| DPS Energy & Heating |

DPS Energy & Heating Ltd is committed to protecting the privacy of your personal information. Our company is registered with the Information Commissioners Office (ICO), in order to make transparent our data handling practices, and complies with the General Data Protection Regulations (GDPR) effective from May 2018.

Our privacy policy is available to view on our website at www.dpsenergy.co.uk/privacypolicy
Are you (or someone in your household) currently claiming any benefits?

Yes No
If so please select which qualifying benefit applies to you?

Income Support Pension Credit Guarantee Working Tax Credit (WTC) Child Tax Credit (CTC) Universal Credit (UC) Child Benefit ( Depends on Income Threshold) Job Seekers Allowance (JSA) Income Based Employment Support Allowance (ESA) Income Based Housing Benefit (New for ECO4) Warm Home Discount (New for ECO4) Pension Credit Savings (New for ECO4)
Is your property electrically heated? *

Yes No
Address *

Street Address

Street Address Line 2

City County

Post Code
Phone Number
Please enter a valid phone number.
Name

First Name Last Name
Number of Bedrooms
Date of Birth

Year Month Day
Date
Do you own your property or is it rented?

Owned Rented
Current Main Heating Source
Do you know what your boiler type is?

Condensing Non Condensing Combi Don't know
Ground Floor Type
House Type
Wall Type (if known)
Is there a Gas Meter present?

Yes No Not sure
Should be Empty:

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