Neb. Admin. Code PUBLIC SERVICE COMMISSION, tit. 291, ch. 6, exh. A
(Date)
Private Water Company, Nebraska
NOTICE OF RATE INCREASE
All affected customers of the __________________ Water Company are hereby notified that increased rates will be effective (Date). Present and proposed rates by type of service are as follows:
| Type of Service | Present Rate | Proposed Rate |
All affected customers are hereby notified that said rates are not subject to approval by the Nebraska Public Service Commission unless petitions signed by twenty-five percent (25%) or more of the customers are received by the Commission before the effective date shown above. At the present time, the company serves _______________ affected customers. Petitions must be in the following form:
TO THE NEBRASKA PUBLIC SERVICE COMMISSION
The undersigned customers of the _________________ Water Company do hereby petition the Nebraska Public Service Commission to determine rates in lieu of those proposed by the water company:
| Date | Printed Name | Subscriber's Signature | Address | Telephone Number |
Each signature shall be dated and shall be that of the customer or the customer's spouse. If a business, the name shall be included with the signature of an officer or agent. Each petition may be signed by one or more customers and shall be mailed to the Nebraska Public Service Commission, Post Office Box 94927, Lincoln, NE 68509-4927.
Neb. Admin. Code PUBLIC SERVICE COMMISSION, tit. 291, ch. 6, exh. A