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What is your relationship to the property which you are applying for? Home OwnerPrivate TenantSocial housing
Are you or anyone in your household in receipt of benefits? Child BenefitChild tax creditsWorking tax creditsAttendance AllowanceArmed Forces Independent PaymentCarter’s AllowanceConstant Attendance AllowanceDisability Living AllowancePension Guarantee Creditncome-related Employment and Support Allowance (ESA)Income-related Jobseeker’s Allowance (JSA)Income supportndustrial Injuries Disablement BenefitPersonal Independence PaymentSevere Disablement AllowanceUniversal tax creditsWar -Veterans Pensions Mobility SupplementNone apply
What type of property are you applying for? Detached houseSemi DetachedMid TerraceEnd TerraceSemi Detached BungalowDetached BungalowFlatOther
How many bedrooms does the property have? 123456+
When was your property built (approximately)? Before 1900Between 1901 -1929Between 1930 -1950Between 1951 - 1980Between 1981 - 2005Between 2006 and NowDon’t know
Does your property have a suspended floor (floorboards), a basement or a cellar? YesNoDon't know
List of MEASURES required BoilerCavity wall ExtractionCavity wall InsulationParty Wall InsulationUnderfloor InsulationSolid wall InsulationInternal wall InsulationExternal wall InsulationFirst time central HeatingNot sure How is your house currently heated? Boiler/radiatorElectric room heaterPortable heaterElectric storage heaterGas room heaterSignal gas fireOther
What type of boiler does the property currently have? Wall MountedFloor MountedBack Boiler (Behind Fire)
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