"Lifeline - How Do I Fill Out the Application?" Transcript

Once you have the application form—either you printed it or received it in the mail—you're ready to fill it out.

Please take special care when filling out the application. All necessary parts of this application must be filled out completely. Incomplete forms will be denied, and you'll have to start all over with a new application.

So let's begin.

Step 1: Personal Information

Step 1 asks for your personal information. Please be sure to print all information clearly on the form, starting with your first name, middle name or initial, and last name. For this part of the form, it's best to write your name exactly as it appears on your phone bill.

The next line asks for your service address. It's important to give us your actual home address and not a P.O. Box. If your service address includes an apartment number, room number, floor, or even bed number (for those living in a nursing facility), please be sure to include it. Also, make sure to include your city, state, and zip code. Never leave the Service Address box empty.

The next line asks for your billing address. If the address where you receive your bills is different than your service (or home) address, then you need to complete this part of the form. But if your service address and billing address are the same, you can skip this part. If your billing address is different from your service address it's best to fill in this part of the form exactly as it shows on your phone bill. In other words, give us the same address where you receive your phone bill currently. And be sure to include your city, state, and zip code.

On the next line, check the box if your service address is a temporary address. You should check "temporary address" if you are in a temporary living situation and expect to move to a permanent address in the future.

The next box asks for your date of birth. Be sure to use two digits for the month, two digits for the day, and four digits for the year. For example, if you were born on January 1st 1945, you would write 01/01/1945.

The next box asks for your Frontier telephone number or account number. This will be the telephone number or account number that matches your phone bill and it must be in your name. If you are a broadband-only customer (that is, you only have internet access with Frontier and not traditional voice or telephone service), your account number will be listed on your bill. A telephone number will be 10 digits [XXX-XXX-XXXX]. An account number will include 7 additional digits [XXX-XXX-XXXX-XXXXXX-X].

The next box on this line asks for an alternate telephone number where you can be reached if we cannot reach you on your primary line.

The last line in the Personal Information section asks for the last 4 digits of your social security number (unless otherwise indicated on your state’s application) or your Tribal identification number if you are an eligible resident of Tribal lands and applying for Tribal Lifeline. We also provide a box that must be checked if you are an eligible resident of Tribal lands and you are applying for Tribal Lifeline. This option is not available in every state. So if you don’t see a box to check for Tribal Lifeline, it means that it’s not available in your state.

Step2: Eligibility

Step 2 of the Lifeline application identifies your eligibility. You must complete either Part 1 or Part 2, but not both.

Program-based Eligibility: For Part 1, if you participate in one of the government assistance programs listed on the application, simply check the box next to the program name. If you participate in more than one of the programs, check only one of the boxes because you need only participate in one program to be eligible for the Lifeline program. You must provide proof of your program participation by sending a copy of the benefit statement, notice letter of participation in a qualifying program, program participation documents, or other official participation document for the program you checked in Part 1. Benefit cards are accepted as proof of program participation, but if the effective date on the card is more than a year old, you will need to show another form of program participation with your Lifeline application.

Remember, you must check the box next to the program you participate in and then include the proof for that program with your application or your application will be considered incomplete.

If you mail your application to us, please send only photocopies as originals will not be returned.

You may provide proof of program participation in the name of someone who is a member of your household (and is living with you) so long as that person is not already receiving Lifeline benefits from Frontier or another company. In this case, be sure to check the box next to the words "I certify that..." and then fill in the name, date of birth, and last 4 digits of his or her social security number (or Tribal ID) for the person whose name is on the proof document.

Income-based Eligibility: Even if you or any member of your household does not participate in one of the government assistance programs listed on the application, you may still be eligible for the Lifeline program if your annual income is below the level listed on the application for the number of members living in your household. In this case, check the box next to the number "2". You must provide proof of income by sending a copy of one of the following documents:

  • Your most recent state, Federal, or Tribal tax return
  • Current income statement or W-2 from an employer
  • Paycheck stub
  • Social Security statement of benefits
  • Veterans Administration statement of benefits
  • Unemployment or Workers' Compensation statement of benefits
  • Federal or Tribal notice letter of participation in General Assistance
  • Divorce decree
  • Child support award
  • Other legal documents that show your total current household income.

If your documentation does not cover a full year of income, you must provide the same type of documentation covering 3 consecutive months within the previous 12 months, such as 3 consecutive months of pay stubs.

Bank statements are not accepted. Please send only photocopies as originals will not be returned.

Be sure to include the number of people living in your household in the appropriate box. If you live alone, the number would be one. If you live with a spouse or domestic partner and no other children or adults, the number would be two. Remember, a household is anyone who lives together at your address and shares in the income and expenses of the household (including children and people who are not related to you).

If you live in Arizona or Michigan, you may be eligible for a Senior discount as well. If you meet the age requirements, check the box for a Senior discount. If you check the Senior Discount box, you must provide proof of age, such as a copy of your driver's license, state ID, or birth certificate, along with the application paperwork.

Step 3: Transfer Consent

Initial this line if you authorize Frontier to transfer any pre-existing Lifeline discount with another carrier to your Frontier account. By initialing this line, you acknowledge that any pre-existing Lifeline discount with another carrier will cease when this transfer becomes effective. Please be aware—a telephone discount may not be transferred if it has been transferred in the last 60 days and an internet discount may not be transferred if it has been transferred in the last year.

Step 4: Signature

The final part of the application is Step 4, the signature section. It's very important that you initial each line in this section. If any line is not initialed, the application will be denied and you'll need to resubmit an entirely new, complete Lifeline form and proof of program participation or income. You must also sign and date the application. If the form is not signed and dated, it will be rejected... so please don't forget to complete this part of the application.

If the form is submitted by a legally authorized representative of the applicant, the legally authorized representative must include his or her name, daytime phone number, signature and date of the signature on the form. In addition, the authorized representative must provide a Power of Attorney or other documentation of authority to represent the applicant with the completed application.

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