Follow the steps to successfully complete the Budget Mobile Phone form.

1. Press the ‘Get Form’ button to access the application form and open it in the editor.
2. Begin by filling in the applicant’s full name and birth date. Ensure that the name written here matches the documentation you will provide.
3. If the name on the voice service account differs from the applicant’s name, please include it in the corresponding field.
4. Enter the customer’s full residential service address. Note that this should not be a P.O. Box.
5. Provide the last four digits of your Social Security Number and the unique DCN if applicable.
6. Input the customer contact telephone number and indicate if this address is temporary by circling ‘Yes’ or ‘No’. If it is temporary, remember that this must be verified every 90 days.
7. Complete the city, town, and zip code fields, and clarify whether this address is also the billing address by marking ‘Yes’ or ‘No’. If it is not the same, provide the billing address.
8. Carefully read the obligations and provisions stated regarding the Lifeline program. Ensure you understand these rules as they pertain to your application.
9. Certify under penalty of perjury that you meet the eligibility criteria for the Lifeline program. Check the boxes indicating the number of individuals in your household if qualifying under income thresholds.
10. Affix your signature and date the form to confirm that the information provided is accurate. Attach all necessary proof of eligibility as specified.
11. Once you have completed the form, you can save the changes, download or print it, and then share it as required for submission.

Start your application process today by completing the Budget Mobile Phone form online.