Extension Request

Please submit the following information and an FPUC Representative will contact you shortly.

Please note all extensions must be requested before the bill due date and are limited to five business days.

Name on Account*
First Last
Company Name
Account Number*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
Best Time to Contact You
- Morning
- Afternoon
- Evening
- Any Time
Additional Comments