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LI Worksheet UniversalForms 2026

The document is a FCC Form 5631, a Household Worksheet for the Lifeline Program, which provides a benefit to reduce monthly phone or internet service costs for eligible low-income households. It outlines the definition of a household, eligibility criteria, and instructions for applicants to determine if they qualify for Lifeline benefits. The form requires personal information and includes a decision tree to assess eligibility based on shared income and expenses within the household.

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Click ‘Get Form’ to open the LI Worksheet UniversalForms in the editor.
Begin by entering your full legal name in the designated fields. Ensure you use capitalized letters and black ink, as specified.
Next, provide your home address. Make sure to include the street number, name, city, state, and zip code without using a P.O. Box.
Follow the decision tree regarding household composition. Answer each question truthfully to determine if you qualify for Lifeline benefits.
In the Agreement section, initial where required and sign and date the worksheet. This confirms your understanding of the one-per-household rule.

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