Assurance Wireless Application Pdf Nj
Enrollment is available to individuals who qualify based on federal or state specific eligibility criteria.
Assurance wireless application pdf nj. You must place a check mark next to all 3 statements then sign and date. Assurance wireless is a federal lifeline assistance program brought to you by virgin mobile. This application is for review for the safelink wireless government assistance plan which can get a qualified recipient up to 250 anytime minutes a free cell phone and a texting plan. The lifeline assistance program is available for only one wireless or wireline account per household.
Turn over to complete. Signed and completed lifeline application. Safelink wireless is the second biggest lifeline assistance cell phone provider in the united states serving more than 4 000 000 customers in 37 states one of which is new jersey. Lifeline is a government benefit program supported by the federal universal service fund.
We would like to show you a description here but the site won t allow us. Assurance wireless po box 686 parsippany nj 07054 9726 to qualify your household yearly income for your household size must be within the ranges listed below. I understand that the completion of this application does not constitute immediate approval for assurance wireless service. I authorize assurance wireless to provide access to or release any records required for the administration of assurance wireless service.
Click to visit online application eligibility by program. Assurance wireless application author. Application checklist please provide the following. 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.
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. Send in your application with the proof of eligibility from section 2 fax to. Click to visit site online application. Assurance wireless services available.
A household is one or more individuals who live together at the same address. Assurance wireless po box 686 parsippany nj 07054 9726 or fax materials to. The printable safelink application can be printed from any standard inkjet or laser jet printer and can be mailed or faxed for review. If applying based on program eligibility a copy of a program identification card or other social service agency documentation showing current participation.
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