Which means-tested benefits do you receive?
Child Tax credit
Disabled Child Premium or Element
Disability, Enhanced Disability or Severe Disability Premiums
Disability Living Allowance (DLA) (for an adult or child within the household)
Personal Independence Payments (PIP) or Attendance Allowance (AA)
Long term Incapacity Benefit
Pensioner Premium or Higher Pensioner Premium
Is your total household income below £20,000 per year?
Are you a homeowner or in rented accommodation?
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Street Address Line 2
State / Province
Postal / Zip Code
Eco Lead Status
Primary Product Interest
Should be Empty: