Tenant Utility Billing Dispute Intake & Investigation Form

Property/Building Identifier

Tenant Entity Name

Tenant Contact Person for Dispute

Tenant Contact Email

Lease Agreement Reference Number

Lease Commencement Date

Lease Expiration Date

Leased Area (Square Meters)

Utility Type in Dispute

Sub-Meter Serial Number

Sub-Meter Manufacturer & Model

Meter Technology Type

Meter Communication Protocols (select all that apply)

Sub-Meter Installation Date

Sub-Meter Physical Location Description

Sub-Meter Circuit/Zone Identifier

Is this sub-meter the primary billing meter for the tenant?

Describe any downstream sub-sub-meters or excluded circuits:

Explain the meter hierarchy and what this specific meter measures:

Data Logging Interval (Minutes)

Last Certified Calibration Date

Meter Reading Cycle (Days)

Billing Rate Schedule Code

Baseline Period Average Monthly Consumption

Has this meter been subject to previous disputes?

Summarize previous dispute dates, causes, and resolutions:

Overall Dispute Complexity Assessment (1=Simple, 5=Highly Complex)

Upload Lease Agreement Excerpt (Utility Clause)

Upload Sub-Meter Identification Plate Photograph

Upload Latest Calibration Certificate

Billing Period Start Date in Dispute

Billing Period End Date in Dispute

Reported Billed Consumption (Disputed Period)

Tenant's Claimed Correct Consumption

Disputed Amount (Financial Value)

Anomaly Severity Assessment (1=Minor, 5=Critical)

12-Month Historical Consumption Comparison

Anomaly Pattern Classification

Has weather normalization been applied to the analysis?

Describe weather normalization methodology and data sources:

Has there been any change in tenant occupancy or operational hours during the disputed period?

Describe the occupancy/operational changes in detail:

Have there been any equipment installations or removals in the tenant space?

Equipment Changes Log

Were there any building-wide system upgrades or maintenance affecting utility distribution?

Describe the system work and dates of impact:

Comparable Tenant Average Consumption (Same Period)

Quality of Evidence Provided by Tenant (1=Poor, 5=Excellent)

Detailed Variance Analysis Summary

Rank Potential Causes by Probability (1=Most Likely)

Upload Tenant's Dispute Letter or Email

Upload Historical Utility Bills (Last 12 Months)

Upload Trend Graphs or Data Visualizations

Field Inspection Date

Field Technician Name & Credentials

Was the sub-meter visually inspected for physical damage or tampering?

Describe any physical anomalies observed:

Was a reference standard meter used for comparison testing?

Reference Standard Meter Accuracy Class

Comparison Test Result - Meter Error Percentage

Field Test Equipment Used

Diagnostic Checklist Results

Was the meter firmware/software updated within the last 6 months?

Firmware Version Number

Were there any environmental factors affecting meter performance? (temperature, humidity, vibration, electromagnetic interference)

Specify environmental conditions and mitigation measures:

Is the meter communication protocol functioning correctly? (Modbus, BACnet, pulse output)

Describe communication failures and data logging gaps:

Comprehensive Diagnostic Test Results Summary

Upload Photograph of Meter Display (Current Reading)

Upload Photograph of Meter Installation & Wiring

Upload Thermal Imaging (if applicable)

Upload Field Test Report & Data Log

Does the field inspection confirm a meter malfunction?

Malfunction Severity Classification

I confirm that all safety protocols were followed during field inspection

Financial Reconciliation Calculation

Total Original Billed Amount

Total Corrected Amount Due

Net Adjustment Amount (Credit to Tenant)

Should this adjustment be applied retroactively to previous billing periods?

Number of Prior Periods Affected

Rate Structure Application Notes

Adjustment Type

Are there any shared/common area allocations included in this billing?

Describe allocation methodology and verify its accuracy:

Do any taxes or government levies apply to this utility billing?

Specify tax types, rates, and application method:

Adjustment Effective Date

Financial Reconciliation Summary & Justification

Upload Detailed Calculation Worksheet

I confirm that all rate calculations have been verified against the current approved tariff schedule

Does the Chief Building Engineer concur with the technical findings?

Document technical objections or additional investigation required:

Chief Building Engineer Technical Review Comments

Chief Building Engineer Signature

Does the Asset Manager approve the financial adjustment?

Document financial objections or require additional approval authority:

Was legal counsel consulted during this dispute?

Legal Counsel Name & Opinion Reference

Asset Manager Financial Review & Approval Comments

Asset Manager Signature

Final Dispute Resolution Decision

Implementation Action Plan & Timeline

Tenant Notification Date

Process Quality Assessment (Engineer & Manager)

I confirm that all investigation steps followed standard operating procedures and quality assurance protocols

I acknowledge that this dispute resolution may be subject to audit and all documentation must be retained per records management policy

I verify that all applicable stakeholders have been notified of this decision