• Number of Bedrooms
  1 2 3 4 5 6+
• Picture of Boiler
• Serial Plate of Boiler
• Flue (vent where steam escapes your property)
• Front of Property (full front)*
• Rear of Property (full rear)*
• Downstairs Kitchen (full room from door way)*
• Downstairs Hall (hall from door way)
• Downstairs Room 3 (full room from door way)
• Downstairs Room 4 (full room from door way)
• Downstairs Room 5 (full room from door way) *if applicable
• Fuel/Heating Type
  Gas Boiler Electric Room Heaters Electric Storage Heaters LPG Boiler (bottled) LPG Boiler (tank) Solid Fuel (wood/coal etc) Oil Solid Fuel
• Postcode*
• Address Line 1*
• Last Name*
• Utility Bill (gas/water/electric/other)*
• Benefit/Credit Type
  Child Tax Credit Child Benefit Working Tax Credit Universal Credit Personal Independence Payment Disability living Allowance Pension Guarantee Credit Attendance Allowance Carers Allowance Armed Forces Independence Payment Constant Attendance Allowance Income Related Employment and Support allowance Income Based Job Seekers Allowance Income Support Industrial Injuries Disablement Benefit Mobility Supplement Severe Disablement Allowance No Benefits
• Benefit Evidence*
• Detected Location
• Should be Empty: