Forms home Redbridge Go Green Grant Phase 3 Scheme 1Introduction2Your details3Tenant details4Property details5Proof of income6Consent for processing of information This application form is for the Redbridge Go Green Scheme (funded by the UK Shared Prosperity Fund) The application should be made by the owner occupier or by the landlord. If you are a landlord, once you have completed this form you will be sent a link in your confirmation e-mail. Pease forward this link to your tenants who will need to complete information about themselves and their income. We will not be able to progress your application until both you and your tenant have completed the application and both parties have consented to taking part in the scheme. Should the Go Green grant scheme become oversubscribed your application may be sent to an alternative provider offering similar schemes in Redbridge where possible. I am*An Owner OccupierA landlordIf you are a tenant, this form must be completed by your landlord. Once they have completed the form, they will receive a link which they should send on to you requesting further information. Your detailsTitleMsMrsMissMrDrRevName* First Last Email* Phone*Please enter your postcode*Find addressSelected address Tenant detailsTitleMsMrsMissMrDrRevName* First Last Email* Phone*Please enter the postcode of the property to receive improvements*Find addressSelected address Name of adults (18+) living at the property (including the applicant)* Property detailsDoes your property currently have an EPC certificate?* Yes No If you do not know if your property currently has an EPC certificate, please visit www.epcregister.com and search for your property. If your property is not listed, this means you most likely do not have an EPC certificate, please select 'no'. If it is listed on that website, please select 'Yes'. What is your current EPC rating?* A B C D E F G Unknown This scheme is not available to properties with an EPC rating of A, B or C. You may want to contact Shine London who can advise you on how to save on energy and if there are any other grants available to you. Please visit Shine London website. Has your property had works done since the EPC certificate was issued that might have improved its energy efficiency?* Yes No Not sure How do you heat your home?* Central heating and a gas boiler Electric storage heaters (are not moveable) Electric heaters that I plug into the wall and can move between rooms Gas fire (not moveable) Gas heaters that I can move between rooms No heating Something else If something else, please state* If something else, please state* Details of the work carried out since EPC certificate was issued Proof of incomePlease note we would need three months’ of bank statements for every account that income comes into, three months’ payslips for everyone over the age of 18 years and not in full time education living at the property and/or state or private pension and all other benefit award letters There are three ways in which we can verify your income and eligibility for the scheme. Please select the statement/s that apply to your household:* I am in receipt of housing benefit or council tax reduction. We can cross check our own records, with your consent. I am in receipt of another means tested benefit such as Universal Credit, Income Support, Job Seekers Allowance (Income Based), Employment Support Allowance (Income Related) or Guarantee Pension Credit. We may be able to accept an award letter as proof of low income. My income cannot be proven through one of the two methods above. We can check documents that you provide to us such as payslips or bank statements. Please select those that apply Universal Credit Income Support Job Seekers Allowance (Income Based) Employment Support Allowance (Income Related) Guarantee Pension Credit Upload award letters or payslips and bank statements (covering the last 3 months):: Drop files here or Select files Max. file size: 10 MB. Applications cannot be processed without income documents being received. Please send all income documents via email if you cannot send with the application. Consent and declaration To enable the administration of the Green Homes Grant Local Authority Delivery Scheme, Redbridge Council is required to process personal information relating to you and your home. Your information will be shared with London Borough of Redbridge, The Appointed Delivery Partner, your installer, and may be shared with the Department of Levelling Up Housing and Communities (DLUHC) and the Greater London Authority (GLA) for auditing purposes. Data processing will only be carried out for the purpose of delivery, administration and evaluation of this scheme as well as statistical, research and fraud prevention purposes. It is expected that processing will include linking of your personal data to other datasets and may involve contacting you to ask if you would like to participate in further research and evaluation activities. View the privacy notice * I have read and understood the Privacy Notice for the scheme. I give you consent to share my information with your delivery partners and funders Consent for re-contact Department of Levelling Up Housing and Communities (DLUHC) and The Greater London Authority (GLA) may contact you to take part in further research. Where the research involves processing of personal data in addition to that already collected for delivery of the Scheme, you will begiven the opportunity to opt-in to that research at the point of contact. Do you consent to being re-contacted by the London Borough of Redbridge, DLUHC, GLA or their appointed contractors, for the purpose of research and evaluation related to the installation received under the Local Authority Green Homes Grant? * Yes No Receipt of public funds declaration I confirm that I have not also applied for any previous funding from the Green Homes Grant scheme. This funding can only be provided for households with an income of £30,000 or less. I confirm that my household income is £30,000 or less per annum. I understand that checks may be carried out to confirm that my household income is £30,000 or less per annum. These checks may include data matching and/or more specific checks, including credit searches. I understand that if I knowingly give false or incomplete information in respect of this application, then this may be considered fraud. If false or incomplete information is suspected in relation to this application, I understand that I may be liable to criminal and/or civil investigation in respect of this matter, the results of which may include criminal conviction and/or the repayment of the value of the cost of works already carried out. I confirm that, to the best of my knowledge and belief, the information I give on this form is complete and correct. * I agree with this statement * I confirm that all of the information provided on this application form is true to the best of my knowledge and belief Once you have submitted the form you should forward the link that will appear on your screen to your tenant. The tenant will need to use this link to submit their details and proof of income. The completed application will then be assessed and we will contact the landlord within 10 working days to let them know the outcome of the application.Where did you hear about the Go Green Scheme?Redbridge LifeThe Recorder or other local newspaperLeaflet/flyerNeighbours, friends or familyRedbridge Council websiteRedbridge Housing Standards TeamOtherAre you? Male Female Other Perfer not to say What is your age? 16-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65 plus Perfer not to say Do you have a disability? Yes No Prefer not to say What ethnicity best describes you? Asian or Asian British Black, Black British, Caribbean or African Mixed or multiple ethnic groups White Any other White background Prefer not to say