79-1095 2007-2026
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How to fill out the CA 79-1095 online
The CA 79-1095 form, also known as the Authorization to Receive Customer Information or Act Upon a Customer's Behalf, enables account holders to delegate specific rights to third parties regarding their PG&E accounts. This guide offers step-by-step directions for completing the form online.
Follow the steps to successfully complete the CA 79-1095 form.
- Use the ‘Get Form’ button to obtain the CA 79-1095 form and open it in your preferred online editor.
- Begin filling in the form by entering your full name in the designated NAME field. If applicable, include your title.
- In the CUSTOMER OF RECORD section, provide the full name and mailing address of the account holder to whom the account belongs.
- Next, fill in the details of the third party you are appointing as your agent, including their name and mailing address.
- List the service accounts covered by this authorization. Include the service address, city, and service account number for each account.
- Indicate the specific information and acts you are authorizing the agent to perform by initialing the applicable boxes provided.
- Select the duration of the authorization by initialing the appropriate box for either a one-time authorization, an annual authorization, or an extended authorization period.
- Specify the preferred format for receiving account information from the utility, checking the applicable boxes.
- Sign the form in the CUSTOMER SIGNATURE section, including the date of execution, your telephone number, and your city and state.
- Ensure the agent also signs the form, including their execution date and contact information.
- Once all information is completed, save your changes. You may then download, print, or share the completed form as needed.
Complete your CA 79-1095 form online today for seamless management of your account information.
Yes, you can look up your 1095-A online by accessing your Health Insurance Marketplace account. This is the fastest way to retrieve your form. If you experience difficulties, customer support can provide further help in finding your documentation. Make sure to have your information ready as you manage your CA 79-1095.
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