EBB Customer Disclosure Emergency Broadband Benefit Program Customer Disclosures For customers of NEMR TelecomThe Emergency Broadband Benefit Program is intended to help low-income households pay for broadband services and connected internet devices. The Program provides a monthly discount of up to $50 for eligible households. This program is temporary and will end when the funds are exhausted or six months after the Department of Health and Human Services declares the end of the COVID-19 health emergency. In order to qualify for the program, eligible consumers must be enrolled in one of the following programs: Medicaid, Supplemental Nutrition Assistance Program, Supplemental Security Income, Federal Public Housing Assistance, Veterans and Survivors Pension Benefit, approved for the free or reduced price school breakfast/lunch program (including through the USDA Community Eligibility Provision), received a federal Pell Grant in the current award year, experienced substantial documented loss of income since February 29, 2020, or qualifies for a participating provider’s existing low-income or COVID-19 relief program NEMR Telecom 718 S West St, PO Box 98 Green City, MO 63545 660-874-4111 Name(Required) First Last (Print First and Last Name) stating you understand the following (please initial each statement below):Contact Phone(Required)Email(Required) -Please initial each statement below acknowledging your consent-*This is a U.S. government program that reduces my internet bill.(Required) *This is a temporary emergency program with an unknown ending date. Upon its conclusion, I will have the option to continue to receive services subject to NEMR Telecom's regular rates, terms, and conditions.(Required) *This program is limited to one per household. A household is defined as anyone living at the same address who share income and household expenses.(Required) *This program is non-transferable to any other individual or household.(Required) *I may choose to participate in the Emergency Broadband Benefit Program from any service provider.(Required) *I may transfer the Emergency Broadband Benefit to another provider at any time during this program.(Required) *I allow NEMR Telecom to transmit my information to the National Lifeline Accountability Database to enroll into the Emergency Broadband Benefit Program.(Required) *At the conclusion of the program, the last month's discount may be reduced based on availability of funds, as determined by the FCC.(Required) *I can continue to participate in the Lifeline Program (if applicable), without enrolling in the EBB program.(Required) SignatureDate MM slash DD slash YYYY NEMR Telecom is an equal opportunity provider and employer.