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FCC FORM 5629 OMB APPROVAL EDITION 3060-0819 Lifeline Program Application Form Page 1 of 8 Need help? Call the Lifeline Support Center at 1-800-234-9473 Universal Service Administrative Company | www.lifelinesupport.org 1. About Lifeline Lifeline is a federal benefit that lowers the monthly cost of phone or internet service. Rules
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Lifeline Application (Form 5629) Lifeline Application Lifeline Application (Spanish) Due Date Submit at any time: Who Must File. Lifeline eligible consumers: Recertification Form (Form 5630) Recertification Form Recertification Form (Spanish) Due Date Annually on anniversary date: Who Must File. Lifeline subscribers (if USAC cannot verify their ...
Complete the Lifeline Program Application Form 5629. Copy of photo ID required if not already on file. Complete your information under section 2. Provide a copy of the award letter from the program you marked under Section 3. If you qualify under income you will need to enclose a copy of one (1) of the following:
Bring or mail the form to this address: USAC Lifeline Support Center P.O. Box 7081 London, KY 40742 1. About Lifeline Lifeline is a federal benefit that lowers the monthly cost of phone or internet service. FCC FORM 5629 OMB APPROVAL EDITION 3060-0819 Lifeline Program Application Form
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📄 FCC FORM 5629 – Lifeline Program Application Form. If you want to apply for Lifeline benefits, start with the Lifeline Application Form (FCC Form 5629). This is the form needed to establish your eligibility and to help you get connected with a Lifeline provider. Apply Online: https://getinternet.gov/apply. Download PDF Forms Here. English.
FCC Form 5629 – The Lifeline Program Application Form. FCC Form 5629 will be used in all states and territories to obtain the information necessary to evaluate whether a consumer is eligible to receive Lifeline service and to obtain the consumer’s certifications, as required by 47 CFR § 54.410.
Feb 22, 2018 · The universal forms include FCC Form 5629 (Lifeline Application Form), FCC Form 5630 (Lifeline Annual Recertification Form), and FCC Form 5631 (Lifeline One-Per-Household Worksheet). These are available on the Lifeline Program Form page.
