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Get the free 2016 Lifeline Subscriber Certification Form - includes 12.02.16 FCC rules(00176729.D...

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NEW HOPE TELEPHONE COOPERATIVE, INC. LIFELINE RATE ASSISTANCE CERTIFICATION Assigned Telephone Number: Assigned Customer/Member/Account Number: ELIGIBILITY FOR LIFELINE ASSISTANCE IN ALABAMA IS DEPENDENT
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The lifeline subscriber certification form is a document that certifies an individual's eligibility to receive discounted phone service through the Lifeline program.
Individuals who wish to receive discounted phone service through the Lifeline program are required to file the lifeline subscriber certification form.
To fill out the lifeline subscriber certification form, individuals must provide their personal information, proof of eligibility, and sign and date the form.
The purpose of the lifeline subscriber certification form is to verify an individual's eligibility to receive discounted phone service through the Lifeline program and ensure compliance with program rules.
The lifeline subscriber certification form must include the individual's name, address, date of birth, last 4 digits of their social security number, and proof of eligibility such as income or participation in certain assistance programs.
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