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Get True Wireless Annual Lifeline Certification Form 2012-2024

Box) ___________________________________________ City _______________ State_______ Zip Code __________ I certify that I: do do not live on Tribal Land. This is my (check one): permanent address temporary address. Billing Address (if different) ___________________________________________ City:_______________ State:_______ Zip Code: _________ Multiple households sharing an address: I certify that I reside at an address occupied by multiple households, including adults who do not contribute .

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