Assurance Wireless Application Form Printable Assurance Wireless Application APPLICATION Questions Please Call 1 800 392 3850 1 PERSONAL INFORMATION For Partner use Only The person below MUST BE the same person applying for Lifeline service Please do not forget to sign the application in Section 3 First Name Last Name Last 4 digits of SSN Date of Birth mm dd yyyy
Be that of the person applying for Assurance Wireless service You MUST be at least 18 years of age to apply First Name Last Name Date of Birth mm dd Home Address Is this a temporary address Street Address yyyy Email If applicable Last 4 digits of Social Security Number Home Telephone Number If applicable Apt Online Application The online application is the most convenient way to apply for Assurance Wireless Follow these steps to complete the process Visit the Website Go to the official Assurance Wireless website and navigate to the application page
Assurance Wireless Application Form Printable
Assurance Wireless Application Form Printable
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Submitting Assurance Wireless Online Application Form
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The Affordable Connectivity Program ACP is an FCC benefit program that helps ensure that households can afford the broadband they need for work school healthcare and more For more information about the Affordable Connectivity Program go here and check out our FAQs on ACP and Lifeline Lifeline provides up to a 9 25 monthly discount on 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 In order to process your application you MUST SEND PROOF OF ELIGIBILITY DOCUMENTATION
Assurance Wireless phone to keep your FREE Lifeline service If you do not place a call send a text or go online using your plan data within 15 days of receiving a termination notice your Lifeline service will be terminated You will no longer be able to use your FREE Assurance Wireless Lifeline phone service and will need to re apply Complete Assurance Wireless Application Printable in just a couple of moments by simply following the instructions below Choose the template you require from the library of legal forms Select the Get form button to open it and begin editing Fill out all the requested fields these are marked in yellow
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Assurance Wireless Application Form Fill and Sign Printable Template Online US Legal Forms Assurance Wireless Application Form Get Assurance Wireless Application Form How It Works Open form follow the instructions Easily sign the form with your finger Send filled signed form or save assurance wireless rating 1 Paper Application If you prefer a traditional approach you can fill out a paper application form Simply download the application form from the Assurance Wireless website print it out and complete it with accurate information Make sure to fill in all the required fields to avoid delays in processing your application
Just follow these steps Fill out the California LifeLine Request Sheet making sure to include your mailing address and create an Account PIN and Secret Answer Mail it back to Assurance Wireless Watch your mailbox for a pink envelope the official California LifeLine Application Form from the California LifeLine Administrator 01 Edit your assurance wireless email address online Type text add images blackout confidential details add comments highlights and more 02 Sign it in a few clicks Draw your signature type it upload its image or use your mobile device as a signature pad 03 Share your form with others
How To Submit Assurance Wireless Application
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Assurance Wireless Application APPLICATION Questions Please Call 1 800 392 3850 1 PERSONAL INFORMATION For Partner use Only The person below MUST BE the same person applying for Lifeline service Please do not forget to sign the application in Section 3 First Name Last Name Last 4 digits of SSN Date of Birth mm dd yyyy
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Be that of the person applying for Assurance Wireless service You MUST be at least 18 years of age to apply First Name Last Name Date of Birth mm dd Home Address Is this a temporary address Street Address yyyy Email If applicable Last 4 digits of Social Security Number Home Telephone Number If applicable Apt
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Assurance Wireless Application Form Printable - Along with your application send a copy of 1 Your government issued photo ID or driver s license 2 An Eligibility Document IMPORTANT Documents must be dated within 12 months of application date Must be your documents Must show your name or your dependent s name
