Assurance Wireless Application Pdf New York
Assurance wireless is overseen by virgin mobile a sprint nextel subsidiary.
Assurance wireless application pdf new york. New york application ny999999999999xb. Lifeline is a federal. I move to a new address. I understand that the completion of this application does not constitute immediate approval for assurance wireless service.
You must place a check mark next to all 3 statements then sign and date. Lifeline is a government benefit program supported by the federal universal service fund. Assurance wireless is a federal lifeline assistance program brought to you by virgin mobile. To be eligible for assurance wireless service you or a member of your household must participate in a qualifying program listed in 2a or your household yearly income must meet the qualifications for lifeline assistance listed in 2b.
Important information about the lifeline program. So it is best to check your state s specific eligibility requirements before applying. If i do not respond to assurance wireless address veriﬁcation attempts within 30 days i may be de enrolled from assurance wireless service. These requirements change from time to time.
Assurance wireless is a lifeline supported service. I certify that i will inform assurance wireless within 30 days of any of the following and may be subject to penalties if i fail to do so. I move to a new address. I authorize assurance wireless to provide access to or release any records required for the administration of assurance wireless service.
As this goal pleases many interested participants assurance wireless on the other hand is glad to take part in this mission of financial support for those who need. If you need help completing the application or you want to apply over the phone you can call assurance wireless at 1 888 898 4888. The assurance wireless program for free government cell phones is delivering a new way of providing phone service among the low income americans who can t afford extra expenses on cell phone service. Turn over to complete.
Mail the application to. Assurance wireless po box 686 parsippany nj 07054 9726 or fax materials to. If your assurance wireless application is based on income eligibility you must provide a copy of last year s state or federal income tax return or three consecutive months of your most current pay stubs social security benefit statements veteran. The lifeline assistance program is available for only one wireless or wireline account per household.
Please note that in california the application is called a service request form but it asks for the same information and is just as fast and easy to complete. Eligible applicants will receive a free cell phone no fees charged what so ever and 250 free local and long distance cell phone minutes every month.
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