Agent Enrollment Form – TPV Summary
Below is the enrollment summary for TPV.
| FIELD | VALUE |
|---|---|
| Retailer | |
| First Name | |
| Middle Name | |
| Last Name | |
| Service Address | |
| Service Address (Line2) | |
| City | |
| State | |
| Zip Code | |
| Date Of Birth | |
| Utility | |
| Product Name | |
| ETF | |
| Term Length | |
| Start Date | |
| Average Rate | |
| Energy Charge | |
| Base Charge | |
| Agent ID | |
| Agency ID | |
| ESI-ID | |
| Primary Phone Number | |
| Language Preference |
TPV Options
Trusted TPV
Dial Number:
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TPV Code:
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