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The Federal Lifeline Program is an FCC benefit program that provides eligible low-income households with a monthly service discount and a connected device discount. Each household is limited to one Lifeline benefit per month from one service provider.
By signing this authorization, you are requesting to enroll in the Lifeline benefit program through Image Access Inc.. Image Access Inc. will provide support for Lifeline services and enable you to use these benefits on their plans.

One Benefit Per Household: Lifeline is a federal benefit, and willfully making false statements to obtain the benefit can result in fines, imprisonment, de-enrollment, or being barred from the program.
Household Definition: A household is defined, for purposes of the Lifeline program, as any individual or group of individuals who live together at the same address and share income and expenses.
One-Per-Household Limitation: Only one Lifeline service is available per household. A household is not permitted to receive Lifeline benefits from multiple providers. Violation of this limitation constitutes a violation of the Commission's rules and will result in the subscriber's de-enrollment from the program.
Non-Transferable Benefit: Lifeline is a non-transferable benefit, and the subscriber may not transfer his or her benefit to any other person

You allow Image Access Inc. and its contracted partners to:Collect, use, share, and retain your personal information for the purpose of applying for, determining eligibility, enrolling in, and seeking reimbursement under the Federal Lifeline service benefit program.
Provide your personal information to the Universal Service Administrative Company (USAC) to ensure the proper administration of Lifeline program services and/or connected devices.
Your consent to these terms is to enroll in the Lifeline benefits provided by Image Access Inc.. Failure to provide this consent will prevent your enrollment in the Lifeline program.Certification: You hereby certify that:You have read and understand the disclosures provided in this document regarding Lifeline benefit enrollment. You authorize Image Access Inc. to enroll you in the Lifeline program. You understand that your eligibility for Lifeline benefits is for this authorization to take effect.

By signing this document, you agree to the terms and conditions outlined above. You will be asked to provide proof of eligibility for the Lifeline program. Providing false information to receive Lifeline benefits is punishable by law.