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Information" form, in order to have access to FPL billing information. FPL reserves the <br />right to request the Agency to provide copies of the forms as part of the program audit <br />requirements. If telephone pre-screening is conducted, the caseworkers will review the <br />information from the release form and seek the applicant's verbal approval to share <br />information. Caseworker should note on the file that the applicant's verbal approval was <br />obtained. <br />The Agency shall ensure that no person shall be subjected to discrimination in connection <br />with the FPL Care To Share program on the basis of age, gender, disability, race, color, <br />creed, national origin, religion or ancestry contrary to applicable law. <br />FPL customers who are potential recipients of FPL Care To Share funds shall have equal <br />opportunity for assistance, and assistance remains available twelve months per year, as <br />funding and resources permit. <br />The eligibility criteria cannot be added to or deviated from without the prior consent of the <br />FPL Area Manager. <br />The Agency signing this Agreement does hereby bind itself to the following terms and <br />conditions: <br />I. Eligibility Criteria <br />Potential recipients must contact the administering Agency and follow the agency's <br />intake process, which could include receiving preliminary screening and making an <br />appointment with the Agency representative when appropriate. <br />An eligible applicant is one who meets all the following criteria: <br />1. Must physically reside in FPL's service area at the address for which assistance is <br />sought. <br />2. Must have an account with FPL or reside at the service location. Should an <br />Agency employee seek to apply for FPL Care To Share assistance through the <br />Agency, an Agency supervisor — such as the Primary or Alternate contact listed on <br />FPL ASSIST Program record - must contact the FPL Area Manager in advance for <br />approval and commitment placement. <br />3. Must have identification that reflects the applicant name and the same address as <br />the FPL account. Some examples of acceptable identification include a driver's <br />license, a rent receipt, a water or phone bill, a tax bill or a mortgage statement <br />4. Must have a delinquent or Past Due FPL bill, final notice, or disconnect notice for <br />the FPL account. Current bill is also eligible, if Agency caseworker reasonably <br />deems it appropriate. <br />5. Must NOT have received a benefit under the FPL Care To Share Program within <br />the last twelve months -at the current service address. The initial commitment set- <br />up date is used to determine the 12 -month time period. <br />2 FPL Care To Share Program Agreement (rev 7-9-2018) <br />