Energy grants for your property

Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Is there Gas connection to the property? *

YES

NO

Was your gas meter installed before 31st March 2022? *

YES

NO

Unknown

Do you have a separate hot water cylinder?

YES

NO

Does your property have a loft or a room in the roof?

YES

NO

Is the loft insulated?

YES

NO

What is the wall Type

Solid brick wall

Cavity wall

Stone wall

Unsure / Other

Do you have any wall insulation?

Filled Cavity

External wall insulation

Internal wall insulation

No insulation / Unsure

Your option of heating available with the funding

High Heat Electric Storage Heaters

First Time Central Heating

Air Source Heat Pumps

Solar PV

What is your current heating system? *

Electric underfloor heating

Electric storage heaters

Gas central heating from boiler

Gas fire / back boiler

Solid fossil fuel fire / open fire

Bottled LPG Heating

Wood/biomass heating

Oil heaters

No heating in place

Not sure

Select the Benefit You Are Receiving? *

*Child Benefit income threshold to qualify to receive ECO 4 funding

Child Tax Credits (CTC)

Child Benefits - depends on income threshold*

Jobseekers Allowance (JSA)

Employment & Support Allowance (ESA)

Income Support (IS)

Pension Credit Guarantee Credit

Universal Credit (UC)

Warm Home Discount Scheme Rebate

Working Tax Credit (WTC)

Housing Benefit

Pension Credit Saving Credit

None