Get 2017 Lifeline Program Annual Recertification Form - Usac

Completing the 2017 Lifeline Program Annual Recertification Form online is essential for maintaining your Lifeline benefits. This guide offers step-by-step instructions to assist you in filling out the form accurately and efficiently.

Follow the steps to complete the form online.

1. Press the ‘Get Form’ button to access the form and open it in your digital editor.
2. Begin by filling out Section 1, which is Subscriber Information. Enter your first name, last name, Lifeline supported telephone number (if applicable), and date of birth in the required fields. Provide the last four digits of your Social Security Number or Tribal Identification Number, and indicate if you reside on Tribal Lands by checking 'Yes' or 'No' as appropriate.
3. Complete your subscriber's address by entering your street address, apartment number (if applicable), city, state, and zip code. If your billing address differs from your service address, fill out the additional fields for the billing address.
4. Move to Section 2, where you will indicate eligibility for Lifeline. You need to check all qualifying federal programs that you, a dependent, or a household member participates in or confirm that your household income is at or below the amount listed for your state and household size.
5. In Section 3, Required Certifications, you will provide initials in the designated areas to certify your information. Ensure that you understand the requirements and acknowledge the penalties for providing false information.
6. Lastly, complete the form by signing and dating it. Save your changes, then download, print, or share the completed form as needed.

Complete your recertification form online today to ensure your Lifeline benefits continue without interruption.