NDEC ACP Issue Ticket

Please complete this form for participants you are working with who are having trouble applying their subsidy or the correct subsidy to their Internet bill.   Please make sure to tell the person who you are submitting this ticket for that we will be sharing the information on this form with their Internet Service Provider as well as the Maine Connectivity Authority to help resolve this issue.

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Address
If the participant lives on tribal lands, please indicate which Maine tribal community below::
ACP Approved Internet Subsidy (please check one):
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Is there also a Lifeline Approved Phone (please check one)?
Are you a new customer with this Internet Service Provider or are you an existing customer?
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Which of the following describes the problem?