The Salvation Army, Manatee County Financial Assistance Pre-Screening
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What type of Assistance are you applying for: *
FPL - Name of the Person as it appears on the Account
FPL - Account Number
TECO - Name of the Person as it appears on the Account
TECO Account Number
Last Name *
First Name *
Birthdate of person of applying *
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Full Street Address including Apartment Number *
Phone Number *
Email Address *
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