Carrig Energy - SEAI Grant Energy Poor - Technical Assessment Application form

Name * Required

Address * Required

Phone * Required

Email * Required

MPRN number * Required

This is located at the top right-hand corner of your electricity bill - 11 digits

House Type * Required

Any additional information:

Confirming that I / we are in receipt of (please tick as appropriate):

Fuel Allowance (National Fuel Scheme)

Job Seekers Allowance for over six months*

Working Family Payment

One-Parent Family Payment

Disability Allowance for over six months*

Domiciliary Care Allowance

Carers Allowance**

*Job Seekers Allowance and Disability Allowance recipients must have children under the age of 7.

*^A Carers Allowance Confirmation form completed and stamped by a DEASP official is also required.

Upon receipt of this application , Carrig Energy will email you the official Department of Employment Affairs and Social Protection form which will need to signed and stamped at your local DEASP offices.

Section 2: Payment Details - €750

Payment made by * Required

Payment to - Carrig Energy Consultancy

IBAN: IE62 AIBK 9353 0122 5021 84

BIC: AIBKIE2D

Branch: AIB Bank, Liberty square, Thurles

(Please provide print screen or receipt for electronic payment -
Also reference your name on banking remittance)

Section 3: Confirmation

I wish to request a Home Energy Assessment** on my property for the purpose of availing of SEAI Grant funding. I acknowledge that my house must achieve a B BER Energy Rating with a minimum uplift of 100kWh/m2/y and a Heat loss indicator of below 2.3 W/m2k to be eligible for SEAI funding under the Community Energy Grant Scheme.

Signature: * Required

Date: * Required

**The Home Energy Assessment sets out the upgrade measures your home needs to meet SEAI's minimum funding requirements. These measures qualify for fixed SEAI grant amounts, and Carrig Energy Consultancy will give you a grant offer based on them.

Terms and conditions apply.