Aristotle Lifeline Eligibility Certification Form

Once you have been approved for the Lifeline benefit and verified that you are in a location where Aristotle can provide the Lifeline discount, please read and complete the form below to allow the Lifeline discount to be applied to your Aristotle internet or phone service account.

Aristotle will submit your personal information, including the information below as well as your Lifeline start and end dates, service provided, and amount of discount, to the administrator of the Lifeline program to ensure its proper administration. Failure to provide truthful information and consent to transmit it will result in denial of your Lifeline benefit.

NOTE: This form is NOT an application for the Lifeline benefit. Learn about qualifications and apply for the benefit at: https://www.lifelinesupport.org

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Lifeline Eligibility Certification

Lifeline is a federal benefit and that willfully making false statements to obtain the benefit can result in fines, imprisonment, de-enrollment or being barred from the program;

Only one Lifeline service is available 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 is not permitted to receive Lifeline benefits from multiple providers;

Violation of the one-per-household limitation constitutes a violation of the Commission's rules and will result in the subscriber's de-enrollment from the program; and

Lifeline is a non-transferable benefit and the subscriber may not transfer his or her benefit to any other person.

By clicking the buttons next to each of the following statements below, I indicate my acknowledgement of them individually and under penalty of perjury:
Choose "I have read..." from the menu.
(If seeking Lifeline emergency communications support, you may enter a prior billing or residential address from within the past six months)
(if different from residence)
Enter the last four digits of your Social Security Number OR your Tribal Identification Number (if you are a member of a federally recognized tribe.)
Enter the phone number associated with service
Enter the email address associated with the service.
Enter the Number of Individuals in Household (if qualifying by income) OR the Name of the Social Program (if qualifying by program)
If someone besides the subscriber is the "Benefit Qualifying Person," please enter their information.

Helpful Links

Aristotle & Lifeline Discounts – Visit Aristotle's webpage about the Lifeline Program.

LifelineSupport.org – Learn more about the Lifeline Program at the official government website.

Lifeline Application – Find out if you qualify and apply for the Lifeline Program at the official government website. 

LifelineSupport@usac.org – Email the official government program with questions about the Lifeline Program—or reach out by phone at: (800) 234-9473 (toll-free)

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