Forms home Redbridge Go Green Scheme Application 1 Introduction2 Your details3 Tenant details4 Property details5 Proof of income6 Consent for processing of information This application form is for the Redbridge Go Green Scheme (funded through the Green Homes Grants LAD delivery Phase 1b) 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. 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?*YesNoIf 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?*ABCDEFGUnknownThis scheme is not available to properties with an EPC rating of A, B or C. You may wish to consider the Green Homes Grant Voucher scheme which is managed by central government.Has your property had works done since the EPC certificate was issued that might have improved its energy efficiency?*YesNoNot sureDetails of the work carried out since EPC certificate was issued Proof of incomeThere 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):: 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 the Department for Business, Energy and Industrial Strategy (BEIS) who are funding the installations as part of the Green Homes Grant Local Authority Delivery Scheme. 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 understand and consent to my information being shared as outlined for the purposes of administering the grant Consent for re-contact The Department for Business, Energy and Industrial Strategy (BEIS) will be conducting an evaluation of the Scheme. This may include you being contacted 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 be given the opportunity to opt-in to that research at the point of contact. Do you consent to being re-contacted by London Borough of Redbridge, BEIS, or their appointed contractors, for the purpose of research and evaluation related to the installation received under the Green Homes Grant Local Authority Delivery Scheme? **YesNoReceipt of public funds declaration I confirm that I have not also applied for funding from the Green Homes Grant Voucher scheme and I will not do so unless I am unsuccessful in my application for funding under the Local Authority Delivery scheme. I understand that to do so is a misuse of public funds and I could be required to repay immediately the value of works carried out. I understand that BEIS will carry out data matching between the local authority scheme (which I am applying for here) and the voucher scheme to ensure there is no misuse of funds. * I agree with this statement 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 on my income and that if my income is found to be more than £30,000, funding will not be provided. If works have already commenced or completed and my income is found to be more than £30,000, I understand that I will be required to repay immediately the value of works carried out that were funded through the scheme.* 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.