Get Cox Lifeline

Filling out the Cox Lifeline application is an important step in securing discounted phone services for eligible users. This guide will help you understand each section of the application to ensure a smooth and efficient process.

Follow the steps to complete your Cox Lifeline application.

1. Press the ‘Get Form’ button to access the Lifeline application form and open it in your preferred editor.
2. Enter your full name in the designated field. Make sure to use your legal name as it appears on official documents.
3. Provide your permanent or temporary address. Note that you cannot use a P.O. Box. Fill in your city, state, and zip code accurately.
4. Input your home phone number and driver's license number, if applicable.
5. If your billing address differs from your home address, please complete that section with the same information, ensuring it includes your city, state, and zip code.
6. Review the important disclosures regarding Lifeline rules and penalties for violations.
7. Answer yes or no to the questions regarding your current status as a Cox customer and whether this will be your only Lifeline service.
8. Select whether you wish to elect toll restriction and indicate your choice.
9. Provide consent for the National Lifeline Accountability Database by confirming the required information with your initials.
10. Choose your eligibility basis by selecting either 'program-based' or 'income-based' participation under eligibility requirements.
11. If applicable, check each qualifying government program you or a household member participate in. If choosing income-based, complete the income and household information fields.
12. Attach proof of eligibility documentation that supports your selection from the previous step.
13. Read and affirm the certification statements in the application by providing your initials and finishing with your signature, date of birth, and Social Security Number.
14. Once completed, you can save changes, download, print, or share the filled form as needed.

Complete your Cox Lifeline application online today to benefit from essential phone services.