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This directory is under active review and may be incomplete. Confirm urgent details directly; No One Left Outside does not guarantee eligibility, availability, funding, acceptance, or placement.

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BenefitsOfficial formconditional

Lifeline Program Application Form

Official owner Federal Communications Commission / USAC

Apply for a phone or internet discount using the official online, mail or participating-company route.

What problem this helps solve

Apply for a phone or internet discount using the official online, mail or participating-company route.

Who completes it: The applicant or an authorized requester, as the official process allows.

What this does not prove

The agency determines acceptance, eligibility and processing; opening the route establishes none of those outcomes.

Dated source check

Official destination checked

The maintained official source was opened and read on September 30, 2026; access is distinct from acceptance or eligibility.

Last checked Sep 30, 2026. A working link does not establish the current edition, suitability, agency acceptance, or service availability.

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Direct document

Before downloading, confirm the agency, form number, and revision date match the summary below.

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Use the official pathway

NOLO's preparation notes summarize the dated sources in this record. Follow the agency's official instructions and current edition when they differ.

1. Check that this route fits

Stage and purpose
Initial application
Who completes it
The applicant or an authorized requester, as the official process allows.
Jurisdiction
United States (federal program)
Application mode
Online; Paper by mail; Company-assisted

2. Prepare before starting

  • Choose initial application rather than recertification.
  • Check one-benefit-per-household rules and any requested proof with USAC.

Documents named by the source

  • Follow USAC requests for proof of program participation, income or identity; use its documentation guide rather than assuming every document is required.
  • The application asks for a physical home address separately from a mailing address. Do not substitute a PO Box for the physical home address.
Fees and fee waivers
Application charge UNKNOWN on examined instructions; company service/device charges remain separate.
Account
Online account route; use paper or participating-company help if account access is a barrier.
Appointment
No appointment route established for USAC mail/online application; confirm any company visit.
Signature
Paper: initial the agreement statements and sign/date page 6. NOLO does not supply initials or a signature.
Third-party certification or assessment
Unknown — confirm any certification, referral, or assessment with the official owner.

3. Follow official submission instructions

Read official instructions
  • Online through the maintained application link
  • Participating phone/internet company assistance
  • Mail completed paper application to Lifeline Support Center, PO Box 1000, Horseheads, NY 14845

4. Get help or an accommodation

Languages: English and Spanish forms; instructions in ten languages on the maintained Tools page.

Accessibility: External accessibility conformance has not been tested by NOLO.

5. Know the supported next step

  • After qualifying, choose a participating company and sign up for service; approval is not device delivery.

Restrictions and unresolved details

  • Month precision: displayed February 1 represents the printed February 2026 edition, not a stated effective day.
  • NOLO does not collect identity numbers, make a household determination or complete the Safe Connections Act survivor section.

The agency determines acceptance, eligibility and processing; opening the route establishes none of those outcomes.

PDF filling support

PDF with fillable fields. Checked 2026-10-05. Signature support and agency acceptance still need confirmation.

Continue with your journey

Return to the connected step to decide what to do next. Opening this record does not complete that step or submit an application. If the official route is unavailable, use the assistance options above or browse help in the journey.

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Form record

Adds to a private plan in this browser tab. Nothing is sent to the provider, and nothing is applied for.

Official title
Lifeline Program Application Form
Form number
FCC 5629
Program
Lifeline
Jurisdiction
United States (federal program)
Revision / edition
Feb 2026
Who completes it
The applicant or an authorized requester, as the official process allows.
Signature
Paper: initial the agreement statements and sign/date page 6. NOLO does not supply initials or a signature.
Submission methods
Online through the maintained application link, Participating phone/internet company assistance, Mail completed paper application to Lifeline Support Center, PO Box 1000, Horseheads, NY 14845
Supporting documents
  • • Follow USAC requests for proof of program participation, income or identity; use its documentation guide rather than assuming every document is required.
  • • The application asks for a physical home address separately from a mailing address. Do not substitute a PO Box for the physical home address.
Languages
English and Spanish forms; instructions in ten languages on the maintained Tools page.
Accessibility
External accessibility conformance has not been tested by NOLO.

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  • • Read the agency’s privacy and consent language before entering personal information.
  • • Save a confirmation or reference number if one is provided.
  • • If a page asks for payment unexpectedly, stop and confirm the fee with the agency.

Source note: The agency determines acceptance, eligibility and processing; opening the route establishes none of those outcomes.

NOLO does not process this form, receive your answers, decide eligibility, or represent the agency. A destination check does not confirm current funding, acceptance, or an outcome.

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