Forms

Lifeline Application English  
Lifeline Benefit Transfer Authorization English  
Change Of Address English  
Annual Re-certification English Español

To obtain Life Wireless service potential subscribers must meet certain eligibility requirements such as receiving governmental assistance or a household income that is 135% or below Federal Poverty guidelines for a household of that size, or the percentage guideline for your state. The specifics of what determines a potential subscriber's eligibility are specific to each state. Life Wireless service is limited to one per household, and cannot be combined with any other :label offering.