Online Application Form
Oregon Telephone Assistance Program

The Oregon Public Utility Commission (PUC) manages the Oregon Telephone Assistance Program (OTAP), also known as Lifeline. If you have active telephone service with a participating phone company (see list below), and receive one of the following qualifying benefits, this federal and state government assistance program reduces your monthly phone bill by $12.75.

  • Supplemental Nutrition Assistance Program; Food Stamps (SNAP)
  • Supplemental Security Income (SSI)
  • Temporary Assistance for Needy Families (TANF)
  • Certain State Medical Programs at or below 135% of the federal poverty guidelines
  • Medicaid

To apply for OTAP benefits:

  • Fill out the form below
  • Click the Submit button (by clicking the submit button you agree that you are electronically signing this online application)

Questions? Contact the PUC Monday through Friday from 9:00 a.m. to 4:00 p.m. at the following telephone numbers and e-mail address below:

Applicant's Name:
(* First) (Middle) (* Last)
   

* Name on Phone Bill:

Note: Applicant must have their name on the telephone bill. Please contact your telephone company to have your name added to the telephone bill. If your name is not on the telephone bill you will NOT be able to submit this form.
 
Is your name on the telephone bill?

 
* Applicant's Social Security # * Applicant's Date of Birth:
(Format: 123-12-1234) (Format: 01/01/1975)
     * Applicant's Phone Number:
* Applicant's Phone Company: (Format: 123-123-1234)

Note: List includes only participating phone companies. Some companies (e.g. MCI, Comcast, Verizon Wireless) do not participate.

Note: To receive OTAP you must have active telephone service with a participating phone company.
 
Applicant's Home Address:
(* Street)    
(* City)    
(* State)
(* Zipcode)

   
     
Applicant's Mailing Address:
(Choose Type)
(Street)   
(City)   
(State)
(Zipcode)   
 
Applicant's Email Address (username@host.domain):
(Format: john.doe@gmail.com)
Please re-enter your Email Address
By checking this box I agree to comply with all Oregon Lifeline rules (click here to read)
 

By submitting this application I certify under penalty of perjury that the information contained in this application is true and correct and that I meet the eligibility criteria for the OTAP/Lifeline benefit.

 
 
 
   

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