FPL Builder Connect Form 1 Page
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Application to Request Temporary Electric Service
Customer Information

Please note that you must enter a business name and a tax identifier in the appropriate box below.

Please provide all the information below for the account.

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*Required fields
Partnership / Corporate Name:
Federal Tax ID Number:
(For the name shown above)
- or -
Non-Corp Business Name:
(DBA)
Social Security Number:
(For the name shown above)

Type of Business:*
Contact Phone Number:* () -
E-mail Address:*
Person Responsible:*
Title/Position:*