Lifeline Household Worksheet
The Lifeline Household Worksheet asks three simple questions about your household. You must complete and submit the Lifeline Household Worksheet using one of the methods below.
Lifeline is a government program that provides a monthly discount on home or mobile telephone services. Only ONE Lifeline account is allowed per household. Members of a household are NOT permitted to receive Lifeline service from multiple providers.
Please read the definition of a household by downloading and completing the worksheet below.
Click the button below to download the Household Worksheet.
Download Household Worksheet
You must submit your completed worksheet by using one of the following methods:
- Email: firstname.lastname@example.org
- Fax: Toll-Free: 1-855-837-5465
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