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This document is for customers receiving Lifeline benefits in Tennessee to recertify their eligibility annually by providing necessary information.
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How to fill out lifeline recertification form

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How to fill out Lifeline Recertification Form

01
Obtain the Lifeline Recertification Form from your service provider or the Lifeline website.
02
Read the instructions carefully before filling out the form.
03
Provide your personal information, including your name, address, and phone number.
04
Include details about your current income or participation in qualifying government programs.
05
Sign and date the form to certify that the information provided is accurate.
06
Submit the completed form by mail, email, or online, as instructed.

Who needs Lifeline Recertification Form?

01
Individuals currently enrolled in the Lifeline program who need to renew their eligibility.
02
Participants who have experienced changes in their income or household status.
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The fastest and easiest way to renew is by phone. Simply call the LifeLine administrator at (877) 858-7463 and follow the prompts.
Updated November 2024. Lifeline Program Application (FCC FORM 5629) Instructions. Page 1: About the Lifeline Program. Lifeline is a federal government program of the Federal Communications Commission (FCC) that provides a monthly phone or internet service discount for qualifying low-income consumers.
1:43 3:08 Account you can login into your Assurance wireless account and if you see an annual renewal. OptionMoreAccount you can login into your Assurance wireless account and if you see an annual renewal. Option under the quick actions. Click it to start the reertification. Process provide the required.
Recertification is an annual requirement for Lifeline subscribers conducted to ensure that active subscribers are still eligible for the Lifeline benefit.
Lifeline offers simple systems for at-home and on-the-go use starting at $29.95 per month.
Lifeline is the FCC's permanent program to support affordable access to essential communications services such as broadband Internet access. The ACP is a new program designed to provide additional support to make broadband more affordable for certain low-income households.
Reverification utilizes several checks to ensure that existing subscribers are eligible for Lifeline. Automated Database Checks. If automated check fails Eligibility Databases. Requires proof of eligibility.

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The Lifeline Recertification Form is a document that individuals must complete to confirm their continued eligibility for the Lifeline program, which provides discounts on phone and internet services to low-income consumers.
All participants of the Lifeline program are required to file the Lifeline Recertification Form to maintain their benefits and ensure they still meet the eligibility criteria.
To fill out the Lifeline Recertification Form, applicants must provide accurate personal information, attest to their ongoing eligibility, and submit any required documentation that supports their claims, as per the guidelines provided by the Lifeline program.
The purpose of the Lifeline Recertification Form is to ensure that individuals receiving Lifeline benefits continue to qualify for the program, thus preventing misuse and ensuring that assistance goes to those who truly need it.
Information that must be reported on the Lifeline Recertification Form includes the participant's name, address, the date of birth, household income, and any other relevant eligibility criteria such as participation in qualifying assistance programs.
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