Lifeline

Forms

Carriers must file online.

FCC Form 481

File Online

FCC Form 481 Template

Carrier Annual Reporting Data Collection Form

FCC Form 481 Instructions

FCC Form 481 Upload Templates

*NEW* Lifeline Claims System

File Online (using E-File credentials)

2018 Data Months: Reimbursement Claims and Revisions

LCS User Guide

LCS Upload Validation Rules

FCC Form 497

Note: Do not use FCC Form 497 for data months in 2018 and later. Instead, use the Lifeline Claims System (available via NLAD).

For data months December 2016 to December 2017:
File Online
FCC Form 497
FCC Form 497 (editable)
FCC Form 497 bulk upload

Lifeline Worksheet

FCC Form 497 Instructions (updated 12/28/16)

FCC Form 497 Online Filing Instructions

Establishing User Entitlements

FCC Form 555 (For Recertification Data)

File Online

FCC Form 555 bulk upload

Annual Lifeline Eligible Telecommunications Carrier Certification Form

FCC Form 555 Instructions

Non-National Verifier Forms

Lifeline Application Form

One-Per-Household Worksheet

Recertification Form

SPANISH Lifeline Application Form

SPANISH One-Per-Household Worksheet

SPANISH Recertification Form

English and Spanish application forms, household worksheets, and recertification forms for non-National Verifier states.

National Verifier Forms

OFFICIAL National Verifier Application Form

OFFICIAL National Verifier One-Per-Household Worksheet

OFFICIAL National Verifier Recertification Form

The paper application, household worksheet, and recertification forms for use in National Verifier states (CO, MS, MT, NM, UT, WY)

Click here for Prior Year Forms