SAFE CONNECTIONS

We are committed to assisting customers who are survivors of domestic violence to stay safe and stay connected.

Jump to start of Line Separation Request Form.

The Safe Connections Act is a law that helps survivors of domestic violence cut ties with their abusers by allowing them to separate lines from a shared account.

Yes. A survivor may designate a representative to submit a line separation request and communicate with Appalachian Wireless. However, the survivor may still need to sign additional forms in order to complete a request.

A survivor may designate a preferred method of contact. Contact options include text, email, phone, or designated representative. A survivor will only be contacted by their preferred method except in cases where a survivor is required to complete or receive additional documents and their preferred method of contact does not permit such transactions.

Access to information provided to Appalachian Wireless by a survivor is restricted to a select group of specially trained employees. Appalachian Wireless will only discuss a survivor’s request with the survivor or a person designated by the survivor in the manner chosen by the survivor.

After completion of a line separation, Appalachian Wireless is required to notify the primary account holder of changes made to the shared account. Prior to notifying the primary account holder, the survivor will be informed of the date of the notification.

An abuser whose line has been separated from the shared account will be contacted by Appalachian Wireless to set up a new account. Prior to Appalachian Wireless making contact with the abuser, the survivor will be informed of the date of contact.

A survivor must complete the Safe Connections Act Line Separation Request Form and provide documentation of their abuse in the form of one of the following:

A signed affidavit from a licensed medical or mental health provider, licensed social worker, victim services provider, or employee of a court acting in the course of their employment
A police report or statement provided by the police to a magistrate or judge
Charging documents
Protective or restraining order
Any other official record that documents the abuse

Up to nine lines may be separated from a shared mobile account. However, all separated lines must be used by the survivor or someone in their care.

A survivor may choose to separate their line, along with anyone in their care, from a shared mobile account, or they may choose to separate their abuser’s line from a shared mobile account.

No. A survivor cannot be charged a fee for separating their line, but they may be responsible for remaining payments on any mobile device they retain after their line is separated. A survivor will also be responsible for payments for any new devices and new plans.

Yes. However, a survivor will be responsible for any remaining payments.

Survivors are able to choose from any currently available plans.

Yes. Lifeline is an FCC program that helps make communications services more affordable for low-income consumers. It is available to all survivors for a period of six months after completion of the line separation process regardless of a survivor’s financial situation. Appalachian Wireless will provide documentation to a survivor which must be presented to USAC in order to apply for Lifeline benefits.

No. An abuser cannot access a survivor’s new account unless the survivor grants access.

Line separation requests must be processed within two business days.

Safe Connections Specialists are available to assist survivors with line separation requests Monday through Friday, 8:00am to 5:00pm. They may be reached by contacting Customer Service at 800-438-2355 and requesting to speak to a Safe Connections Specialist.

Appalachian Wireless is required to notify account holders of any changes made to their account. In the case of a line separation, the notification is delayed until after the line separation is complete, and the survivor will be informed prior to the account holder being notified.

If the survivor chooses to remove an abuser’s line from the shared account, Appalachian Wireless will need to make contact with the abuser to set up their new account, but only after the line separation request is complete, and the survivor will be informed prior to the abuser being contacted.

A completed line separation request may be submitted by one of the following methods:

By mail: Appalachian Wireless, Attn: SCA, 101 Technology Trail, Ivel, KY 41642
By email: safeconnections@ekn.com
In person: At any retail store
Online: https://www.appalachianwireless.com/safe-connections

Yes. Once a line separation is complete and a new account is set up, the survivor may choose to request a number change.

Once a line separation is complete and a new account is set up, the survivor may choose to port out their line to another carrier.

Additional support may be found at the National Domestic Violence Hotline, or you can find a local domestic violence shelter near you.

Notice to Consumers

OVERVIEW OF THE LINE SEPARATION PROCESS

The Safe Connections Act (SCA) is a federal law that ensures Survivors of domestic violence (and other related crimes and abuse) can separate from Abusers without losing independent access to their mobile service plan. It allows Survivors of domestic violence to separate lines of service that are together on the same account so the Survivor (and any person(s) under the care of the Survivor) does not have to share an account with their Abuser.

If you are, or someone in your care is, a Survivor of domestic violence (or other related crime or abuse) and the mobile device you use is on the same account as the device your Abuser uses, you can request a line separation. Your line separation request is kept secure and confidential. For your safety, Appalachian Wireless will only communicate with you when necessary and only as you instruct in your request. If your request is approved, Appalachian Wireless will notify you (or your designated representative) prior to contacting the account holder or Abuser to notify them of any account changes.

Definitions

Abuser means a person who has committed or allegedly committed a covered act against a Survivor, or someone in the care of a Survivor.
Covered Act means an act that constitutes abuse, including domestic violence, dating violence, sexual assault, stalking, sex trafficking, neglect, abandonment, economic abuse, technological abuse, and other similar crimes. A criminal conviction or any other determination of a court is not required for these actions to constitute a covered act.
Shared Account means a mobile service account that includes service for two or more telephone numbers, regardless of the type of device.
Survivor means a person who is 18 or older and has had a covered act committed or allegedly committed against them or someone in their care (provided that the person providing care is not the Abuser). A person who “cares for” another person, or person “in the care of” another person, includes (1) any people who are part of the same household; (2) parents, guardians, and minor children even if the parents and children live at different addresses; (3) those who care for, or are in the care of, another person by valid court order or power of attorney; and (4) a person who is the parent, guardian, or caretaker of a person 18 or older upon whom others are financially or physically dependent (and those dependents).

A line separation request begins with completing a Safe Connections Act Line Separation Request Form. This form may be downloaded HERE, picked up at any Appalachian Wireless store, or filled out below. Once completed, you can submit the form (along with required documentation) by any of the following means:

Online: https://www.appalachianwireless.com/safe-connections
Email: safeconnections@ekn.com
Mail: Appalachian Wireless, Attn: SCA, 101 Technology Trail, Ivel, KY 41642
In person at any Appalachian Wireless store. Find a store here.

You (or your designated representative) will be notified of the completion or denial of the line separation request within two business days.

If you have requested your line be separated from a Shared Account, you may be required to fill out additional forms after the line separation is complete.

Please be aware that the SCA does not permit Appalachian Wireless to make a line separation conditional upon the imposition of penalties, fees, or other requirements or limitations.

DESCRIPTION OF SERVICE OPTIONS THAT MAY BE AVAILABLE TO SURVIVORS

You may keep the same plan or choose a new plan from any of the plans currently available. You may also choose to continue using your device associated with the separated line, bring your own device not under contract or installments, or purchase a new one. You may request a separation of any line on the Shared Account including phones, watches, and tablets.

AVAILABILITY OF LIFELINE

Standard Lifeline Support

Lifeline is a government assistance program that provides a discount for qualifying households¹. You may qualify if your household income is at or below 135% of the Federal Poverty Guidelines² or if any member of your household is currently enrolled in:

Medicaid
Supplemental Nutrition Assistance Program (SNAP)
Supplemental Security Income (SSI)
Federal Public Housing Assistance
Veterans Pension Benefit
Survivors Pension Benefit

Federal Lifeline

$5.25 discount available on any eligible plan with at least 1000 voice minutes (phones only)
OR
$9.25 discount available on any eligible plan with at least 4.5 GB of data (phones or tablet)

Kentucky Lifeline

$6.00 discount available on any eligible plan with unlimited voice (phones only)

Emergency Communications Support for Survivors

Emergency Communications Support is also available under the Lifeline program for qualifying Survivors who are suffering financial hardship. You may qualify if your household income is at or below 200% of the Federal Poverty Guidelines² or at least one member of your household meets the following criteria:

Is approved to receive benefits under the free and reduced-price school lunch program or the school breakfast program, including through the USDA Community Eligibility Provision;
Received a Federal Pell Grant in the current award year; or
Receives assistance through the Supplemental Nutrition Assistance Program (SNAP).

If you qualify for Emergency Communications Support, you may receive the federal Lifeline benefit of $9.25 for any voice service with at least 1000 voice minutes or any service that includes at least 4.5 GB of data per month.

Emergency Communications Support is available for a period of six months. After the six-month period, if you have not shown your eligibility to continue under the standard Lifeline program terms, you will be de-enrolled.

Step 1 – You must apply through the Lifeline National Verifier. Please visit www.lifelinesupport.org for more information on how to apply.

In order to qualify for Emergency Communications Support, in addition to showing financial hardship as defined above, you must also submit proof to the Lifeline National Verifier that you requested a line separation under the Safe Communications Act.

Step 2 – After your Lifeline eligibility has been approved by the Lifeline National Verifier, you can enroll with Appalachian Wireless and the Lifeline discount will be applied to reduce your bill. You must submit a completed Appalachian Wireless Lifeline Enrollment form, which is available on our website or at any retail store.

¹Benefit amounts and minimum standards for eligible plans are determined by the federal and/or state government and are subject to change. Your Lifeline benefit is non-transferable. Proof of eligibility is required, and only eligible customers may enroll. Only one Lifeline discount is allowed per household. Consumers who willfully make false statements in order to obtain the Lifeline benefit can be punished by fine or imprisonment or being barred from the program. The Lifeline discount will be applied beginning in the service period that includes the first day of the month following successful enrollment. Appalachian Wireless offers Lifeline services only in Kentucky. The Lifeline Enrollment Form must be in the name of the account holder. Lifeline is not available on Advance Pay plans.

²Find the qualifying income limits based on household size at www.lifelinesupport.org/do-i-qualify/.

SAFE CONNECTIONS ACT LINE SEPARATION REQUEST FORM

SECTION 1: SURVIVOR NAME AND CONTACT INFORMATION

The Survivor named below is requesting a line separation under the Safe Connections Act (47 U.S.C. §345) and the FCC’s rules (64 C.F.R. §64.400, et seq.).

^*Who is completing the form?:

^*Name of Survivor:

Address:

IMPORTANT NOTICE – WE MAY CONTACT YOU TO CONFIRM THE LINE SEPARATION, TO INFORM YOU IF WE ARE UNABLE TO COMPLETE THE LINE SEPARATION, OR TO REQUEST ADDITIONAL INFORMATION

By what method may we contact you? (You must select one. You may include additional methods by filling in the blanks below.)

Preferred Method of Communication:

Text

Phone

Special Instructions for Communicating with Survivor:

SECTION 2: DESIGNATED REPRESENTATIVE INFORMATION

The individual listed below is the designated representative of the Survivor listed above and has assisted the Survivor with this line separation request.

Designated Representative Name:

Relationship to Survivor:

Designated Representative Phone:

Designated Representative Fax:

Designated Representative Email:

Representative Address:

SECTION 3: ABUSER INFORMATION AND DOCUMENTATION

^*Abuser Name:

You must submit one of the following documents as evidence that the Abuser has committed or allegedly committed a Covered Act against you or someone in your care:

A signed affidavit from a licensed medical or mental health provider, licensed social worker, victim services provider, or employee of a court acting in the course of their employment
A police report or statement provided by the police to a magistrate or judge
Charging documents
Protective or restraining order
Any other official record that documents the abuse

This documentation must have the name of the Abuser and the name of the Survivor.

Max file size is 20MB. Max size of all files is 50MB.

SECTION 4: ACCOUNT INFORMATION

Instructions: Provide the following information for the Shared Account from which the requested lines should be separated. This information is not required to process the line separation request, and the request will not be denied if the information is not provided or is inaccurate.

Account #:

Primary Phone #:

PIN/Password:

Account Address:

SECTION 5: LINE SEPARATION INFORMATION

Instructions: List all lines the Survivor is requesting to be separated from the Shared Account listed above. Check which lines are used by the Survivor, by the Abuser, and/or by the person(s) under care of the Survivor. If the line(s) of someone in the Survivor’s care is being separated, the Survivor must also sign and date the statement below close in time to the submission of this form.

How many lines need separated?

By typing my full name in the space provided, I affirm that (1) I am the Survivor listed in Section 1 of this form, and (2) the lines listed above which are marked “Person Under Care of Survivor” belong to individuals under my care, and those individuals are the users of those specific lines.

SECTION 6: PLANS AND DEVICES

Instructions: For each line listed above as belonging to the Survivor or a Person Under Care of Survivor, check below whether you intend to (1) keep your current plan, change plans (write in your preferred plan), or are unsure; and (2) keep your current device, get a new device (write in your preferred new device), bring your own device, or if you are unsure. If you check unsure regarding the choice of plan or device, a specialist will attempt to contact you in the manner you have indicated above to discuss your options. If the specialist is unable to reach you within two business days, your line will be transferred with the same plan and same device and we will work with you in the future to switch you to a plan and/or device of your choice. DO NOT COMPLETE THIS INFORMATION FOR LINES BELONGING TO THE ABUSER.

For assistance with completing this form or questions regarding your options under The Safe Connections Act, you may contact Customer Service at (800) 435-2355 and request a Safe Connections Specialist.

SAFE CONNECTIONS

Common FAQs

What is the Safe Connections Act?

Can someone submit a line separation request on behalf of a survivor?

How will Appalachian Wireless communicate with a survivor while processing a line separation request?

Are line separation requests confidential?

What information or documents are required?

How many lines can be separated?

Whose lines can be separated?

Is there a fee?

Can a survivor keep their phone?

What plans are available to survivors?

Is financial assistance available to survivors?

Will an abuser have access to a survivor’s new account?

How long does the process take?

Who can I talk to at Appalachian Wireless?

Will an abuser know about a survivor’s line separation request?

How can a request be submitted?

Can a survivor change their number?

Does a survivor have to stay with Appalachian Wireless?

What other resources are available to survivors of domestic violence?