Home Emergency Information Sheet
Where the stopcock, the gas or oil shut-off and the consumer unit are, and how to use them.
Safety, records and practical forms · SF-492 · Record
Free printable power cut record — date, time off and back on, cause given, reference number and what was affected. PDF and fill-in-online versions.
2 pages. The A4 and US Letter files are laid out identically, so neither is shrunk to fit.
Print it and write on it
Fillable PDF type and save
Or no download needed
Fill it in onlineThe fillable versions have real form fields — open them in any PDF reader, type into them and save. Printing help.
The same sheet, on screen. Tick, type, add or remove rows, then print it or download the completed version as a PDF. Everything stays in your browser — your entries are kept in this browser's own storage on this device, nothing is uploaded, and there is no account.
A dated line for every time the power went off. Each entry records when it went, when it came back, what the supplier said the cause was and the reference they gave you, so a run of cuts is a list rather than an argument about how often it happens.
Households on a supply that drops out more than they would like, anyone gathering evidence for a supplier or ombudsman complaint, and people whose freezer, medical equipment or work depends on the electricity staying on.
The printable is laid out inside a box that fits both A4 and US Letter, so the two files are identical and neither one is scaled. The fillable PDF has real form fields. The online version keeps what you enter in your own browser and builds the completed PDF on your device.
Download the A4 or US Letter file to match the paper in your printer, open it in a PDF reader and print at 100% — not "fit to page", which shrinks the writing space. Both files leave a 14 mm margin, which clears the unprintable edge on home printers. To print the online version with your entries in it, use the Print this sheet button, which prints only the sheet and none of the page around it. More on printing.
Because the fifth one is only obviously the fifth if the first four were written down. A dated list with reference numbers is what a supplier, a landlord or an ombudsman can work from; a memory of 'it keeps happening' is not.
From whoever you report the cut to — your supplier or the network operator for your area. They usually quote a reference on the call or in a text. Write it in the reference column while you have it.
No. It is a record, not advice. What you do about heating, medical equipment or a freezer is for you and the people who supply them; the second table is where you write your own arrangements down.
Whether anything is payable depends on your supplier, your insurer and the rules where you are. What this sheet does is give you the dates, the duration and the reference numbers that any such conversation starts with.
Use it as it stands and write the premises in the address field. The daily occurrence log suits a site that records a wider range of events.
Where the stopcock, the gas or oil shut-off and the consumer unit are, and how to use them.
When each appliance was last emptied, wiped or defrosted.
Printable sheets, workbooks and tools on the same subject.
Make sure anyone in the household can turn off the water, gas or electricity quickly, including people who did not move in with the property.
Keep a contemporaneous record of a shift, written as things happen rather than reconstructed at the end of it.
Build a running record of readings and the usage between them, so a bill is something you can check rather than something you have to accept.
Every sheet, binder, game and puzzle on Upkeep Papers is free to download, with no email and no account. Making them is not free: each one takes days of research, design and checking, and the site costs money to run. If something here saved you time, you can buy us a coffee. It is entirely optional: nothing is locked, and nothing changes if you don’t.
Opens PayPal in a new tab. Any amount, and nothing changes if you would rather not.