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Name
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Last name
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Phone
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Email Address
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Date of Birth
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4 last SSN#
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I authorize Frontier and its contracted partners, for the purpose of applying for, determining eligibility, enrolling in and seeking reimbursement of the Affordable Connectivity Plan (ACP), to collect, use, share and retain my personal information, 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 ACP service 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 Universal Service Administrative Company (USAC) via entry into the National Lifeline Accountability Database (NLAD) to ensure proper administration of the ACP. Failure to provide consent will result in me being denied ACP benefits and service.
I agreed
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I agree to receive sms messaging updates regarding the status of my application.
I agreed
Submit