IN-PERSON RECERTIFICATIONS IMPORTANT NOTE: WE HAVE BEEN TEXTING CUSTOMERS IN NEED OF RE-CERTIFICATION, NOTIFYING THEM THAT THEY CAN RE-CERTIFY AT ANY LIFE WIRELESS RETAILER. OUR GOAL IS THAT WE WILL NOTIFY ALL 140 THOUSAND CUSTOMERS WITHIN THE NEXT FEW WEEKS. We are pleased to announce that the In-Person Re-certifications feature is live for all customers nationally. This feature will instantly create enormous opportunities for added commissions. The Re-Certification is a very simple process that begins when you take a short course in the Learning Management System (LMS): 1. Simply use your Portal ID and password to enter the LMS and take the In-Person Re-certification course. 2. Customers can re-certify at your Business Location and your commission will be $8.00 per customer. 3. The re-certification will include both a photo ID and subsidy proof upload. Failure to do so will result in no commission payout. 4. We are now sending text messages to your customers and other customers in your area to let them know that they can recertify at your location if you take the Recertification training course. 5. Ensure that you know how to re-certify by completing the LMS course first and referring to the attached procedure document with screenshots. After early adoption nationally, we will target specific zip codes on an individualized basis and direct customers to your exact locations. We are confident this feature will substantially increase your commissions, reduce failure-to-recertify disconnections, and create a valuable customer service experience.
Re-exert option can be found under the Re-certification J U,:1-xt
2. The recertifier will verify and confirm that the auto-populated customer information is correct: 3. The re-certifier will complete an electronic version of the form below based on the customer s responses: Annual Certification and Verification Form Telrite Corporation LIFE Wireless PO Box 2840 Covington, GA 30015 FAX: 1-866-770-6110 EMAIL: lwforms@lifewireless.com Call today for more information: 1-888-543-3620 Each year as a participant in the Lifeline program you are required by law to re -certify that you remain eligible to receive the Lifeline benefit. Re-certification will only take a few minutes but you must answer all of the below questions to retain service with Life Wireless and to continue receiving the Lifeline benefit. Lifeline is a government assistance program and willfully making false statements to obtain a Lifeline benefit may result in fines, imprisonment, de-enrollment or being barred from the program. Lifeline benefits are limited to a single line of service per household. 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. A household may not receive multiple Lifeline discounts. You may apply your Lifeline discount to either one landline or one wireless number, but you cannot have the discount on both and you cannot receive Lifeline benefits from multiple providers. Note that not all Lifeline services are currently marketed under the name Lifeline. Lifeline is a non-transferable benefit and you may not transfer your benefit to any other person, including another eligible low-income consumer. Violation of the one-per-household limitation constitutes a violation of the Federal Communications Commission s rules and will result in your de-enrollment from the program, and potentially prosecution by the United States Government.
I hereby certify, under the penalty of perjury, that I have read and understoodd the disclosures listed above and that, to the best of my knowledge, my household is not already receiving a Lifeline service benefit. I hereby authorize Life Wireless to access any records required to verify my statements and to confirm my eligibility for the Lifeline program. I also authorize Life Wireless to release any records required for the administration of the Lifeline (name, telephone number, address, date of birth, last 4 digits of SSN, amount of support being sought, means of qualification for support, and dates of service initiation and termination), to the Universal Service Administrative Company (USAC), to be used in a Lifeline database and to ensure the proper administration of the Lifeline Program. Failure to consent will result in denial of service. Check One I understand the above and agree I do not agree Customer Validation and Eligibility: The information you enter below must match the detail Life Wireless has on file as accumulated at the time of enrollment into the Lifeline program. First Name: Middle Initial: Last Name: Print the last four digits of your Social Security Number: Tribal ID number (if no Social Security Number): Date of Birth (DOB): Life Wireless Cell Phone # Street Address (no PO Box): Apt: City: State: ZIP Code: Is this a temporary address? Check One Yes No Billing address, if different from service address (may include Post Office Box) Street Address: City: State: Apt: ZIP Code: Do you reside on Tribal lands? Check One Yes, I hereby certify that I reside on Federally-recognized Tribal lands No PUERTO RICO RECERTIFICATIONS - Version 1.3 (Revised August 20, 2015) This document is intended for the recipient only. Any reproduction
Do you live at an address at which there are multiple households? (If yes is checked, you must complete a supplemental form to recertify your eligibility. Please contact Life Wireless) Check One Yes No 1) I meet the income-based or program-based eligibility criteria for receiving Lifeline service and have provided documentation of eligibility if required. I certify that I participate in at least one of the below programs: Check One: Supplemental Nutrition Assistance Program (SNAP) Section 8 Federal Public Housing Assistance (FPHA) Supplemental Security Income (SSI) Temporary Assistance for Needy Families (TANF) Low Income Home Energy Assistance Program (LIHEAP) National School Lunch Program s freee lunch program Food Distribution Program on Indian Reservations (FDPIR) Tribally Administered TANF (TATNF) t (meeting income qualifying standards) Print the name of the program OR I do not receive benefits, but my dependent or a member of my household does receive benefits from a program checked above. Full name of dependent or household member receiving benefits: I hereby certify under penalty of perjury that I (or my dependent or other member of my household) currently receive(s) benefits from the federal/state program(s) identified above or my annual household is at or below 135 percent of the Federal Poverty Guidelines. 2 ) I am 18 years of age or older. Check One Correct Not Correct 3 ) I will notify the Company within 30 days if for any reason I no longer satisfy the criteria for receiving Lifeline including, as relevant, if I no longer meet the income-based or program-based eligibility criteria, I begin receiving more than one Lifeline benefit, or another member of my household is receiving a Lifeline benefit. I understand that I may be subject to penalties if I fail to follow this requirement. PUERTO RICO RECERTIFICATIONS - Version 1.3 (Revised August 20, 2015) This document is intended for the recipient only. Any reproduction
4 ) Life Wireless may continue to monitor my participation in the identified federal/state program(s) for continued eligibility for Lifeline Program benefits. 5 ) I am not listed as a dependent on another person's tax return (unless over the age of 60). Check One Correct Not Correct 6 ) The address listed on my original application is my primary residence, not a second home or business. Check One Correct Not Correct 7 ) If I move to a new address, I will provide my new address to Life Wireless within 30 days. Check One Correct Not Correct 8 ) If I provided a temporary residential address to Life Wireless, I will verify my temporary residential address every 90 days. 9 ) I acknowledge that willfully making false statements or providing false or fraudulent information to receive Lifeline benefits is punishable by law and can result in fines, imprisonment, de-enrollment, or being barred from the program 10 ) I acknowledge that I may be required to re-certify my continued eligibility for Lifeline at any time, and my failure to re-certify as to my continued eligibility within 30 days will result in de-enrollment and the termination of my Lifeline benefits. 10 ) The information contained in this certification form is true and correct to the best of my knowledge. Signature: Date: Printed Name:
4. If each response is satisfactory to continue the process, a green line will appear next to the question once it is answered. If not satisfactory, a red line will appear and the process cannot be completed: 5. The customer will sign their name affirming that the responses they provided are true to the best of their knowledge:
6. The recertifier will then be required to take a photo of the customer s subsidy proof AND the customer s government-issued photo ID and upload it:
7. The recertification is now complete: