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Elegibility status

Application number

SUCCESSFULY VALIDATED

Congratulations! You qualify for the ACP program.

Please read carefully the contractual information on the next section and check every checkbox to proceed.

Elegibility status

Application number

IS PENDING

Your application is pending for approval because more information is needed.

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Error

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Transfer exception

It seems that you are already applied to the ACP Program. Select the ACP certification if you choose to transfer:

Improper Transfer
Operations Ceased
Rules Violation
Moved outside service area

1 Your Information

2 Address

3 Eligibility

4 Consent

5 Plan

6 Checkout

User Information

First Name

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Middle Name

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Last Name

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Email Confirmation

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Phone Number

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Date of Birth (MM/DD/YYYY)

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I have a SSN

I have a Tribal ID

I have an alternative ID

Last 4 digits of SSN

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Tribal ID

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I accept to be contacted by WirelessGo and my information to be stored for promotional purposes

Home Address

Address

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Apt / Unit

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Zip Code

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State

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City

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Add a different Mailing Address

Add a different Billing Address

Home Address will be used for mailing and billing address if not provided

Mailing Address

Address

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Apt / Unit

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Zip Code

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State

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City

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Billing Address

Address

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Apt / Unit

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Zip Code

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State

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City

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Qualifying programs

Medical assistance (Medicaid)
Food stamps
Household income
Supplemental security income (SSI)
Federal public housing
Tribal - Bureau of Indian Affairs General Assistance
Tribally-Administered Temporary Assistance for Needy Families (TTANF)
Tribal - Food Distribution Program on Indian Reservations (FDPIR)
Tribal - Head start (Income qualifying Only)
Veteran’s pension
Program Eligibility Approved by State Administrator
School Lunch/Breakfast Program
Federal Pell Grant
Special Supplemental Nutrition Program for Women Infants, and Children (WIC)
Substantial Loss of Income
This program is not currently accepted by ACP
Existing low income program
This program is not currently accepted by ACP

Public Housing Type

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School

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Who receives the benefit

Myself

Child or dependent in household

Child or dependent information

First Name

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Middle Name

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Last Name

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Date of Birth

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SSN

Tribal ID

Has an alternative ID

Last 4 digits of SSN

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Tribal ID

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Consent

0 of 12 certifications completed.

Please read carefully and check the

boxes bellow to provide your consent.

User Information

Full Name:

Email:

Phone:

Last 4 digits SSN or Tribal:

Date of Birth:

Home Address

Address:

City:

State:

Zip Code:

Mailing Address

Address:

City:

State:

Zip Code:

Billing Address

Address:

City:

State:

Zip Code:

Affordable Connectivity and Lifeline Program Enrollment Application

The Affordable Connectivity and Lifeline Program Enrollment Application The Affordable Connectivity Program (ACP) and Lifeline are separate programs. ACP benefits may be combined with Lifeline benefits and applied to the same service plan. You may also apply ACP and Lifeline benefits to different service plans. You do not need to enroll in ACP in order to enroll in Lifeline and you do not need to enroll in Lifeline in order to enroll in ACP. You may choose to get ACP and Lifeline services from different service providers. You may transfer your Lifeline and ACP services to another provider subject to certain regulatory restrictions.

Completion of this form is required. This form is used for the purpose of verifying your eligibility for and enrolling you in ACP and or Lifeline benefits and an eligible IPC service plan and will not be used for any other purpose. ACP/Lifeline benefits are subject to verification of eligibility by IPC and the National Verifier.

ACP /Lifeline services are subject to availability and IPC's Terms and Conditions and Policies available at www.ipc-llc.com.

You may obtain Internet access service supported by the ACP Program from any participating provider of your choice, and you may transfer your ACP Program benefit to another participating provider at any time. Only one ACP Program discount per household is permitted. You may not transfer your ACP Program discount to another person. You may be de-enrolled from the ACP Program if you receive the ACP Program discount from another provider. You may be disconnected from ACP-supported service after 90 consecutive days of nonpayment. You may file a complaint against your ACP benefit provider via the FCC consumer complaint center.

Service activation and usage requirement

IPC service is a prepaid service offered by the company to subscribers eligible for ACP and Lifeline discount benefits in states where it is authorized to do so. To maintain your service and benefits, you must personally activate the service by initiating data usage, or by responding to instructions from IPC to activate the service. To keep your account active, you must use the service at least once during a 30-day period by completing an outbound call, sending a text message, using cellular data, purchasing additional service from IPC, answering an in-bound call from someone other than IPC, or by responding to a direct contact from IPC confirming that you want to continue receiving service from IPC. If your service goes unused for 30 days, you will no longer be eligible for ACP benefits and your service is subject to a 15-day cure period during which you must use the service (as described above) in order to fully re-activate your service and remain enrolled in the ACP and or Lifeline Program.

I hereby certify that I have read and understood the disclosures listed above regarding activation and usage requirements.

ACP / Lifeline Disclosures, Authorizations and Certifications

The Affordable Connectivity Program (ACP) and Lifeline are government benefit programs operated by the Federal Communications Commission (FCC) that provides discounts on monthly voice and broadband Internet access service and certain connected devices. For more information about the ACP / Lifeline programs and the program eligibility requirements, call us at 1-888-224-6958 (Option 2) or visit www.ipc-llc.com.

Willfully making false statements to obtain the benefit can result in fines, imprisonment, de-enrollment or being barred from the program.

ACP and Lifeline benefits may be obtained from any participating provider of your choosing and your monthly service benefit may be transferred to another provider no more than once in a service month.

ACP and Lifeline discounts can be applied to any available IPC service plans at the same terms available to households that are not eligible for ACP or Lifeline supported services. Upload/download speeds will be determined by your particular service plan, and other factors, including your device, network availability from our underlying carrier, your proximity to cellular towers, and environmental factors may affect speeds, as described in our Broadband Transparency Disclosure at www.ipc-llc.com. A complete listing of our plans, including plans that are fully covered (no co-pay after application of the ACP discount), is available at www.ipc-llc.com.

IPC's complete Terms and Conditions, including the Acceptable Use Policy, Privacy Policy and ACP/Lifeline Terms and Conditions, apply and are available at www.ipc-llc.com.

ACP/ Lifeline monthly service and one-time device discounts are not transferrable to other households or individuals.

An eligible household is limited to one monthly service discount and a single one-time device discount.

An eligible household does not have to purchase an ACP discounted connected device in order to enroll in the ACP and receive monthly service discounts. Tablets available for ACP discounts are listed at www.ipc-llc.com.

Eligibility for the ACP/Lifeline enrollment is determined by the National Verifier and National Lifeline Accountability Database, administered by the Universal Service Administrative Company (USAC), or an alternative verification process approved by the FCC.

Your ACP discount benefit is separate from your Lifeline discount benefit. Your household can receive only one ACP benefit and one Lifeline benefit. Your ACP benefit can be separate or combined with your Lifeline benefit, depending on your choice and the service plan you choose. Lifeline participants may maintain their existing Lifeline services without enrolling in the ACP and may choose to take ACP benefits from another service provider.

If the FCC announces the end of the ACP, or we discontinue our ACP service offers, or you transfer your ACP benefits to another provider, or we determine your household is no longer eligible, you will be notified. You may keep your service plan by paying the applicable undiscounted rate plus applicable fees and taxes.

If you select a plan that is not fully covered by applicable discounts and requires monthly post-payments (IPC does not offer any such plan at this time), IPC may disconnect your ACP or Lifeline supported service after 90 consecutive days of non-payment.

A household may file a complaint against an ACP/ Lifeline service provider via the FCC's Consumer Complaint Center.

Completion of this form does not eliminate the need for the applicant to complete the National Verifier's Standard ACP/Lifeline Application Form which is required.

I hereby certify that i have read and understood the disclosures listed above regarding the ACP/Lifeline benefits and consent to enroll in the ACP and or Life program with ICP.

If I am seeking to qualify for ACP and or Lifeline benefits as an eligible resident of Tribal lands, I certify that I live on Tribal lands, as defined in FCC rule 47 C.F.R 54.400(e).

I acknowledge that I am providing the information I have included in this form to IPC and further authorize IPC to receive and use my information for enrollment verification and waste, fraud, and abuse mitigation purposes. I also authorize IPC to receive and use my historic Emergency Broadband Benefit, ACP and or Lifeline enrollment information for verification and waste, fraud, and abuse mitigation purposes.

I authorize IPC and its contracted partners, for the purpose of applying for, determining eligibility, enrolling in and seeking reimbursement of ACP and or Lifeline service and connected device benefits, to collect, use, share, and retain my personal information, including but not limited to information required for purpose of establishing eligibility for and enrolling in the ACP and or Lifeline programs, and including, but not limited to, full name, full residential address, date of birth, last four digits of social security number, telephone number, eligibility criteria and status, the date on which the service discount was initiated and if applicable, terminated, usage status and other compliance requirements, the amount of support being sought for the service, and information necessary to establish identity and verifiable address. This information may be shared with USAC to ensure proper administration of the ACP / Lifeline programs. Failure to provide consent will result in me being denied service in the discounted programs and connected devices benefits.

I agree that any state, local, Tribal government, school, or school district, may share information about my receipt of benefits that would establish eligibility for the ACP and or Lifeline program, and that such information will be used only to determine program eligibility.

I certify that if I receive a connected device discount from ICP as part of the ACP, I will pay a minimum of $10.01 and a maximum of $49.99 for the device and that, to the best of my knowledge, no one in my household has received a connected device discount from any service provider through the ACP or the Emergency Broadband Benefit program.

ACP/Lifeline Benefit Transfer Consent

A subscriber already enrolled in the ACP or Lifeline program with another provider must consent to the transfer of their ACP and or Lifeline benefit to IPC.

The effect of an ACP and or Lifeline benefit transfer is that your ACP and or Lifeline benefit will be applied to IPC program services and will no longer be applied to service retained from your former ACP and or Lifeline service provider. You may be subject to your former ACP/Lifeline provider's undiscounted rates as a result of the transfer if you elect to maintain service from that provider.

You are limited to one ACP and one Lifeline benefit transfer transaction per service month, with limited exceptions for situations where a subscriber seeks to reverse an unauthorized benefit transfer or is unable to receive service from a specific provider.

After receiving and reviewing the foregoing required disclosure, I consent to and authorize IPC to transfer my current ACP benefit to IPC, if I am found to already be receiving an ACP discount benefit from another ACP provider.

After receiving and reviewing the foregoing required disclosure, I consent to and authorize IPC to transfer my current Lifeline benefit to IPC, if I am found to already be receiving an Lifeline discount benefit from another Lifeline provider.

ACP Discounted Connected Tablet Purchase Election:

I hereby confirm that want to purchase and receive an APC discounted connected device from IPC.

Certification of Truth and Correctness Under Penalty of Perjury:

By checking this box, I hereby certify, under penalty of perjury, that the information included in the foregoing applications and certifications is true and correct to the best of my knowledge.

E-sign Certification:

I consent to use of this electronic form. I understand I have the right to enroll in the service using non-electronic methods. I further understand that I have the right to withdraw this consent at any time prior to the activation of my service. IPC has advised me and I understand that I may request a paper copy of my contractual terms and associated fees or withdraw this consent by calling 1-888-224-6958 ( Option 2).

Select your Plan

Free IPhone at Month 6

Checkout

Application ID # 123456789

User Information

Full Name:

Email:

Phone:

Last 4 digits SSN or Tribal:

Date of Birth:

Home Address

Address:

City:

State:

Zip Code:

Billing Address

Address:

City:

State:

Zip Code:

Product

ACP Tablet

(One time payment) $12

Total

$

Once submitted, your order usually is delivered within 7 to 10 business days.

Payment

Card Number

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Name on the card

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CVV

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Expiration Date

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Billing Address

Select one from the available addresses:

Home Address

Mailing Address

Billing Address

Add a new billing address

Zip Code

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State

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City

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Address

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Apt / Unit

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Your transaction was complete!

Your product will be delivered between 7 to 10 business days.

Once submitted, your order is typically delivered within 7 to 10 business days

Thank you for submitting your documents.

If you successfully submitted the required documentation, the validation process will be completed in the next few days. Please keep an eye on your email for any additional requirements.

Once your application is approved, you will receive a confirmation email to finalize the application process.

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Customer Service

Phone: 1-833-778-0321

E-mail: support@wirelessgo.com

Continued Service Disclaimer:

To retain FREE voice, text, and data, users must utilize the provided tablet at least once monthly, either through a phone call or text message.

Free iPhone Offer Disclaimer:

Qualification requires six months' continuous service and minimum monthly tablet use (at least one call or text). Upon qualification, a Free iPhone will be shipped to your account address. If the specified iPhone model is unavailable, WirelessGo reserves the right to offer a comparable device. By participating, you indicate adherence to our Terms of Service. The offer is non-transferable and subject to change; WirelessGo may amend or terminate this limited-time promotion.

Device Color Disclaimer:

Devices in the Affordable Connectivity Program (ACP) may vary in color due to availability. Participation implies acceptance of potential color variations. Refer to campaign terms or contact support for details.

Integrated Path Communications, LLC (IPC) is a service provider for the government-funded Affordable Connectivity Program (ACP). The ACP is a government benefit program operated by the Federal Communication Commission (FCC) that provides discounts on monthly broadband Internet access service and certain connected devices. The ACP provides discounts of up to $30 per eligible household on monthly broadband Internet access service (or up to $75 per eligible household on Tribal lands) and up to $100 on certain connected devices (with a required co-payment of between $10 and $50). ACP service and device discounts cannot be transferred to another household or individual. Eligible households are limited to one monthly service discount and one device discount. Rates and device discounts are available for QUALIFIED CUSTOMERS only. When the ACP ends or a customer/s household is no longer eligible, the customer/s will be subject to our regular undiscounted rates. For more information about ACP eligibility criteria, applicable terms and conditions, and the program visit www.wirelessgo.com (powered by IPC) or call us at IPC's ACP Support Number 833-778-0321(Toll-Free).

Terms & Conditions