Lifeline

Forms

Prior Year Forms

Please note that these forms are provided as historical reference only and contain information, such as mailing addresses, that are no longer valid. Please see the Lifeline Program Forms page for accurate and up-to-date information and forms.

If you would like to submit or revise an FCC Form 555 for a previous data year, please select the appropriate form below and submit it to USAC via email.

FCC Form 497 (For Months July 2012 and Prior)

2008 FCC Form 497

Lifeline and Link Up Worksheet

2008 FCC Form 497 Instructions

FCC Form 555 (For 2015 Recertification Data)

2015 FCC Form 555

Filing due date was February 1, 2016

2015 Annual Lifeline Eligible Telecommunications Carrier Certification Form

2015 FCC Form 555 Instructions

FCC Form 555 (For 2014 Recertification Data)

2014 FCC Form 555

Filing due date was January 31, 2015

2014 Annual Lifeline Eligible Telecommunications Carrier Certification Form

2014 FCC Form 555 Instructions

FCC Form 555 (For 2013 Recertification Data)

2013 FCC Form 555

Filing due date was January 31, 2014

2013 Annual Lifeline Eligible Telecommunications Carrier Certification Form

2013 FCC Form 555 Instructions

FCC Form 555 (For 2012 Recertification Data)

2012 FCC Form 555

Filing due date was August 31, 2012

2012 Annual Lifeline Eligible Telecommunications Carrier Certification Form

2012 FCC Form 555 Instructions