Page 11 - Indiana

Proof of Eligibility:
Guidelines and Examples

Proof of Eligibility Guidelines

The following programs and income qualifications are all acceptable proof of eligibility documents for
any customer wishing to apply for TruConnect LifeLine Wireless Service. When determining proof of
eligibility, the address listed on the customer’s eligibility document must match the state where the
customer is applying. Unlike proof of identity, proof of eligibility must show that the customer is a
resident of the state where they are applying to receive LifeLine wireless service.

Federal and State-Specific government assistance programs that may be used as proof of eligibility are
listed below:

• Federal Public Housing Assistance (FPHA)
o FPHA Housing Contract for a federal public housing property with the consumer’s name,
address, and lease dates
o Lease Agreement with the consumer’s name, landlord or owner, address, housing
assistance information, and lease dates
o Rent Change Notice with the consumer’s name, address, effective date, and housing
assistance information
o Owner’s Certification of Compliance with the consumer’s name, effective date, and
housing assistance information
• Medicaid
o Benefit approval or statement letter issued by the federal or state government, with the
consumer’s name, address, Medicaid/identification number, and eligibility dates
o Verification of Coverage letter issued by the federal or state government, with the
consumer’s name, address, Medicaid/identification number, and eligibility dates
o A Printout or screenshot from an online portal or website tool with the consumer’s
name, Medicaid identification number, eligibility dates, and date of when the site was
accessed
o Unexpired Medicaid card with the consumer’s name, Medicaid identification/card
number
o Unexpired health care card with the consumer’s name, indication of Medicaid
participation
• Supplemental Nutrition Assistance Program (Food Stamps or SNAP)
o Benefit approval letter issued by the federal or state government with the program
name, consumer’s name, case/identification number, and eligibility dates or current
participation status
o Benefits statement or letter issued by the federal or state government with the
consumer’s name, program name, case/identification number, and eligibility dates or
current participation status
o Verification of Coverage letter issued by the federal or state government with the
program name, consumer’s name, case/identification number, and eligibility dates or
current participation status
o A Printout or screenshot from an online portal or website tool with the program name,
consumer’s name, case/identification number, eligibility dates, and date site accessed

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Proprietary and Confidential 1/20/2020