Oregon Lifeline Program Application and Information
This file provides important information about the Oregon Lifeline Program, including application details and eligibility requirements. It contains essential forms and instructions for low-income households seeking discounts on phone and internet services. The packet ensures compliance with federal and state regulations.
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How do I fill this out?
To fill out the form, start by gathering your personal information, including your legal name and Social Security number. Carefully follow the instructions provided on each page to complete the required sections. Ensure that all fields are filled out accurately to avoid delays in processing your application.

How to fill out the Oregon Lifeline Program Application and Information?
1
Gather necessary personal information.
2
Complete sections A, B, C or D, and E.
3
Provide the required documentation.
4
Review the form for accuracy.
5
Submit the completed form as instructed.
Who needs the Oregon Lifeline Program Application and Information?
1
Low-income households needing phone service discounts.
2
Individuals applying for high-speed internet assistance.
3
Families dependent on Supplemental Nutrition Assistance Program (SNAP) benefits.
4
People seeking to access the Oregon Lifeline program’s benefits.
5
Residents needing information on local utility services.
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What are the instructions for submitting this form?
To submit the completed form, mail it to the Oregon Public Utility Commission at PO Box 1088, Salem, OR 97308-1088. You can also fax your application to 877-567-1977. For email submissions, contact puc.rspf@puc.oregon.gov, and ensure all required documents are attached. Remember to keep a copy for your records before submitting.
What are the important dates for this form in 2024 and 2025?
The application for the Oregon Lifeline Program is available continuously. Ensure to check for updates on eligibility criteria as they can change annually. Important deadlines for application submissions are typically set at the end of each fiscal year, so stay informed.

What is the purpose of this form?
The Oregon Lifeline Program application is designed to assist low-income households in accessing affordable communication services. By completing this form, eligible individuals can obtain discounts on phone and internet bills, thereby enhancing their access to essential services. This program is critical in bridging the digital divide for those with limited financial means.

Tell me about this form and its components and fields line-by-line.

- 1. Applicant's legal name: The full legal name of the applicant is required.
- 2. Social Security Number: A valid Social Security number is needed for verification.
- 3. Date of birth: The applicant's date of birth must be provided.
- 4. Account number: This is the account number for the telephone or internet service.
- 5. Home address: The current residential address of the applicant.
What happens if I fail to submit this form?
Failure to submit this form may result in your inability to access the Oregon Lifeline discounts. Without the application, you could miss out on important savings on your phone and internet bills. The program is designed to assist eligible families, and not applying means losing potential benefits.
- Loss of Discounts: Not applying means you won't receive potential bill discounts.
- Inaccessibility to Resources: Missing out on the program can limit access to necessary communication services.
- Increased Financial Burden: Without the Lifeline support, eligible families may struggle with utility payments.
How do I know when to use this form?

- 1. Eligibility Check: Use the form to verify your eligibility for the Oregon Lifeline Program.
- 2. Discount Application: Submit this form to apply for discounts on communication services.
- 3. Service Provider Requirements: Fill out this form when required by your service provider.
Frequently Asked Questions
What is the Oregon Lifeline Program?
The Oregon Lifeline Program provides discounts on phone and internet services to qualifying low-income households.
How can I apply for the Lifeline discount?
You can apply by completing the Oregon Lifeline application form included in this file.
What information do I need to fill out the application?
You'll need your legal name, Social Security number, and details about your current service provider.
Are there any eligibility requirements?
Yes, you must meet certain low-income criteria to qualify for the program.
Can I edit the PDF form?
Yes, you can edit the PDF using our online editor before submitting.
How do I submit the completed form?
Follow the submission instructions included in this file.
Can I save my edits?
You can download the edited PDF after making changes, but saving is not available at this time.
What if I make a mistake on the form?
You can edit the PDF again to correct any errors before final submission.
Is electronic signing available?
Yes, you can sign the PDF electronically on our platform.
How do I ensure my application is processed quickly?
Fill out all required fields accurately and submit as instructed.
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