What is the ACP?

The ACP was created by Congress and implemented by the Federal Communications Commission (FCC) to help eligible households receive a subsidy of up to $30 a month, or up to $75 a month on Tribal Lands, towards internet service. 

Who is eligible to participate in the ACP?

You may be qualified for the program if:

• You, your child or dependent participate in certain government assistance programs, such as SNAP, Medicaid, WIC, or other programs.
• You’re a member of select Tribal Assistance programs.
• You, your child or dependent already receive a Lifeline benefit.
• You received a Federal Pell Grant in the current award year.
• You’re eligible based on your household income.

How do I enroll in the ACP?

• Step 1: Apply to qualify at ACPBenefit.org.
• Step 2: After your internet service has been activated, enroll here to have the subsidy applied to your bill.

Note: ACP is non-transferrable and limited to one monthly internet discount. ACP is a federal government benefit program operated by the Federal Communications Commission and, if it ends, or when a household is no longer eligible, customers will be subject to the provider’s regular rates, terms, and conditions.

Agreement

Please initial next to each statement and sign this form to finish the process.I certify, under penalty of perjury, that:I certify, under penalty of perjury, that:Initial

I (or my dependent or other person in my household) currently get benefits from the government program(s) listed on this form or my annual household income is 200% or less than the Federal Poverty Guidelines (the amount listed in the Federal Poverty Guidelines table on this form).Initial

I agree that if I move I will give my internet company my new address within 30 days.Initial

I understand that I have to tell my internet company within 30 days if I do not qualify for the ACP anymore, including:

1. I, or the person in my household that qualifies, do not qualify through a government program or income anymore.
2. Either I or someone in my household gets more than one ACP benefit.

Initial

I know that my household can only get one ACP benefit and, to the best of my knowledge, my household is not getting more than one ACP benefit. I understand that I can only receive one connected device (desktop, laptop, or tablet) through the ACP, even if I switch ACP companies. Initial

I agree that all of the information I provide on this form may be collected, used, shared, and retained for the purposes of applying for and/or receiving the ACP benefit. I understand that if this information is not provided to the Program Administrator, I will not be able to get ACP benefits. If the laws of my state or Tribal government require it, I agree that the state or Tribal government may share information about my benefits for a qualifying program with the ACP Administrator. The information shared by the state or Tribal government will be used only to help find out if I can get an ACP benefit.Initial

For my household, I affirm and understand that the ACP is a federal government subsidy that reduces my broadband internet access service bill and at the conclusion of the program, my household will be subject to the company’s undiscounted general rates, terms, and conditions if my household continues to subscribe to the service.Initial

All the answers and agreements that I provided on this form are true and correct to the best of my knowledge.Initial

I know that willingly giving false or fraudulent information to get ACP benefits is punishable by law and can result in fines, jail time, de-enrollment, or being barred from the program.Initial

The ACP Administrator or my service provider may have to check whether I still qualify at any time. If I need to recertify my ACP benefit, I understand that I have to respond by the deadline or I will be removed from the Affordable Connectivity Program and my ACP benefit will stop.Initial

I was truthful about whether or not I am a resident of Tribal lands, as defined in the “Your Information” section of this form. 

(If) you qualify for the Affordable Connectivity Program benefit!

Sign up with an internet provider within 3 months (US Eastern Time) to start receiving your benefit and obtain the one-time discount on a computer or tablet.