Article 23.  Forms

88. (Rule 88)  Forms

The following skeleton forms of applications, complaint, answer, protest, and certificate of service are merely illustrative.  The content of a particular document will vary, depending on the subject matter and applicable rules.

1. Application

2. Complaint

3. Answer

4. Application-Shortened Procedure Tariff Docket

5. Protest-Shortened Procedure Tariff Docket

6. Certificate of Service

No. 1-Application

(See Rules 2-2.6, 4-6 and 15-43.8)

Before the Public Utilities Commission of the State of California

Application of JOHN JONES (Jones Rapid Transit) to operate bus service between San Francisco and South San Francisco; to establish fares; and to issue a $10,000 note.

Application No. _________________________ (Commission will insert number)

APPLICATION

The application of (exact legal name, mailing address and telephone number of each applicant) respectfully shows:

1. That communications in regard to this application are to be addressed to (name, title, and address).

2. (Here, and in succeeding numbered paragraphs, set forth the specific facts required by the applicable rules, together with additional facts deemed material.)

WHEREFORE, applicant requests an order (here state clearly and concisely the specific authorization sought by applicant).

Dated at _______________, California, this _______ day of __________, 20____.

_____________________________________________

(Signature of applicant)

_____________________________________________

_____________________________________________

(Signature, address, and telephone number of attorney, if any)

VERIFICATION^*

(See Rule 2.4)

(Where applicant is an individual)

I am the applicant in the above-entitled matter; the statements in the foregoing document are true of my own knowledge, except as to matters which are therein stated on information or belief, and as to those matters I believe them to be true.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on ___________________ at ________________________, California.

(Date) (Name of city)

_____________________________________________

(Applicant)

No. 1-Application-Continued

VERIFICATION

(See Rule 2.4)

(Where Applicant is a Corporation)

I am an officer of the applicant corporation herein, and am authorized to make this verification on its behalf. The statements in the foregoing document are true of my own knowledge, except as to matters which are therein stated on information or belief, and as to those matters I believe them to be true.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on ___________________ at ________________________, California.

(Date) (Name of city)

_____________________________________________

(Signature and Title of Corporate Officer)

(Where applicant is absent from

County of Attorney's Office)

I am the attorney for the applicant herein; said applicant is absent from the County of _____________, California, where I have my office, and I make this verification for said applicant for that reason; the statements in the foregoing document are true of my own knowledge, except as to matters which are therein stated on information or belief, and as to those matters I believe them to be true.

I declare under penalty of perjury that the foregoing is true and correct.

Executed on ___________________ at ________________________, California.

(Date) (Name of city)

_____________________________________________

(Attorney for Applicant)

No. 2 - Complaint

(See Rules 2-2.6, 4-6 and 9-11)

BEFORE THE PUBLIC UTILITIES COMMISSION OF THE STATE OF CALIFORNIA

(B)   )

)

)

)

)

(Fill in Complainant (s) name)

vs.

(C) )

)

)

)

)

(Fill in Defendant (s) name)

CASE  

(for Commission use only)

(A) Have you tried to resolve this matter informally with the Commission's Consumer Affairs staff?

   /   

YES NO

Has staff responded to your complaint?

   /   

YES NO

Did you appeal to the Consumer Affairs Manager?

   /   

YES NO

Do you have money on deposit with the Commission?

   /   /$       

YES NO AMOUNT

Is your service now disconnected?

   /   

YES NO

COMPLAINT

(D) The complaint of    

(Insert exact legal name, mailing address and telephone number of each complainant)


respectfully shows that:

(E) 1. Defendant(s)

(Insert full name and address of each defendant)

(F) 2. Explain fully and clearly the details of your complaint. (Attach additional pages if necessary.)

(G) 3. Scoping Memo Information

(a) The proposed category for the Complaint is (check one):

_ adjudicatory

_ ratesetting (if the complaint challenges the reasonableness of a rate)

(b) Are hearings needed? YES NO

(c) The issues to be considered are:

(d) The proposed schedule for resolving the complaint within 12 months (if categorized as adjudicatory) or 18 months (if categorized as ratesetting) is as follows:

Prehearing Conference: 30 to 40 days from the date of filing of the Complaint.

Hearing: 50 to 70 days from the date of filing of the Complaint.

Explain here if you propose a schedule different from the above guidelines.

(H) Wherefore, complainant(s) request(s) an order: State clearly the exact relief desired.

(Attach additional pages if necessary)

(I) Dated    , California, this     day of    , 20    

(city) (date) (month) (year)

 

(Signature of each complainant)

 

 

 

(Signature, address and telephone number
of representative, if any)

 

 

 

 

VERIFICATION (For Individual or Partnerships)

I am (one of) the complainant(s) in the above-entitled matter; the statements in the foregoing document are true of my knowledge, except as to matters which are therein stated on information and belief, and as to those matters, I believe them to be true.

I declare under penalty of perjury that the foregoing is true and correct.

(J) Executed on    , at    , California.

(date) (city)

(If more than one complainant, only one need sign)    

(Complainant)

VERIFICATION (For a Corporation)

I am an officer of the complaining corporation herein, and am authorized to make this verification on its behalf. The statements in the foregoing document are true of my own knowledge, except as to the matters which are therein stated on information and belief, and as to those matters I believe them to be true.

I declare under penalty of perjury that the foregoing is true and correct.

(K) Executed on    , at    , California.

(date) (city)

(Signature and Title of Corporate Officer)    

   

 

(L) FILE the original complaint plus 7 copies, plus 1 copy for each named defendant, with the Commission.

(M) MAIL TO: California Public Utilities Commission

Attn: Docket Office

505 Van Ness Avenue, Room 2001

San Francisco, CA 94102

No. 3-Answer

(See Rules 2-2.6 and 13)

Before the Public Utilities Commission of the State of California

John A. Jones, Complainant, vs. Smith Public Utility System, a corporation, Defendant.

Case No. _________________________ (Insert number of complaint)

ANSWER

Defendant (exact legal name, mailing address and telephone number of each defendant joining in answer), for answer to the above complaint, respectfully shows:

1. (Here, and in succeeding numbered paragraphs, admit or deny material allegations of the complaint, and set forth any matters constituting a defense.)

WHEREFORE, defendant requests that the complaint be dismissed (or other appropriate request).

Dated at _______________, California, this _______ day of __________, 20____.

_____________________________________________

(Signature of each defendant joining in answer)

_____________________________________________

_____________________________________________

(Signature, address, and telephone number of attorney, if any)

VERIFICATION

Use appropriate form of verification as set forth following Form 1, substituting "defendant" for "applicant."

No. 4-Application-Shortened Procedure Tariff Docket

(See Rules 2, 2.1, 2.5, 4-6 and 25-28)

Before the Public Utilities Commission of the State of California

Application of John Jones under the Shortened Procedure Tariff Docket to make increases in (here state specifically or by reference the increase in rates sought to be made, and specify short notice and long- and short-haul authority, if any, sought).

Application No. _________________________ (Commission will insert number)

APPLICATION-SHORTENED PROCEDURE TARIFF DOCKET

The application of (exact legal name, mailing address and telephone number of each applicant) respectfully shows:

1. Authorization is requested to (here state clearly and concisely the specific authority or authorities sought, together with the current rates, fares, charges or rules being increased).

2. This application is based upon the following facts and circumstances:

(Here, and in succeeding numbered paragraphs or attached exhibits, set forth the specific facts required by the applicable rules, a statement of or reference to exhibits showing present and proposed rates, fares, charges, or rules, and the additional facts and circumstances deemed to be material).

3. The position of interested parties in this matter is as follows:

(Here list the position of each interested party insofar as known.)

4. Applicant will furnish a copy of this application to any interested party upon written request.

Dated at _______________, California, this _______ day of __________, 20____.

Signature: _____________________________________________

Title: _____________________________________________

Address: _____________________________________________

Telephone Number:

VERIFICATION

Use appropriate form of verification set forth following Form 1.

No. 5-Protest-Shortened Procedure Tariff Docket

(See Rules 2, 2.1, 2.5, 4-6 and 30-31)

Before the Public Utilities Commission of the State of California

Application of John Jones under the Shortened Procedure Tariff Docket to make increases in (here state specifically or by reference the increase in rates sought to be made, and specify short notice and long- and short-haul authority, if any, sought).

Application No. _________________________ (Commission will insert number)

PROTEST-SHORTENED PROCEDURE TARIFF DOCKET

The protest of (exact legal name, mailing address and telephone number of each protestant) respectfully shows:

1. (Here, and in succeeding numbered paragraphs or attached exhibits, state the facts constituting the grounds for the protest and show how protestant is affected by the proposed increase and indicate in what respects the proposed increase is considered not justified.)

2. Applicants, as shown on the following list (or on an attached list), have been served with a copy of this protest by (here state the manner of service). (Here list the names and addresses of parties served.)

3. Protestant will furnish a copy of this protest to any other interested party upon written request.

Dated at _______________, California, this _______ day of __________, 20____.

Signature: _____________________________________________

Title: _____________________________________________

Address: _____________________________________________

Telephone Number:

VERIFICATION

Use appropriate form of verification set forth following Form 1, substituting "protestant" for "applicant."

No. 6-Certificate of Service

(See Rule 2.3)

CERTIFICATE OF SERVICE

I hereby certify that I have this day served a copy of [title of document, e.g., "Applicant UtilCorp's Motion to Strike" or "Notice of Availability of Application"] on all known parties to [proceeding number, e.g., A.93-01-010] by [here describe manner of service, e.g., mailing a properly addressed copy by first-class mail with postage prepaid or transmitting a facsimile copy, etc.] to each party named in the official service list [or appropriate special service list or specific parties required to be served by ruling or order, etc.].

Executed on [date] at [location], California.

		[signature]
		John Jones

Table of Filing Fees

(See Rule 3.3)

Type of Filing	Type of Utility	Fee	PU Code Reference
Application for Certificate of Public Convenience and Necessity (CPCN)	Passenger stage corporation UNLESS already operating in the immediate vicinity under the Commission's jurisdiction	$500 $75	§1036(a) §1904(a)
	Passenger air carrier	$150	§2754
	All others, including street railroads, gas corporations, electric corporations, telegraph corporations, telephone corporations, water corporations, and common carrier vessels	$75	§§1001, 1007, 1008, 1904(a)
	Passenger stage corporation	$300	§1036(b)
	Passenger air carrier	$150	§2756
Application to sell, mortgage, Lease, assign, transfer, or encumber a CPCN	All others, including street railroads, gas corporations, electric corporations, telegraph corporations, telephone corporations, water corporations, and common carrier vessels	$75	§1904(a)
Application to register	Interstate highway carrier	$5 per vehicle, plus $25 for carriers exempt from ICC regulation	§3902(a)(3) Res. TL-18520, Res. TL-18582
	Private carrier	$35 initial registration $30 renewal	§4006(a), (b)
Application for permit	Household goods carrier	$500	§5136
	Charter-party carrier of passengers	$500 plus $15 per tour bus to a maximum of $6,500	§5373.1(a), (b)
Application for issuance or renewal of Class A certificate	Charter-party carrier of passengers	$1,500 (new) $500 (renewal) plus $15 per tour bus up to a maximum of $6,500	§§5371.1(b), 5373.1(a)(1)-(2), (b)
Application for issuance or renewal of Class B certificate	Charter-party carrier of passenger	$500 plus $15 per tour bus up to a maximum of $6,500	§§5371.1(b), 5373.1(a)(3), (b)

Type of Filing	Type of Utility	Fee	PU Code Reference
Application for issuance or renewal of Class C certificate (until Jan. 1, 1994)	Charter-party carrier of passengers	$500 (Class B certificate fee may be transferred) plus $15 per tour bus to a maximum of $6,500	§§5371.1(b), 5373.1(a)(4), (b)
Application to sell, lease, assign, or otherwise transfer or encumber a certificate	Charter-party carrier of passengers	$300	§5377.1
Application to transfer permit	Household goods carrier	$150 or $25 for transfer after death of permittee and after court approval of distribution of estate, or if no probate or court distribution necessary	§5136

^* Where execution occurs outside California, verification must be made in accordance with the law of the state where execution occurs.