Fcc form 5631-2026

The FCC Form 5631 is a Household Worksheet for the Lifeline Program, which provides a discount on phone or internet service for eligible low-income households. The form helps determine if multiple households reside at the same address and outlines the criteria for qualifying for Lifeline benefits. It defines what constitutes a household, explains shared income and expenses, and includes a decision tree to assess eligibility. Additionally, it emphasizes the one-per-household rule and requires applicants to submit this worksheet along with their Lifeline application.

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Click ‘Get Form’ to open FCC Form 5631 in the editor.
Begin by entering your full legal name in the designated fields. Ensure that you use the name as it appears on official documents.
Next, provide your home address where you will receive service. Avoid using a P.O. Box and include all necessary details such as apartment number, street name, city, state, and zip code.
Follow the decision tree provided in the form to determine if you qualify for Lifeline. Answer each question carefully regarding your living situation and financial sharing with other adults.
Initial the agreement section confirming your understanding of the one-per-household rule and sign and date the worksheet at the bottom before submission.

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