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Main Page > English > Application Status
What is the Lifeline Certification Form?
The Lifeline Certification Form (an FCC requirement) allows you to agree to the conditions of receiving the Lifeline discount. You must provide all of the information requested on the form, such as name, address, social security number, and date of birth. You must also initial each of the certifications to indicate your understanding and agreement, and sign and date the form. These certifications state that:

      1. You meet the eligibility of the program

      2. You will notify the Texas Lifeline program within 30 days if you move to anew address

      3. You will notify the Texas Lifeline program within 30 days if you no longer meet the eligibility criteria of the

      4. Your household will only receive ONE Lifeline discount

      5. You consent to allow your personal information to be shared with USAC and/or its agents to verify that you
          are only getting one lifeline discount

      6. You may be required to re-certify for Lifeline at any time

      7. You certify that you qualify for Lifeline as an eligible resident of tribal lands & live on tribal lands (if applicable)

     ◦ You cannot transfer the Lifeline benefit to anyone else
     ◦ If you indicate that you are living at a temporary address, you are required to verify your address every 90 days
       (If applicable)
Article ID: 152 Article Created: 02-01-2014 21:25 PMLast Modified: 05-21-2019 08:59 AM

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