Page 15 - Oklahoma

Proof of Eligibility:
Guidelines and Examples

o A letter of participation or enrollment confirmation in a Tribal Head Start Program will
include the name of the child, who may be the consumer's dependent or a member of
the consumer's household.
o Head Start Program eligibility only refers to those households that have already met the
income-qualifying standard.
• Food Distribution Program on Indian Reservations (FDPIR)
Although the Food Distribution Program on Indian Reservations (FDPIR) is a federal program,
administered by the Food and Nutrition Service (FNS), award letters are generally provided by
either an Indian Tribal Organization (ITO) or another state agency.
o Valid documentation of participation in the FDPIR includes:
▪ Notice of Action (award letter) acknowledging eligibility for FDPIR benefits;
▪ FDPIR participation documents (e.g., a benefit card or copy of a benefit card); or
▪ Letter from the administering agency confirming participation in FDPIR.
o All award letters, or other official notices of eligibility, should include the following:
▪ Name of the beneficiary;
▪ The beginning and ending dates of the award or certification period; and
▪ The telephone number of the Food Distribution Program office, and the name
and address of the person to contact for additional information.
o The beneficiary named on the FDPIR documentation may be the consumer, the
consumer's dependent, or a member of the consumer's household.

Qualifying Through Child or Dependent:

• Consumers who are applying to Lifeline because their child or dependent is a Benefit Qualifying
Person (BQP) or is participating in a Lifeline qualifying program, should ensure documentation
provides information to complete all NLAD fields. A new validation, as of September 2017,
requires information for all BQP fields in NLAD.

Low Income Eligibility Guidelines and Acceptable Income Statements/Documents are listed below:

• Oklahoma Specific Federal Poverty Level Guidelines
• Most recent wage and tax statement or W-2
• Prior year’s personal tax return or Form 1040 with the consumers’ name and address
• Employer paycheck or pay stubs with the consumer’s name, address, and payment amount
• Benefit or statement letter issued by the SSA with the consumer’s name, address, claim number,
income, and effective date
• Benefit statement issued by the VA with the consumer’s name, address, and description of
benefit
• Retirement/pension statement with the consumer’s name, date, and payment amount
• Federal or Tribal notice letter of participation in General Assistance with consumer’s name and
effective date
• Unemployment/workers' compensation statement of benefits with the consumer’s name,
address, and effective date
• Divorce Decree, child support award, or other official document containing income information.

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Proprietary and Confidential 1/20/2020