Energy Usage Credit Log Form
Record energy usage, credit adjustments, and supporting details for an account or site.
Account and Site Information
Account or Customer Reference
*
Site or Facility Name
*
Department or Unit
Usage Period and Meter Details
Reporting Period Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reporting Period End Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Meter or Utility Reference
*
Energy Source
*
Please Select
Electricity
Natural Gas
Solar
Wind
District Heating
Other
Energy Usage and Credit Entry
Usage Amount
*
Credit Amount
*
Adjustment Type
Please Select
Credit
Correction
Carryover
Reversal
Reason for Credit
Supporting Notes
Submission Details
Submitted by
*
First Name
Middle Name
Last Name
Submission date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Internal reference or approval note
Submit
Should be Empty: