FAQ
Fact Sheet
Agency Application
Safelink Wireless
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Below you will find a registration form. Please take a moment to fill in all the requested information. Once complete, simply click submit and follow the prompts. We look forward to assisting your organization with Lifeline Services.
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Organization Name:
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Shipping Address:
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Physical Address:
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City:
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City:
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State:
AL
AR
AZ
CT
DC
DE
FL
GA
IA
IL
IN
KS
KY
LA
MA
MD
ME
MI
MO
MS
NC
NH
NJ
NM
NV
NY
OH
OR
PA
PR
RI
SC
TN
TX
UT
VA
WA
WI
WV
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State:
AL
AR
AZ
CT
DC
DE
FL
GA
IA
IL
IN
KS
KY
LA
MA
MD
ME
MI
MO
MS
NC
NH
NJ
NM
NV
NY
OH
OR
PA
PR
RI
SC
TN
TX
UT
VA
WA
WI
WV
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Zip:
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Zip:
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Phone:
Fax:
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Contact Name:
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Accounts Rec. Name:
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Contact Phone:
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Contact Email:
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Accounts Rec. Email:
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Fed Tax ID (You must fax or email us a signed W-9):
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Organization Type:
Corporation
Non-Profit Corp
S-Corp
LLC
Other
Terms and Conditions:
SAFELINK WIRELESS Agency Partners Terms and Conditions ("Terms and Conditions"). Please read these Terms and Conditions carefully. These SAFELINK WIRELESS Agency Partners Terms and Conditions apply to the authorized social services agencies and/or entities ("Agency Partners") who are authorized to access and use this website (including but not limited to assisting SafeLink Wireless Lifeline applicants in their enrollment, ordering SafeLink Wireless Lifeline applications and informational materials, and tracking Safelink Wireless Lifeline subscriber applications). TracFone reserves the right to deny any agency or entity authorization to act as a SafeLink Wireless Agency Partner in its sole discretion. TracFone reserves the right to revoke any Agency Partner's authorization at any time and for any reason in TracFone's sole discretion. These Terms and Conditions are a legally binding agreement between the Agency Partner and TracFone Wireless, Inc. ("TracFone"). TracFone reserves the right to change or modify any of these Terms and Conditions at any time and at its sole discretion. Any changes or modifications to these Terms and Conditions will be binding once posted on the SAFELINK WIRELESS Agency Partners website found at www.safelinkagencies.com. - Agency Partners must successfully complete the SafeLinkAgencies.com registration process and receive authorization to be eligible to participate in the compensation program through TracFone. - Agency Partners must provide their federal tax ID number and a copy of their W9 form. - TracFone will provide each registered Agency Partner a unique promo code to utilize for approved application credit. - Agency Partners must utilize their assigned promo code on all applications to receive credit. - TracFone will only compensate Agency Partners for approved applications that utilize a promo code. - TracFone will compensate Agency Partners for approved application credit on a quarterly basis. Payment detail will be available on the SafeLinkagencies.com website. - Payment by TracFone will be sent to the address provided during the Agency Partner registration process. - Residual payments to Agency Partners will be based on shipments net of undeliverable returns, stolen phones, dead on arrival phones, and other cases where customers report non-receipt of shipment of a functional phone. - Residual payment to Agency Partners will be calculated based on the total of shipments in the current quarter minus the current quarter's exceptions. Any exceptions reported in the prior quarter post residual payment, will be reflected in the subsequent quarter. - Agency Partners will ensure that each individual applying for SafeLink is the person who consents to all terms of eligibility and the enrollment process. - Agency Partners may not consent on behalf of any applicant in the enrollment process. - Agency Partners represent and warrant that TracFone d/b/a SafeLink Wireless is the exclusive wireless Lifeline carrier associated with the Agency Partner. - Agency Partners will follow all applicable federal and state laws and regulations pertaining to enrollment in the Federal Lifeline program. In the event of any dispute between TracFone and an Agency Partner regarding the compensation program, the calculation of residual payments and/or any other issue between TracFone Wireless, Inc. and any SafeLink Wireless Agency Partner, the parties agree to first submit their dispute to non-binding mediation to be conducted in Miami-Dade County, Florida and to be presided over by a mediator that is acceptable to both parties. In the event the parties are unable to resolve their dispute in mediation, the parties agree to submit their dispute to arbitration before the American Arbitration Association ("AAA") before a panel of three (3) arbitrators.
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I agree to the terms and conditions.
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To complete registration Please fax a signed W9 to
503-653-0146
or email to
W9@safelinkagencies.com
