Get FREE Wireless service Now!

1. Check Your Information

USAPhone Lifeline Program: Confirm Enrollment

Powered by American Broadband & Telecommunications Company, LLC (AMBT)

Step 1: Check Your Information

This information may be pre-filled from your earlier form. Please review carefully and make any corrections if needed.

Personal Identifiable Information (PII)

Residential Address (no PO Boxes)

Contact information:

Qualify through your income:

Or

Including you, how many people live in your household? (check one)
Is your income the same or less than the amount listed for your state and household size? (only check yes or no next to your household size)
All 48 States, DC, and Territories (not Alaska and Hawaii) Alaska Hawaii
$20,331 $25,394 $23,369
$27,594 $34,479 $31,725
$34,857 $43,565 $40,082
$42,120 $52,650 $48,438
$49,383 $61,736 $56,795
$56,646 $70,821 $65,151
$63,909 $79,907 $73,508
$71,172 $88,992 $81,864
Add $7,263 Add $9,086 Add $8,357
Click to add government ID ( not required )
Click here to add your Award Letter (Proof of Benefit).
Click to add Military ID ( not required )
Click to add Passport Photo( not required )
Click to add Taxpayer Identification Number ( not required )
Click to add Other Goverment ID ( not required )

Step 2: Acknowledgements

Each section below must be acknowledged to continue. Check each box to confirm you have read and understood the disclosures.

  • I consent to use of this electronic Application, Disclosures, Authorizations and Certifications . I understand I have the right to enroll in the service using non-electronic methods. I further understand that I have the right to withdraw this consent at any time prior to the activation of my service. AMBT has advised me and I understand that I may request a paper copy of my contractual terms and associated fees or withdraw this consent by calling 1-877-266-7212.
  • I acknowledge that I am providing the information in this form to CGM Solutions, Inc. (CGM) and authorize CGM to receive and use my information for enrollment verification and waste, fraud, and abuse mitigation purposes.
  • I authorize AMBT and its marketing and channel partners, including CGM, to collect, use, share, and retain my personal information as required for eligibility verification and enrollment in Lifeline. This includes full name, residential address, DOB, SSN4, telephone number, eligibility criteria and status, and related compliance data.
  • I understand this information may be shared with USAC. Failure to provide consent will result in denial of Lifeline benefits and service.
  • After reviewing the foregoing required disclosures, I consent to and authorize AMBT to transfer my current Lifeline benefit to AMBT, if I am found to already be receiving a Lifeline discount benefit from another Lifeline provider.
  • By checking this box, I hereby certify, under penalty of perjury, that the information included in this application is true and correct to the best of my knowledge.
  • I authorize and give express consent for AMBT and its marketing and channel partners to contact me to validate eligibility or subscription via email, telephone, or text message, including autodialed or prerecorded messages.
  • I understand I may revoke consent at any time by dialing 611, calling 901-251-0044, or replying STOP to a text message.
  • I understand opting out will not affect AMBT’s ability to contact me about Lifeline or service-related notices.
  • I authorize and give express consent for AMBT to use and share my Customer Proprietary Network Information (CPNI) for marketing purposes.
  • I understand I may withdraw consent at any time and will still continue to receive AMBT services. To withdraw call (our lifeline number)
  • I hereby certify that I have read and understood the disclosures listed below regarding activation and usage requirements.
  • I hereby certify that I have read and understood the disclosures listed below regarding Lifeline benefits and consent to enroll in Lifeline with AMBT.

Step 3: E-Signature

Please type your full legal name to electronically sign this application.

Date: 10272025

2. Acknowledgements

3. Signature/Submit