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Ome Discount Rate. I authorize the agency(s) providing my benefits to release information to National Grid for the purposes of enrollment and annual recertification for the Discount Rate and to notify the company if my benefits are discontinued. I also understand that I must notify National Grid if my benefits are discontinued. National Grid Account Number: Name Social Security Number: Telephone Number Address City State ZIP Eligibility Criteria for the discount rate: You are a residentia.

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