EXAMPLES OF ACCEPTABLE PROOF OF PROGRAM PARTICIPATION
Federal
Programs
Not all inclusive


Proof in General


All award letters should contain the following basic information:
o Name of program
o Name of beneficiary
o Address of beneficiary
o Date of award


IS NOT a Federally recognized Lifeline program.
However, SSDI may be used for income verification purposes. Please ensure you
complete the income portion of the application and provide proof of income.

SSI Statement of Benefits should contain:
o Name of program
o Name of beneficiary
o Address of beneficiary
o Date of award
o Award amount
A bank statement that clearly shows SSI was deposited in the applicant’s account, may be
accept as proof of SSI; however, not as income.
An SSI benefit check stub from the Social Security Administration may also be submitted
as proof of participation, if the check stub clearly states the date and name of the
beneficiary.
National School
Lunch Program
(NSLP)
Social Security
Disability
Insurance (SSDI)
SSI:



All award letters should contain the following basic information:
o Name of program
o Name of beneficiary
o Address of beneficiary
o Date of award

Medicaid award letters should clearly state the following:
o Name of program
o Name of beneficiary
o State of residence
o Issued or effective date
We cannot accept any Medicaid that has a spend-down amount.
Low Income Home Energy Assistance Program (LIHEAP) is administered by a wide range
of local agencies; the program’s name may vary by state.
The award letter will include the following:
o Name of program
o Date of award
o Name of beneficiary
o Award amount
A utility bill that reflects the Housing Assistance credit.
o The utility bill should clearly reflect inclusion of an Energy Assistance credit.
Temporary
Assistance for
Needy Families
(TANF)
Medicaid:



LIHEAP:


SNAP:
Proof should be dated within the last 12 months.
Social Security statements are not proof of program participation. Social Security is not a
program recognized for Lifeline benefits. However, Social Security Income statements may
be acceptable proof of Income eligibility.
Proof must have the recipient’s name, address and effective dates of award.
All award letters should contain the following basic information:
o Name of program
o Name of beneficiary
Copyright © CenturyLink 2013. All Rights Reserved. (cgilstr – 03.01.13)
o
o
Address of beneficiary
Date of award


SC8:
Income
The document must state that the applicant is receiving HUD or Section 8.
An Award Letter. The award letter should include the following information:
o Name of program
o Date of award
o Name of beneficiary
o Award amount
 A Public Housing Assistance Lease Agreement or a Section 8 Voucher. These items
should clearly reflect the type of Public Housing Assistance credit issued.
Any Income documentation provided to prove Income level must display dollar amounts
that can be used to figure Annual Income.
 Last year's Federal or State Income Tax Return
 Current Annual Income Statement from Employer
 Social Security Statement of Benefits
 Veteran's Administration Statement of Benefits
 Retirement or Pension Statement of Benefits
 Unemployment or Worker's Compensation Statement of Benefits
 Letter of Participation in General Assistance
 Divorce Decree or Child Support Documentation
 Paycheck stubs or other official document containing income information for any three
consecutive months within the last twelve months
 Must include number of members in the household.
NOTE: If the documentation relied on does not cover a full year, such as a end of year pay stub or
income statement, the subscriber must present the same type of documentation covering three
consecutive months within the previous twelve months.
Tribal
Programs
Bureau of Indian
Affairs General
Assistance
Not All Inclusive



Tribally
Administered
Temporary
Assistance to
Needy Families
(TANF)
Head Start
Food Distribution
Program on
Indian
Reservations
(FDPIR)
An award letter from the national or regional BIA office.
A benefit check stub from the BIA if it clearly states:
o Date of Award
o Name of beneficiary
Program Name (BIA General Assistance)

All award letters should contain the following basic information:
o Name of program
o Name of beneficiary
o Address of beneficiary
o Date of award

A letter of participation or enrollment confirmation in a tribal Head Start Program will include
the name of the child.




Notice of Action (award letter) acknowledging eligibility for FDPIR benefits
FDPIR benefit card
Letter from the administering agency confirming participation in FDPIR
All award letters, or other official notices of eligibility, should include the following:
o Name of beneficiary;
o The beginning and ending dates of the award or certification period;
o The telephone number of the Food Distribution Program office, and the name and
address of the person to contact for additional information.
Copyright © CenturyLink 2013. All Rights Reserved. (cgilstr – 03.01.13)