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OCEB Self Declaration Form Cambridge and North Dumfries Hydro

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CAMBRIDGE AND NORTH DUMFRIES HYDRO INC.
SELF DECLARATION FORM

PLEASE RETURN THIS COMPLETED FORM TO:

Mail: Cambridge and North Dumfries Hydro Inc.
P. O. Box 1060, 1500 Bishop Street,
Cambridge, ON N1R 5X6 Or Fax: 1-519-621-7420
Attention: Customer Care Department

The Ontario Clean Energy Benefit provides eligible customers a 10 per cent rebate on the total cost of electricity charges related to electricity consumption on their bills, including HST, effective January 1, 2011. This rebate will be in effect for five years until December 31, 2015.

Step One – Does your account qualify?

You qualify for OCEB if you:

1. Your account relates to:

a. A property as defined in the Condominium Act, 1998

b. A residential complex as defined in subsection 2 (1) of the Residential Tenancies Act, 2007 or

c. A building or related group of buildings in which two or more of any of the following are located

i. A member unit or non-member unit as defined in subsection 1 (1) of the Co-operative Corporations Act,

ii. A premise that is demised premises within the meaning of the Commercial Tenancies Act,

iii. A unit as defined in subsection 2 (1) of the Residential Tenancies Act, 2007.

2. Carry on a business that is a farming business for the purposes of the Farm Registration and Farm Organizations Funding Act, 1993, and hold a valid registration number assigned under that Act or the consumer’s obligation to file a farming business registration form was waived pursuant to an order made under subsection 22 (6) of that Act; or

You can find these acts on the government’s e-laws web site at www.e-laws.gov.on.ca.

Step Two – Fill in this form:

If your account qualifies, please fill in the information below. If you have more than one qualified account, list each one separately. Please attach a separate page if you run out of room. If there are units in your building or complex that are metered or billed separately from the account referenced, do not include them in the total number of units for this account.

Cambridge and North Dumfries Hydro
Account Number(s)		 Account Name Basis for Qualification Number of Units

Acknowledgement:

By self-declaring for OCEB eligibility you are also acknowledging that under the OEB Act, and O.Reg. 95/05 that you automatically fall under the prescribed Regulated Price Plan (RPP) fixed rate consumer class, unless you meet the exemption criteria defined in the Act and or regulations for the RPP.

By self-declaring for OCEB eligibility, you are acknowledging that your account will automatically be switched to RPP if you do not meet the exemption criteria. However, if you wish to remain out of the RPP, you can do so through one of the following:

1. Opt out of the RPP by signing a contract with a retailer of electricity for commodity supply. If you are currently under a retailer commodity price option, your rate plan will not change through this declaration.

2. Select any other commodity pricing option as permitted by Ontario Energy Board regulation. For more information about electricity commodity prices please visit the OEB website at http://www.ontarioenergyboard.ca/OEB/Consumers/Electricity/Electricity+Prices#role

Note: Self-declaring customers will be moved to their required rate option at the start of the next billings date, as billings are on a go forward basis.

Step 3: What would you like to declare?

The following individuals have authority to provide and certify the accuracy of the information on this form and any additional attachments. Please complete the applicable sections below.

Corporation’s Name:

Name & Office of Authorized Officer:

I certify the above information to be true, correct and complete.

Signature of Authorized Officer

Date

Sole Proprietor:

Name of Applicant:

I certify the above information to be true, correct and complete.

Signature of Applicant (should be same as the Account Name)

Date

Partnership’s Name:

Name of Authorized Individual to sign on behalf of Partnership:

I certify the above information to be true, correct and complete.

Signature of Authorized Individual (should be same as the Account Name)

Date

You must advise Cambridge & North Dumfries Hydro Inc. in writing if your account ceases to qualify for the Ontario Clean Energy Benefit or if there is a change in the number of units with the property or complex. Failure to do so will lead to the requirement to reimburse to us any OCEB credit outside of the eligible time frame.

All information submitted in this process will be used by Cambridge and North Dumfries Hydro Inc. in support of its obligations under the Electricity Act, 1998, The Ontario Clean Energy Benefit Act, and the Ontario Energy Board Act, 1998, applicable Ontario Energy Board Codes and Rules, associated policies, standards and procedures and its license. Cambridge and North Dumfries Hydro Inc. will use the information collected on this form for the purposes of confirming your eligibility for the RPP and the Ontario Clean Energy Benefit, and for applying the Ontario Clean Energy Benefit to your bill and for auditing purposes.

If you have any questions about this collection, the ways in which your personal information may be used by Cambridge and North Dumfries Hydro Inc. or would like further information about our privacy policies, please contact our Customer Care Department, by telephone at 519-621-3484, or by e-mail at: customercare@camhydro.com. You may also visit our website at www.camhydro.com and view our Privacy Statement for more information.

Nov. 5, 2013

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What the OCEB Self Declaration Form Cambridge and North Dumfries Hydro Is

The OCEB Self Declaration Form Cambridge and North Dumfries Hydro is a customer-facing declaration used to report or confirm account details, eligibility, or specific meter and service information for Cambridge and North Dumfries Hydro. It documents a customer's statements about usage, account ownership, or program eligibility and typically includes identifying information, account numbers, a declaration statement, and a signature block. Although issued by a local utility, U.S.-based users should confirm jurisdictional acceptance of electronic signatures and submission channels with the utility prior to filing.

Why this form matters for account accuracy and compliance

Completing the OCEB Self Declaration Form accurately establishes an official record for enrollment, billing adjustments, or program access and reduces disputes. A correct declaration speeds administrative processing and helps ensure the utility applies the appropriate rates or credits to the right account.

Why this form matters for account accuracy and compliance

Typical filers and signers for this utility declaration

The form is most commonly used by customers, authorized agents, and municipal or administrative staff when confirming account data or eligibility.

  • Residential account holders providing ownership or occupancy confirmation for billing purposes.
  • Authorized agents or property managers submitting declarations on behalf of customers with written authorization.
  • Municipal or social service workers completing declarations for program enrollment or eligibility verification.

Confirm who may sign on behalf of an account with the utility; some organizations require additional authorization documentation or agent designation.

Core components found in a professional OCEB Self Declaration Form

A standard OCEB self-declaration template includes structured fields for clear legal and operational use; each section supports accuracy, verification, and secure recordkeeping.

Header

Identifies the issuing utility, form title, reference number and any version or effective dates used for tracking and audit purposes.

Account Details

Fields for customer name, account number, service address, and contact details so administrators can quickly match the declaration to billing records.

Declaration Statement

A concise statement describing what the signer is declaring, including required factual assertions and any program-specific eligibility criteria.

Supporting Data

Optional fields for meter readings, dates of occupancy, or other factual inputs that substantiate the declaration and reduce follow-up questions.

Signature Block

Placement for signature, printed name, title (if signing for an organization), date, and witness or notary fields when required by policy or law.

Instructions

Clear completion guidance, acceptable formats for dates and IDs, and contact details for questions or document submission routes.

Step-by-step: filling and submitting the OCEB declaration

Use this concise sequence to prepare the form, verify accuracy, and choose the correct submission method to avoid processing delays.

  • 01
    Gather documents: Collect account statement, ID, meter reads, and any authorization letters.
  • 02
    Complete form: Enter all required fields in the requested formats and double-check numbers.
  • 03
    Sign appropriately: Sign as required: wet, notarized, or e-signed per the utility's rules.
  • 04
    Submit and retain: Send via accepted channel and keep a dated copy for your records.

How to configure an online completion workflow

When digitizing the form, configure authentication, required fields, and storage to match the utility's acceptance criteria and audit needs.

Field Configuration
Authentication Email verification, SMS code, or stronger KBA where required
Signature Fields Mark signature and date as required; enable signer name capture
Conditional Logic Show agent fields only when 'Agent' checkbox is selected
Storage Export PDF with audit trail to secure cloud or local archive

Typical digital submission flow for a self-declaration

This sequence outlines a common electronic workflow when the utility accepts e-submissions and e-signatures.

  • Upload Document: Sender uploads the completed declaration PDF to the signing platform.
  • Place Fields: Sender adds signature, date, and any conditional fields for the signer.
  • Signer Authentication: Signer confirms identity via email, SMS code, or KBA.
  • Finalize & Archive: Signed PDF and audit trail are stored and a copy sent to parties.

Technical channels and integrations for eSubmission

Choose a platform that supports required authentication, secure storage, and the utility's accepted file formats.

  • Integrations: Salesforce, NetSuite and Google Workspace integrations commonly supported
  • File Formats: PDF, DOCX and exported PDF/A are standard export options
  • Authentication: Email link, SMS, KBA, and optional advanced signer authentication

Typical eSignature vendor pricing and feature snapshot for form processing

Comparing common vendor starting prices and feature availability can help planners estimate eSignature costs for high-volume or single-use forms.

signNow DocuSign Adobe Sign PandaDoc HelloSign
Starting Price $8/user/mo $15/user/mo $14/user/mo $19/user/mo $15/user/mo
Free Trial 7-day free trial Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes No
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No

Security and compliance considerations for storing declarations

Encryption: AES-256 at rest
In Transit: TLS 1.2/1.3
Certifications: ISO 27001 and SOC 2 Type II
Healthcare: HIPAA compliant with BAA
FDA Records: 21 CFR Part 11 support available
Audit Trail: Comprehensive timestamps and logs

Key risks and penalties for incorrect or false declarations

False Declaration: Civil/criminal exposure
Service Denial: Possible suspension or refusal
Billing Dispute: Delayed resolution and credit risk
Notary Failure: Document may be rejected
Data Breach: Privacy liability
Legal Penalties: Fines or statutory sanctions

Common errors that delay acceptance

  • Omitting the account number or entering the wrong service address causes routing errors and slows processing.
  • Using inconsistent names between the form and official ID leads to additional verification and possible rejection.
  • Failing to sign or date the declaration in the required format causes the utility to treat the form as incomplete.
  • Submitting scanned, low-quality documents or incorrect file formats can prevent automated ingestion and manual review increases turnaround time.

Practical tips for accurate, efficient completion

Adopt the following practices to reduce follow-up requests and to ensure the utility accepts your form on first submission.

Verify identity documents before signing
Compare the name and address you enter with the exact wording on government-issued ID to avoid mismatches that can delay verification and require resubmission.
Use MM/DD/YYYY for dates
Consistently use the requested date format throughout the form to prevent interpretation errors and to ensure accurate application of eligibility periods.
Attach supporting evidence
When declaring occupancy or eligibility, include copies of recent bills, leases, or authorization letters to substantiate claims and speed approval.
Keep a signed copy
Retain a dated copy of the signed declaration and any audit evidence from the eSignature platform for your records and potential audits.

Download, storage, and supporting documents

Ensure you submit accompanying documents and retain signed copies in accepted formats for long-term access and audit readiness.

Accepted Formats

PDF and PDF/A are preferred for signed copies; DOCX may be accepted for drafts but final submissions should be PDF with embedded signature evidence.

Supporting Documents

Attach recent utility bills, lease agreements, ID copies, or agent authorizations to substantiate the declaration and reduce follow-up.

Archival Storage

Store signed PDFs with audit trails in secure cloud storage or local archives that support access control and immutable backups.

Export Options

Export a single combined PDF that includes the signed form and any appended supporting attachments for submission and recordkeeping.

Real-world examples of digital declarations and eSigning

Examples show how organizations streamline similar declarations while preserving verification and auditability.

Optica Ventures — operational ease

Optica automated customer declarations to centralize records and reduce queries.

  • The interface is simple and easy-to-use for our team.
  • This approach allowed faster reconciliation with billing records and reduced manual follow-ups while preserving a clear audit trail.

Martin Properties — mobile signing

A property manager used mobile signing for occupancy declarations during move-ins.

  • I can process and execute all of these documents online with 100% compliance and built-in security.
  • Mobile signing reduced turnaround times for occupancy confirmations and improved tenant onboarding efficiency while maintaining required documentation.

Frequently asked questions about the OCEB Self Declaration submission

Answers to common practical and legal questions about completing, signing, and submitting this utility declaration.


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