CCPA Data Management Request

If you are a California resident and would like to exercise your rights under the CCPA, please fill out the form below.  We may request additional information from you to verify that you are a consumer about whom we have collected personal information.

Please note that we will retain any information as required by local, state, and federal law as well as FCC/USAC Lifeline regulatory compliance. Contact us at 1.866.488.8719 for more information.

  ID Guidelines

  • U.S. Driver License
  • Certificate of U.S. Citizenship
  • Certificate of Naturalization or Citizenship
  • U.S. Passport/U.S. Territory Passport
  • Foreign Passport
  • U.S. government, military, state or Tribal issued-ID, which includes date of birth and/or Social Security Number and/or Tribal ID
  • U.S. Military ID cards (active or reserve duty, dependent of a military member, retired member, discharged from service, medical/religious personnel)
  • Common Access Card (only if designated as Active Military or Active Reserve or Active Selected Reserve)
  • Military Discharge documentation, which includes date of birth and/or Social Security Number and/or Tribal ID
  • Northern Mariana Card
  • Permanent Resident Card
  • Permanent Resident Alien Card
  • Permanent Resident Re-Entry Permit
  • Temporary Resident Identification Card
  • Employment Authorization Card
  • Mexican Consular Card (Matricula Consular - 2006, 2014, 2015 and later versions)

 

*All forms of ID must be valid and used before expiration date.

Qualify by income and provide one of the following as proof.

  • Prior Year’s State, Federal or Tribal Tax Return
  • Unemployment/Workers' Compensation Benefits Statement
  • Divorce Decree or Child Support Documents
  • Veterans Administration Benefits Statement
  • Current Income Statement from Employer or Paycheck Stubs
  • Retirement/Pension Benefits Statement
  • Social Security Benefits Statement

Bureau of Indian Affairs General Assistance (BIA)

BIA Award letter, should contain the following basic information:

  • Name of the program,
  • Name of the beneficiary
  • Address of the beneficiary
  • Date of the award

Tribal Head Start

Head Start Award letter, should contain the following basic information:

  • Name of the program,
  • Name of the beneficiary
  • Address of the beneficiary
  • Date of the award

Tribally-Administered Temporary Assistance to Needy Families (TANF)

TANF Award letter, should contain the following basic information:

  • Name of the program,
  • Name of the beneficiary
  • Address of the beneficiary
  • Date of the award

Food Distribution Program on Indian Reservations (FDPIR)

Notice of Action (award letter) acknowledging eligibility for FDPIR benefits;

  • Name of the beneficiary;
  • The beginning and ending dates of the award or certification period; and
  • The telephone number of the Food Distribution Program office, and the name and address of the person to contact for additional information.

OR

FDPIR participation documents(e.g., a benefit card or copy of a benefit card);

  • Name of the beneficiary
  • The beginning and ending dates of the award or certification period; and
  • The telephone number of the Food Distribution Program office, and the name and address of the person to contact for additional information.

Lifeline Program

Due to sharing many of the same eligibility requirements those currently enrolled in the lifeline program may qualify for The Affordable Connectivity Program (ACP) also.

 

Medi-Cal / Medicaid

Program Approval Letter, Benefit Statement, or Verification of Coverage Letter, should contain the following basic information:

  • Name of the program or state equivalent,
  • Name of the beneficiary,
  • Address of the beneficiary, and
  • Date of the award

OR

Eligibility Screenshot or printout from an online portal or website tool, should contain the following basic information:

  • Name of the program or state equivalent,
  • Name of the beneficiary
  • Medical Identification number, OR
  • Case number,
  • Eligibility dates, OR
  • Current participation status

CalFresh / Food Stamps / SNAP

Program Approval Letter, Benefit Statement, or Verification of Coverage Letter, should contain the following basic information:

  • Name of the program,
  • Name of the beneficiary,
  • Eligibility dates, OR
  • Current participation status

OR

Eligibility Screenshot or printout from an online portal or website tool, should contain the following basic information:

  • Name of the program or state equivalent,
  • Name of the beneficiary,
  • Case number,
  • Eligibility dates, OR
  • Current participation status

Federal Veterans Affairs (VA) Veterans Pension and Survivors Benefit

Pension Grant Letter should contain the following basic information:

  • Participant’s name
  • Address
  • A decision about the participant’s monthly entitlement amount
  • Payment start date

Federal Public Housing Assistance (FPHA)

FPHA award letter should contain the following basic information:

  • Name of the program,
  • Date of the award,
  • Name of the beneficiary, and
  • Award amount.

Supplemental Security Income (SSI)

Approval Letter or Benefit Statement issued by the SSA or on SSA letterhead.

  • Consumer’s name
  • Date
  • Eligibility Date
  • Claim number OR Other consumer identification number
  • Payment amount

Medicaid / Medi-Cal

Program Approval Letter, Benefit Statement, or Verification of Coverage Letter should contain the following basic information:

  • Name of the program or state equivalent,
  • Name of the beneficiary,
  • Address of the beneficiary, and
  • Date of the award

OR

Eligibility Screenshot or printout from an online portal or website tool should contain the following basic information:

  • Name of the program or state equivalent,
  • Name of the beneficiary
  • Medical Identification number, OR
  • Case number,
  • Eligibility dates, OR
  • Current participation status

SNAP / Food Stamps / CalFresh

Program Approval Letter, Benefit Statement, or Verification of Coverage Letter should contain the following basic information:

  • Name of the program,
  • Name of the beneficiary,
  • Eligibility dates, OR
  • Current participation status

OR

Eligibility Screenshot or printout from an online portal or website tool should contain the following basic information:

  • Name of the program or state equivalent,
  • Name of the beneficiary,
  • Case number,
  • Eligibility dates, OR
  • Current participation status

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  Eligibility Documents

  • Current or prior year's statement of benefits from a qualifying state, federal or Tribal Program.
  • Notice letter of participation in a qualifying state, federal or Tribal Program.
  • Program participation documents.
  • Another official document evidencing the consumer's participation in a qualifying state, federal or Tribal Program.
  • Unemployment Documentation (notice of unemployment benefit payment or notice of successfully submitted application for unemployment benefits)
  • Copy of last year's State or Federal income tax return.
  • 3 consecutive months' worth of your most current pay stubs.
  • Social Security benefits statement. Veterans Administration benefits statement.
  • Retirement/Pension benefits statement.
  • Divorce decree or child support document.
  • Unemployment/Workers' Compensation benefits statement.