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For Office Use Only Type of Documentation Date Reviewed Reviewed by Lifeline Household Worksheet Yes No Date NLAD Queried. Inc. PO Box 168 New Augusta MS 39462 Fax 601-964-8317 Lifeline is a federal benefit that makes monthly telephone service more affordable for eligible households. If you answer no you may not receive Lifeline on this account. Yes transfer my Lifeline service No do not transfer my Lifeline service I do not currently have Lifeline SECTION 1 - Applicant Information Applicant...

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