Customer Action Plan


Detached: Semi: Ter (Mid): Ter (End): Bungalow:


Reduce Energy Bill

Yes: No:

Current Gas Supplier

Prepay

Direct Debit

Price per kw

Current Electricity Supplier

Prepay

Direct Debit

Price per kw

Reduce Energy Loss

Yes: No:

Loft Insulation Required

Yes   No   N/A  

Depth Less Then 150mm

Work Completion

Cavity Wall Insulation Required

Yes   No   N/A  

 

 

Work Completion

Solid Wall Insulation Required

Yes   No   N/A  

 

 

Work Completion

Double Glazing Required

Yes   No   N/A           Full      Part  

Work Completion

Energy Efficient Doors Required

Yes   No   N/A  

 

 

Work Completion

Conservatory Required

Yes   No   N/A  

 

 

Work Completion

Energy Efficiency

Yes: No:

Efficiency Boiler Required

Yes   No   N/A   Boiler Age

Work Completion

Solor Installed

Yes   No   N/A   K/Wh

Work Completion

Solar Buy Back Interest

Yes   No   N/A  

 

 

Work Completion

Batteries Interest

Yes   No   N/A  

 

 

Work Completion

Funding Availability

Yes: No:

Boiler Sedbuk Number

Customer Benifit Number

Energy Action Plan Consent

I give home Efficiency Team and it's authorised partners my consent to use the above information in order to improve my home efficiency rating in relation to the action plan items listed above

Customer Name
Action Plan Date
I agree to the terms above regarding to the use of my personal and property details
Yours details will be stored securely in accordance with the
Data Production act 1998.

ICO / Data Protection Number: ZA154569

Energy Assessor Details

Assessor Name
Energy Audit Completed
Yes   No  
EPC Completed
Yes   No  
Assessor Notes