Assurance Wireless Application Pdf New York
Mail the application to.
Assurance wireless application pdf new york. 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. I move to a new address. If you sign up with assurance wireless and your application is approved you receive a cell phone free of charge and a basic plan of 250 free voice minutes local or long distance domestic and unlimited text messages each month. Assurance wireless is overseen by virgin mobile a sprint nextel subsidiary.
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. 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. Lifeline is a federal. Assurance wireless is a lifeline supported service.
I understand that the completion of this application does not constitute immediate approval for assurance wireless service. Enrollment is available to individuals who qualify based on federal or state specific eligibility criteria. 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. 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.
Important information about the lifeline program. I authorize assurance wireless to provide access to or release any records required for the administration of assurance wireless service. I move to a new address. 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.
Assurance wireless po box 686 parsippany nj 07054 9726 or fax materials to. Turn over to complete. If i do not respond to assurance wireless address veriﬁcation attempts within 30 days i may be de enrolled from assurance wireless service. The lifeline assistance program is available for only one wireless or wireline account per household.
Assurance wireless the fastest growing provider of free government cell phones offers service in new york. So it is best to check your state s specific eligibility requirements before applying. 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. You must place a check mark next to all 3 statements then sign and date.
These requirements change from time to time. New york application ny999999999999xb.
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