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Lifeline Telephone Assistance Program
Proof of Eligibility

If you qualify for Lifeline based on income, you may be asked to provide proof of your income. The following documents are acceptable proof:

• Last year's state, federal or tribal tax return
• Current income statement from an employer or paycheck stub
• A Social Security statement of benefits
• A Veterans Administration statement of benefits
• A retirement/pension statement of benefits
• An Unemployment/Worker's Compensation statement of benefits
• A federal or tribal notice letter of participation in General Assistance
• A divorce decree, child support award or other official document containing income information

If the prospective subscriber presents documentation of income that does not cover a full year, such as current pay stubs, the prospective subscriber must present the same type of documentation covering three consecutive months within the previous 12 months.

If you qualify for Lifeline based on program-based eligibility, you may be asked to provide proof of your eligibility. The following documents are acceptable proof:

• The current or prior year's statement of benefits from a qualifying assistance program
• A notice or letter of participation from a qualifying assistance program
• Program participation documents
• An official document demonstrating that the prospective subscriber, one or more of the prospective subscriber's dependents, or the prospective subscriber's household receives benefits from a qualifying assistance program

Rev. 05/31/12