Disclosure of Affordable Connectivity Benefits Transfer

Disclosure of Affordable Connectivity Benefit Transfer
In some cases, an application may have been submitted under a name/person OTHER than the one listed above. Please list the benefit-qualifying person's (BQP) info below?

Maximum file size: 516MB

Please check the box below to confirm your understanding that:

1. You are enrolled in a government program that reduces your broadband Internet bill by $30 per month.

2. You may obtain broadband service supported by the ACP Program from any participating provider of your choosing.

3. You may transfer your ACP Program benefit to another provider at any time.

4. By submitting this form you agree to allow ATC Communications to submit this information to USAC to verify and confirm your eligibility.

Consent Time