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Applicants must certify participation in one qualifying public assistance program, select exactly one option, and provide copies of supporting documents with matching name and address. The form requires checkmarks, signature, date, and an e-signature affirmation under penalty of perjury, with rules about notifying changes within 30 days, one benefit per household, and non-transferability. 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Any discrepancies may delay approval or lead to rejection of service.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"Which programs can I select on the form?",{"text":114,"@type":110},"You must certify participation in at least one qualifying public assistance program and select exactly ONE program option from the list. Supporting documents must be provided as a copy.",{"name":116,"@type":107,"acceptedAnswer":117},"What happens if I provide false information or violate Lifeline rules?",{"text":118,"@type":110},"Providing false or fraudulent information is punishable by law. The form also states Lifeline is available for only one line per household, benefits are non-transferable, and willful violations can result in penalties or de-enrollment.","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},306516,1790357027,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":40,"category_name":41,"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":73,"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":9},5909892079670,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","# Section 1\n\nPlease make sure that you provide correct personal information.Your information will be validated against PublicPlease make sure that you provide correct personal information.Your information will be validated against PublicRecords and any discrepancies could result in delays in your application approval or rejection of service.Records and any discrepancies could result in delays in your application approval or rejection of service.  \n# Section 2\n\nI hereby certify that I participate in at least ONE of the following public assistance programs (select just ONE program):  \n□Low-Income Home Energy AssistanceProgram (LIHEAP)  \n□Medicaid  \n□Supplemental Nutrition Assistance Program(SNAP)Food Stamps  \nNational School Lunch Program's(froe lunch nrocram)(Tree luncn program)  \nSupplemental Security Income (SSI)  \n□Federal Public Housing Assistance (Section 8)  \nTemporary Assistance for NeedyFamilies(TANF)  \nYou must send a COPY of any current document that proves your participation in one of the programs previouslyselected.All documents must have the same name and address as provided in this application.  \nSafeLink is a Lifeline supported service.Lifeline is a federal benefi,and only eligible subscribers may enroll.Customers who willfully make false state-ments in order to obtain the benefit can be punished by fine or imprisonment or can be barred from the program.Lifeline is available for only one lineper household.A household is defined as any individual or group of individuals who live together at the same address and share income and expenses.A household is not permitted to receive Lifeline benefits from multile providers.Violation of the one-per-household rule constitutes a violation of FCCrules,and willresult in the Customer's deenrollment from Lifeline.Lifeline is a non-transferable benefit,and a Customer may not transfer his or herbenefit to another person.  \n# Section 3\n\nYou MUST place a check mark(√)next to each statement,then Sign and Date below(your application cannot beapproved without these items).  \nI certify under penalty of perjury to each of the following:  \n□1.I participate in the above designated qualifying program.  \n2.I understand that I must notify SafeLink within 30 days if l no longer participate in the qualifying program,ifl or another member of my household obtains Lifeline supported service from another carrier,or,for anyother reason,I no longer qualify for Lifeline support.  \n3.I understand I may be required to recertify my continued eligibility for Lifeline at any time,and failure to doso willresult in termination of my Lifeline benefits.  \n4.If I change my address,I will provide my new address to SafeLink within 30 days.  \n5.My household will receive only one Lifeline benefit and to the best of my knowledge,my household is notalready receiving a Lifeline service.  \n6.The information contained in this application is true and accurate to the best of my knowledge,and lacknowledge that providing false or fraudulent information to obtain Lifeline benefits is punishable by law.  \nChě @la^Aæe^Šj\\Áa^|·:     ][每caA^]i^·^}cea^A kKFED·^j ala&[·A^Ai[c&caR^aloaQ+i{ac}CPDAE [}-a{A^每aaj aA}*[每*Aaa输AaAl月^e·acj &^LCED88…每^A^&[la·A^a^aA A^laA^  \n·ce{^}cA@!^aLCDE I&[}-{A^[}^aAa aAal月^e·acj &LC DC A]aæeA ^aái^·  Aa]:[]^IA a*aaái^A{aelC Dt A:[ca^A^Aæ ^e]@}^A{a^|B aaaái^Ą A@Aya^·aAi^ica&Aa{aādaea^/O[{]a^gUOEDp@{adae 14A@AI[*la Dajai面e^}cAA@A¹][·再^a每*A@eic[A[CA^&^A[^A@g4}^Ya…^a每*A^Aacą ac}每A}^:[*Iaæc·A@eaaA ^A āAl月^e·ac]&E  \nBy signing below,I separately affirm and agree to each of the above statements.  \nPrinted Name  \nDate  \nApplicant Signature  \nE-Signature  \nReferred bv a Eriend  \nReferred By A Friend  \nCustomer's Last Name  \nSafeLink Phone Number  \nCustomer's First Name  \nPlease check this box if you would like to receive pre-recorded special offers for SafeLink Customers andpromotional offers from TracFone at the Home Telephone number provided in the Contact information.  \nPlease Return to  \nMail Application:S","cbCaiqj9oEj1XX7n","https://ap.wps.com/l/cbCaiqj9oEj1XX7n","pdf",258646,"English","# Section 1\n# Section 2\n## Qualifying programs selection\n## Lifeline eligibility rules\n# Section 3\n## Checkmarks and certifications\n## Signature, printing, and submission","[{\"question\":\"What information does the application require for SafeLink enrollment?\",\"answer\":\"The application requires correct personal information, which is validated against public records. Any discrepancies may delay approval or lead to rejection of service.\"},{\"question\":\"Which programs can I select on the form?\",\"answer\":\"You must certify participation in at least one qualifying public assistance program and select exactly ONE program option from the list. Supporting documents must be provided as a copy.\"},{\"question\":\"What happens if I provide false information or violate Lifeline rules?\",\"answer\":\"Providing false or fraudulent information is punishable by law. The form also states Lifeline is available for only one line per household, benefits are non-transferable, and willful violations can result in penalties or de-enrollment.\"}]","SafeLink by Program | PDF",1789837302]