Tools
See our worksheets and other resources to help you receive your benefit.
Forms
The Lifeline program Application, Household Worksheet, and Recertification Form are available in English and Spanish.
- Application Form – English
- Formulario de Aplicación – Español (Spanish)
- Household Worksheet – English
- Planilla de Hogar – Español (Spanish)
- Recertification Form – English
- Formulario de Recertificación – Español (Spanish)
Instructions
Instructions to complete the Lifeline program online and paper applications are available in English and 9 other languages.
Online Application Instructions
- Instructions – English
- Instrucciones – Español (Spanish)
- التعليمات – عربي (Arabic)
- 说明 – 简体中文 (Simplified Chinese)
- Instructions – Français (French)
- 지침 – 한국어 (Korean)
- Instruções – Português (Portuguese)
- Инструкции – русский (Russian)
- Mga tagubilin – Tagalog (Tagalog)
- Hướng dẫn – Tiếng Việt (Vietnamese)
Paper Application Instructions
- Instructions – English
- Instrucciones – Español (Spanish)
- التعليمات – عربي (Arabic)
- 说明 – 简体中文 (Simplified Chinese)
- Instructions – Français (French)
- 지침 – 한국어 (Korean)
- Instruções – Português (Portuguese)
- Инструкции – русский (Russian)
- Mga tagubilin – Tagalog (Tagalog)
- Hướng dẫn – Tiếng Việt (Vietnamese)
Survivor Benefit Online Application Instructions
- Instructions – English
- Instrucciones – Español (Spanish)
- التعليمات – عربي (Arabic)
- 说明 – 简体中文 (Simplified Chinese)
- Instructions – Français (French)
- 지침 – 한국어 (Korean)
- Instruções – Português (Portuguese)
- Инструкции – русский (Russian)
- Mga tagubilin – Tagalog (Tagalog)
- Hướng dẫn – Tiếng Việt (Vietnamese)
Survivor Benefit Paper Application Instructions
- Instructions – English
- Instrucciones – Español (Spanish)
- التعليمات – عربي (Arabic)
- 说明 – 简体中文 (Simplified Chinese)
- Instructions – Français (French)
- 지침 – 한국어 (Korean)
- Instruções – Português (Portuguese)
- Инструкции – русский (Russian)
- Mga tagubilin – Tagalog (Tagalog)
- Hướng dẫn – Tiếng Việt (Vietnamese)
Documentation Guidelines
Below is a list of acceptable documentation for the Lifeline Program. These document guidelines are available in English and Spanish.