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A TRUE COPY <br />CERTIFICATION ON LAST PAGE <br />�:YAN L. BUTLER, CLERK <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 Business Specialist Manage . <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 Business Specialist MaRageF <br />in advance for 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. If, however, the customer's account is not delinquent, the <br />customer with a current bill may satisfy this requirement by showing proof of a <br />family or personal crisis. The Agency is responsible for reasonably determining <br />what constitutes a family or personal crisis. r, FFeRt hill is al69 eligible if <br />"nnnm <br />Annnm <br />2 FPL Care To Share Program Agreement (rev 11-27-2023) . <br />