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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 446 Bude MS 39630 Fax 601-384-5500 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 is the...
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