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BY SIGNING THIS APPLICATION I AUTHORIZE THE TOWN OF BENSON TO USE MY INFORMATION TO DETERMINE MY DEPOSIT AND UTILITY ACCOUNT ELIGIBILITY.
FOR TRADITIONAL CUSTOMERS SWITCHING TO PREPAY ONLY, I UNDERSTAND IF I WANT TO SWITCH BACK TO TRADITIONAL BILLING, A NEW DEPOSIT WILL BE REQUIRED.
BY TYPING YOUR FULL NAME INTO THIS FIELD YOU ARE SIGNING THIS DOCUMENT.
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