Affordableconnectivity wp-contentAffordable Connectivity Program Application (FCC Form 5645-2025

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The document is an application checklist for The Pink Fund, which provides financial assistance to individuals diagnosed with breast cancer. It outlines the required documents and forms needed for a complete application, including personal, medical, and financial information. The checklist emphasizes the importance of submitting a complete application by mail, as incomplete applications will not be funded. Additionally, it provides instructions for contacting The Pink Fund for assistance and details the processing timeline.

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What is considered income for the affordable connectivity program?

You are likely eligible if your households income is below 200% of the Federal Poverty Line, or if you or someone you live with currently receives a government benefit like SNAP, Medicaid, SSI, WIC, Pell Grant, or Free and Reduced-Price Lunch.

What documents should a consumer submit to prove they participate in a federal government program?

Document Examples Prior years state, federal or Tribal tax return. Current income statement from your employer or a paycheck stub. Veterans Administration statement of benefits. Unemployment or Workers Compensation statement of benefits. Federal or Tribal notice letter of participation in General Assistance.

What is income proof for ACP?

An issue date within the last 12 months ▪ Your prior years state, federal, or Tribal tax return. Current annual income statement from your job. A Social Security statement of benefits. An unemployment or workers compensation statement of benefits.

How do I get $100 off for a laptop with ACP?

One-time $100 Discount on Computers *One-time device discount requires a consumer co-payment of more than $10 and less than $50. **Device inventory will vary based on refurbished supply provided by recycling partners. Qualifying households are limited to one monthly service credit and one device discount.

How can a consumer qualify for the affordable connectivity program?

Who Is Eligible? of the Federal Poverty Guidelines, or if a member of the household meets at least one of the criteria below: or Lif eline; Participates in one of these assistance programs and lives on Qualifying Tribal lands: Check out fcc.gov/ACP for a Consumer FAQ and other program resources.

What is FCC Form 5645?

FCC Form 5645 is an application form for the Affordable Connectivity Program (ACP) that provides monthly internet service discounts and a one-time device benefit for qualifying low-income consumers. The form includes sections for personal information, identity verification, and household details.

How much is the ACP credit?

ACP applies to monthly charges for Internet service and mobile data usage and service fees. Qualified households will receive a total credit of up to $30/month toward Xfinity Internet service, including Internet Essentials, and/or Xfinity Mobile data usage and service fees.

What is proof of income for an Affordable Connectivity Program?

Current annual income statement from your job. A Social Security statement of benefits. An unemployment or workers compensation statement of benefits. A Federal or Tribal notice letter of participation in General Assistance.

Affordableconnectivity wp-contentAffordable Connectivity Program Application (FCC Form 5645-2025

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Got questions?

What is considered income for the affordable connectivity program?

What documents should a consumer submit to prove they participate in a federal government program?

What is income proof for ACP?

How do I get $100 off for a laptop with ACP?

How can a consumer qualify for the affordable connectivity program?

People also ask

What is FCC Form 5645?

How much is the ACP credit?

What is proof of income for an Affordable Connectivity Program?

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Affordableconnectivity wp-contentAffordable Connectivity Program Application (FCC Form 5645-2025

Here's how it works

The best way to modify Affordableconnectivity wp-contentAffordable Connectivity Program Application (FCC Form 5645 in PDF format online

See more affordableconnectivity wp-contentAffordable Connectivity Program Application (FCC Form 5645 versions

Complete this form in 5 minutes or less

Got questions?

What is considered income for the affordable connectivity program?

What documents should a consumer submit to prove they participate in a federal government program?

What is income proof for ACP?

How do I get $100 off for a laptop with ACP?

How can a consumer qualify for the affordable connectivity program?

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What is FCC Form 5645?

How much is the ACP credit?

What is proof of income for an Affordable Connectivity Program?

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