Triangle Communications Lifeline Application





SECTION 1 - Applicant Information
The Applicant is the person who has telephone service with Triangle. 




SECTION 2 - Eligibility Information
I certify that I, my dependent, or my household receives assistance from at least one of the programs listed below, or that my total household income is at or below 135% of the Federal Poverty Guidelines.

2017 135% of the Federal Poverty Guidelines (annual household income before tax)
1 person up to $16,281 per year | 2 people up to $21,924 | 3 people up to $27,567 | 4 people up to $33,210  | 5 people up to $38,853  |  6 people up to $44,496  |  7 people up to $50,139  |  8 people up to $55,782 | Add $5,643 for each extra person











If you checked Total Household Income at or below 135% of federal poverty guidelines above, provide the number of people in your household.


SECTION 3 - Certification

Lifeline is a federal benefit that makes monthly telephone or broadband internet service more affordable for eligible households. Eligible households may apply the monthly Lifeline discount to either broadband internet service (home or wireless) or phone service (home or wireless) but not both. Your household may not receive the Lifeline benefit from more than one company. For the purpose of Lifeline, a household is an individual or any group of individuals who live together at the same address and share income and expenses. You may not transfer your Lifeline discount to another person, even if he or she is eligible. You may lose your Lifeline benefit and may be prosecuted by the United States government if you violate the one-per-household rule or otherwise make false statements to receive Lifeline.

The Lifeline discount will not be applied without proper proof.