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The document explains what a household is, how shared income and household expenses are counted, and how eligibility is assessed when another adult at the address may already receive Lifeline. 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Your answers help determine whether there is more than one qualifying household at your address.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"How does the worksheet define a household?",{"text":114,"@type":110},"A household is a group of people who live together and share income and expenses, even if they are not related. If people share money, they count as one household.",{"name":116,"@type":107,"acceptedAnswer":117},"What happens if someone in your household already gets Lifeline?",{"text":118,"@type":110},"You do not qualify for Lifeline because the rule allows only one Lifeline discount per household. If you break this limit, you will lose your Lifeline benefit.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},305500,1790418166,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":79,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":73},1236954509970,"https://us-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","FCC FORM 5631  \nLifeline Program  \nHousehold Worksheet  \nOMB APPROVAL EDITION 3060-0819 Avg. Burden Est. per Respondent: .25 hours  \nAbout Lifeline  \nLifeline is a Federal Communications Commission (FCC) program that provides a monthly phone or internet service discount for qualifying low-income consumers.  \nWhat this worksheet is for  \nUse this worksheet if someone else at your address gets the Lifeline benefit. The answers to these questions will help you find out if there is more than one household at your address.  \nWhat is a household?  \nA household is a group of people who live together and share income and expenses (even if they are not related to each other) . Complete the Lifeline household worksheet to determine if more than one qualifying household is located at your address. If more than one person in your household participates in Lifeline, you are breaking the FCC’s rules and will lose your benefit.  \nExamples of one household:  \n• A married couple who live together are one household. They must share one Lifeline benefit.  \n• A parent/guardian and child who live together are one household. They must share one Lifeline benefit.  \n• An adult who lives with friends or family who financially support him/her are one household. They must share one Lifeline benefit.  \nExamples of more than one household:  \n• 4 roommates who live together but do not share money are 4 households. They can have one Lifeline benefit each, 4 total.  \n• 30 seniors who live in an assisted-living home but do not share money are 30 households. They can have one Lifeline benefit each, 30 total.  \nHousehold expenses  \nA household shares expenses. Household expenses include, but are not limited to, food, healthcare expenses, and the cost of renting or paying a mortgage on your place of residence and utilities.  \nIncome  \nHouseholds share income. Income includes salary, public assistance benefits, social security payments, pensions, unemployment compensation, veteran’s benefits, inheritances, alimony, child support payments, worker’s compensation benefits, gifts, and lottery winnings.  \nPage 1 of 4 [Universal Service Administrative Company |](Universal Service Administrative Company | www.lifelinesupport.org)[ www.lifelinesupport.org](Universal Service Administrative Company | www.lifelinesupport.org)  \nNeed help? Call the Lifeline Support Center at 1-800-234-9473  \nFCC FORM 5631  \nLifeline Program  \nHousehold Worksheet  \nOMB APPROVAL EDITION 3060-0819  \nYour  \nInformation  \nAll fields are required unless indicated. Use only CAPITALIZED LETTERS and black ink to fill out this form.  \n\n| What is your full legal name?\u003Cbr>The name you use on official documents, like your Social Security Card or State ID. Not a nickname.\u003Cbr>First\u003Cbr>Middle (optional) Suffix (optional)\u003Cbr>Last\u003Cbr>What is your home address? (The address where you will get service. Do not use a P.O. Box)\u003Cbr>Street Number and Name |  |\n| --- | --- |\n| Apt., Unit, etc.\u003Cbr>State Zip Code | City |\n\nPage 2 of 4 [Universal Service Administrative Company |](Universal Service Administrative Company | www.lifelinesupport.org)[ www.lifelinesupport.org](Universal Service Administrative Company | www.lifelinesupport.org)  \nNeed help? Call the Lifeline Support Center at 1-800-234-9473  \nFCC FORM 5631  \nLifeline Program  \nHousehold Worksheet  \nOMB APPROVAL EDITION 3060-0819  \nCan you apply?  \nFollow this decision tree to confirm if you qualify for the Lifeline Program.  \n1. Do you live with another adult?  \nAdults are people who are 18 years old or older, or who are emancipated minors. This can include a spouse, domestic partner, parent, adult son or daughter, adult in your family, adult roommate, etc.  \nYes  \nIfyes, answer question 2  \nNo  \n2. Do they get Lifeline?  \nYes  \nIfyes, answer question 3  \nNo  \n3. Do you share money (income and expenses) with them?  \nThis can be the cost of bills, food, etc., and income. If you are married, you should check yes for this question.  \nYes No  \nYou do not qualify ","cbCaidrUKIZ6xExi","https://ap.wps.com/l/cbCaidrUKIZ6xExi","pdf",193426,"English","# About Lifeline\n# What this worksheet is for\n# What is a household?\n# Household expenses\n# Income\n# Your information\n# Can you apply?\n# Agreement\n# Notice","[{\"question\":\"What is the purpose of FCC Form 5631 Lifeline Household Worksheet?\",\"answer\":\"It is used when someone else at your address already receives the Lifeline benefit. Your answers help determine whether there is more than one qualifying household at your address.\"},{\"question\":\"How does the worksheet define a household?\",\"answer\":\"A household is a group of people who live together and share income and expenses, even if they are not related. If people share money, they count as one household.\"},{\"question\":\"What happens if someone in your household already gets Lifeline?\",\"answer\":\"You do not qualify for Lifeline because the rule allows only one Lifeline discount per household. If you break this limit, you will lose your Lifeline benefit.\"}]","FCC FORM 5631 - Lifeline Program - Household Worksheet | PDF",1789825476]