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Measure Required
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Loft Insulation
Cavity Wall Insulation
Internal Wall Insulation
Room In Roof Insulation
Solar Panels
Air Sourced Heat Pump
Electric Storage Heaters
Fuel Type
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Electric
LPG
Main Gas
Solid Fuel
Oil
No Heating at All
Do you receive any of the following benefits?
"Income-Based" Job Seekers Allowance
"Income-Based" Employment & Support Allowance
Income Support
Pension Credit Guarantee
Pension Credit Savings
Working Tax Credit
Child Tax Credit
Housing Benefit
No, I don’t receive any of the above benefits
Is the house hold income less than £ 31,000 ?
Yes
No
First Name
Last Name
Address Line 1
Address Line 2
Phone
Email
ZIP/Postal Code
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