FCC FORM 5629 Lifeline Program Application Form-2026

1. Click ‘Get Form’ to open the FCC FORM 5629 in our platform.
2. Begin by filling out 'Your Information' section. Use capitalized letters and black ink. Provide your full legal name, phone number, date of birth, email address, and the last four digits of your Social Security Number (SSN). If you do not have an SSN, enter your Tribal Identification Number.
3. Next, complete your home address accurately. Ensure that you do not use a P.O. Box and indicate if you live on Tribal Lands.
4. If applying through a child or dependent, check the appropriate box and provide their full legal name, date of birth, and last four digits of their SSN.
5. In the 'Qualify for Lifeline' section, check all applicable government programs or indicate if qualifying through income. Follow the prompts to confirm household size and income eligibility.
6. Review the 'Agreement' section carefully. Initial next to each statement confirming your understanding and agreement before signing at the bottom of page 6.
7. Finally, submit your completed form by bringing or mailing it to the specified address provided in the instructions.

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