Affordable Connectivity Program Opt in

Lifeline program participants are eligible to participate in the Affordable Connectivity Program.

The Easy Wireless FREE Lifeline & ACP plan includes unlimited voice, text and data with hotspot capability.

By filling in your name and clicking the button to Opt-In, you are electronically signing this application. This electronic signature has the same legal validity as your handwritten signature.

For more information about the ACP Program visit https://myeasywireless.com/affordable-connectivity-program/ or call us at 611 or 888-792-0076.

Lifeline and the Affordable Connectivity Program (ACP) are separate programs. Lifeline benefits may be combined with ACP benefits and applied to the same service plan. You may also apply Lifeline and ACP benefits to different service plans. You do not need to enroll in Lifeline in order to enroll in ACP and you do not need to enroll in ACP in order to enroll in Lifeline. You may choose to get Lifeline and ACP 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 benefits and an eligible Easy Wireless service plan and will not be used for any other purpose. ACP benefits are subject to verification of eligibility by Easy Wireless and the National Verifier.

ACP services are subject to availability and Easy Wireless’s Terms and Conditions and Policies available at https://myeasywireless.com/terms-of-use/

ACP Disclosures, Authorizations and Certifications[1]

The Affordable Connectivity Program (ACP) is a government benefit program operated by the Federal Communications Commission (FCC) that provides discounts on monthly broadband Internet access service and certain connected devices. For more information about the ACP and program eligibility requirements, call us at 1-877-476-3451 or visit https://MyEasyWireless.com/affordable-connectivity-program/.

ACP discounts can be applied to any available Easy Wireless service plans at the same terms available to households that are not eligible for ACP 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 https://MyEasyWireless.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 htps://MyEasyWireless.com/acp-only-plans.

Easy Wireless’s complete Terms and Conditions, including the Acceptable Use Policy, Privacy Policy and ACP Terms and Conditions, are available at https://MyEasyWireless.com. You agree that your service will be activated upon submission of this application form and completion of the eligibility verification and enrollment process.

ACP monthly service and one-time device discounts are not transferrable to other households or individuals. ACP benefits may be obtained from any participating provider of your choosing.

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. Devices available for ACP discounts are listed at https://MyEasyWireless.com.

Eligibility for the ACP, including Tribal benefits, is determined by the National Verifier and National Lifeline Accountability Database, administered by the Universal Service Administrative Company (USAC).

If the FCC announces the end of the ACP, we discontinue our ACP service offers, you transfer your ACP benefits to another provider, or we determine your household is no longer eligible, we will notify you and you will revert to receiving the standard FREE Lifeline plan where available and if you are enrolled in Lifeline with Easy Wireless and remain eligible. You may keep your service plan by paying the applicable undiscounted rate plus applicable fees and taxes.

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

You authorize EASY Wireless and its contracted partners, including EASY Insurance Plans, LLC, to collect, use, share, and retain your personal information, including but not limited to information required for the purpose of establishing eligibility for and enrolling in the ACP, or waste/fraud/abuse prevention, and including, but not limited to, full name, full residential address, date of birth, last four digits of social security number, phone number, eligibility criteria and status, the date on which any ACP service and/or device discount was initiated and if applicable, terminated, device information, 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. Failure to provide consent will result in being denied ACP connected device and service benefits.

You (or your dependent or other person in your household) currently get benefits from the government program(s) listed on this form or your annual household income is 200% or less than the Federal Poverty Guidelines.

You agree that if you move you will give EASY Wireless your new address within 30 days.

You understand that you have to tell EASY Wireless within 30 days if you do not qualify for the ACP anymore, including: (1) you, or the person in your household that qualifies, do not qualify through a government program or income anymore; (2) either you or someone in your household gets more than one ACP benefit.

You know that your household can only get one ACP benefit and, to the best of your knowledge, your household is not getting more than one ACP benefit. You understand that you can only receive one connected device (desktop, laptop, or tablet) through the ACP, even if you switch ACP companies.

You know that willingly giving false or fraudulent information to get ACP benefits is punishable by law and can result in fines, jail time, de-enrollment, or being barred from the program.

The ACP Administrator or your service provider may have to check whether you still qualify at any time. If you need to recertify your ACP benefit, you understand that you have to respond by the deadline or you will be removed from the ACP and your ACP benefit will stop.

You were truthful about whether or not you are a resident of Tribal lands in this enrollment.

Easy Wireless service is a prepaid service offered by the company to subscribers eligible for ACP discount benefits in states where it is authorized to do so. To maintain your service and benefits, you must personally activate the service by placing a call, initiating data usage, or by responding to instructions from Easy Wireless to activate the service. To keep your account active, you must use the service at least once during any 30-day period by completing an outbound call, sending a text message, using cellular data, purchasing additional service from Easy Wireless, answering an in-bound call from someone other than Easy Wireless, or by responding to a direct contact from Easy Wireless confirming that you want to continue receiving service from Easy Wireless. If your service goes unused for 30 days, you will no longer be eligible for Lifeline benefits and your service may be suspended (allowing only 911 calls and calls to the Easy Wireless's customer care center) 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, keep your telephone number and remain enrolled in the ACP.

You understand that new ACP enrollments have been suspended by the FCC as of February 8, 2024. By certifying below, you agree that if and when new ACP enrollments are permitted by the FCC, you consent to enroll in ACP with EASY Wireless.

I hereby certify that I have read, understand and consent to the disclosures listed above regarding the ACP benefits. I also understand that new ACP enrollments have been suspended by the FCC as of February 8, 2024, but if and when new ACP enrollments are permitted by the FCC, I consent to enroll in the ACP with EASY Wireless.

I agree that if I receive a connected device discount from EASY Wireless as part of the ACP, I will pay a minimum of $10.01 and a maximum of $49.99 for the connected 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 Benefit Transfer Consent

A subscriber already enrolled in the ACP with another provider must consent to the transfer of their ACP benefit to EASY Wireless.

The effect of an ACP benefit transfer is that your ACP benefit will be applied to EASY Wireless’ ACP service and will no longer be applied to service retained from your former ACP service provider. You may lose service or be subject to your former ACP 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 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.

I hereby certify that I have read, understand and consent to the disclosures listed above regarding the ACP benefit transfers and consent to and authorize EASY Wireless to transfer my current ACP benefit to EASY Wireless, if I am found to already be receiving an ACP discount benefit from another ACP provider.

Additional Disclosures, Consents and Certifications

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. I understand that willfully making false statements to obtain benefits may result in fines, imprisonment, de-enrollment, or being denied benefits.

Consent to Receive Communications

I authorize and give express consent to being contacted via email, telephone, or text messaging, including calls or messages using an automated telephone dialing system, manually, or with pre-recorded/artificial voice messages. EASY Wireless may contact me for service-related, informational or marketing purposes, including for offers from EASY Wireless affiliates, including EASY Insurance Plans, LLC via these methods. I also provide express consent to be contacted, regardless of whether my number is listed on the Do-Not-Call Registry or a state equivalent registry. Consent to such contacts is not a condition of service and may be revoked at any time. Consent for emails, calls and texts is optional and can be revoked at any time by dialing 611 from my EASY Wireless provided wireless number or by calling 1-888-792-0076 and revoking consent. However, I understand that opting out will not affect EASY Wireless’s ability to contact me with free notices and messages regarding my wireless service and devices and my Lifeline and/or ACP benefits via the methods listed herein. For more information, see the Terms and Conditions at https://myeasywireless.com/terms-of-use/ and Privacy Policy at https://myeasywireless.com/privacy-policy/.

I authorize and give express consent for EASY Wireless to use and share my Customer Proprietary Network Information (CPNI) for marketing purposes. I have a right, and EASY Wireless has a duty, under federal law, to protect the confidentiality of CPNI. CPNI is information made available to EASY Wireless solely by virtue of EASY Wireless’s relationship with me that relates to the type, quantity, destination, technical configuration, geolocation data, and amount of use of the telecommunications services I purchase from EASY Wireless, as well as information related to the billing for those services. CPNI does not include subscriber list information, such as name, postal address, or telephone number. I will continue to receive EASY Wireless communications services if I choose to not consent. CPNI is described in our Privacy Policy at https://myeasywireless.com/privacy-policy/. I may withdraw my consent at any time by using the contact information as described in the Privacy Policy.

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. Easy Wireless 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 1-877-476-3451.

Opt-In to ACP

[1] Completion of this form does not eliminate the need for the applicant to complete the National Verifier’s Standard ACP Application Form which is required.