Forms home Redbridge Go Green Scheme Application for tenants 1Contact details2Proof of income3 TitleMsMrsMissMrDrRevName First Last Please find your address by entering your postcode belowFind addressSelected address Email PhoneLandlord reference number Do you have any health conditions or disabilities or live with someone that is affected? Health conditions Disabilities Who has the disability? You Someone in your household Please select the disability you or someone you live with have? Hearing Reduced mobility Mental health issues Speech Other disability 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: If you are in receipt of housing benefit or council tax reduction, we can cross check our own records, with your consent. If you are 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. If your 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. Upload award letters or payslips and bank statements (covering the last 3 months):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 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 Prefer 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
