Customers must enroll in Lifeline service and must provide proof of eligibility before receiving support. To apply for Lifeline support for the first time, please complete this application (Adobe Reader Required) and send it along with proof of your eligibility (for example, a copy of your SNAP or Medicaid card, an SSI award letter, last year’s tax return, three consecutive months of pay stubs, or any other documentation you have to prove eligibility) to firstname.lastname@example.org or mail to 11118 State Route 9 – PO Box 782 Champlain, NY 12919-0782. If you are completing an annual recertification for Lifeline support, please complete this recertification form and follow the same instructions as described above. We encourage you to contact us if you believe you qualify for this program. Please contact us at (518) 298-2411 (option 2) or come in and talk with one of our customer service representatives at our business office. We will work with you to answer any questions you may have.