Forms
Service providers must file all FCC forms electronically. Paper forms are for reference only.
Consumers and subscribers may complete online or paper forms.
Service Providers: Disbursements
| Lifeline Claims System
File online (use E-File credentials) Due Date |
Who Must File
Service providers participating in the Lifeline program |
Service Providers: Annual Filings
| FCC Form 481 File onlineDue Date July 1 |
Who Must File
High Cost and Lifeline service providers |
| FCC Form 555
Due Date |
Who Must File
All Lifeline service providers to report recertification and non-usage Learn more |
Consumers
| Lifeline Application (Form 5629)
Lifeline Application Due Date |
Who Must File
Lifeline eligible consumers |
| Recertification Form (Form 5630)
Recertification Form Due Date |
Who Must File
Lifeline subscribers (if USAC cannot verify their eligibility) |
| Lifeline Household Worksheet (Form 5631)
Lifeline Household Worksheet Due Date |
Who Must File
Lifeline eligible consumers who live at the same address as a Lifeline subscriber if the consumer is the only person in their household receiving the Lifeline benefit |
The eligibility verification process varies slightly in the National Lifeline Accountability Database (NLAD) opt-out states (California, Oregon, and Texas) and consumers in these three states may need to submit different forms.