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Get the free Camellia Lifeline Recertification Form - complies with USAC (00179391xAB3E9) (001793...

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HAYESVILLE FIBER TRANSPORT, INC. D/B/A CAMELLIA COMMUNICATIONS LIFELINE RATE ASSISTANCE RECERTIFICATION Assigned Telephone Number: Assigned Customer/Member/Account Number: CONTINUED ELIGIBILITY FOR
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To fill out the Camellia Lifeline recertification form, follow these steps:
02
Start by entering your personal information, such as your full name, address, and contact details.
03
Indicate your current employment status and provide any necessary documentation or proof.
04
Specify your household income and provide supporting documents like pay stubs or tax returns.
05
Complete the section regarding your household composition, including the number of family members and their relationship to you.
06
If applicable, provide information about any government assistance programs you are currently enrolled in.
07
Review the form for accuracy and completeness, making sure all required fields are filled out.
08
Sign and date the form to certify the information provided is true and accurate.
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Submit the completed form through the designated submission method, typically by mail or online.

Who needs camellia lifeline recertification form?

01
Individuals who are currently enrolled in the Camellia Lifeline program and need to renew their eligibility are required to fill out the Camellia Lifeline recertification form.
02
This form is specifically for existing program participants who need to provide updated information and certify their continued eligibility for the program.
03
The Camellia Lifeline program provides discounted telephone service to qualifying low-income households.
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The Camellia Lifeline recertification form is a document used to verify and update the eligibility of participants in the Camellia Lifeline program, ensuring they continue to receive necessary services.
Individuals who are currently enrolled in the Camellia Lifeline program are required to file the recertification form to maintain their eligibility for the services.
To fill out the Camellia Lifeline recertification form, participants need to provide personal information, confirm their eligibility criteria, and submit any required documentation that supports their application.
The purpose of the Camellia Lifeline recertification form is to ensure that all participants meet the ongoing eligibility requirements and to confirm their continued need for the services provided.
Participants must report personal identification details, proof of income, household size, and any changes in circumstances that may affect their eligibility.
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