Grant Eligibility Check - The ECO Grants Team

ECO4 Grant Scheme Application Form

Section 1: Personal Information

Full Name: Date of Birth: Contact Number: Email Address: Address:

Section 2: Property Information

Property Ownership:

Homeowner Tenant (with landlord permission)

Type of Property: Current Heating System: Year of Property Construction (if known):

Section 3: Eligibility Criteria

Do you receive any of the following benefits? (Select all that apply)

Child Benefit Pension Guarantee Credit Income-related Employment and Support Allowance (ESA) Income-based Jobseeker's Allowance (JSA) Income Support Tax Credits (Child Tax Credits and Working Tax Credits) Universal Credit Housing Benefit Pension Credit Saving Credit

Is your household income less than £30,000 per year?

Yes No

Section 4: Desired Upgrades

Which energy efficiency upgrades are you interested in? (Select all that apply)

Section 5: Additional Information

Do you have any specific concerns or requirements regarding your property’s energy efficiency? Preferred Contact Method:

Phone Email

Best Time to Contact:

Morning Afternoon Evening

Section 6: Declaration

I confirm that the information provided is accurate and complete to the best of my knowledge

Got Questions? Call Us 24/7

Head Office

Unit 3, St Ivel Way, Warmley, Bristol, South Glos, BS30 8TY

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