Lumos Renewables Ltd. | UK Renewables Supplier

household Is last

Title

Name

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Email

Phone

Date Of Birth

We use this information to confirm your residential status at the address above

Referral

Please let us know if an individual or company has referred you to Lumos Renewables.

Referrer Name

Please let us know the name of the individual or company who has referred you to Lumos Renewables.

What type of property are you applying for?

What is your relationship to the property?

Are you registered for council tax in this property?

This will confirm eligibility on this property

What products are you interested in?

Solar / EV / Battery
Insulation measures
Heating controls

Select all applicable

What are the main sources of heating in the property?

Select all applicable

Has the property had any of the following upgrades in the last 10 years?

Select all applicable

How many bedrooms does your property have?

Bedrooms: 1

This allows us to identify the best measures for your property

Is the combined registered household income above or below £31,000?

Combined income below £31,000 may entitle you to increased levels of property upgrades

Is anyone living at the property in receipt of any benefits or government support?

If you are in receipt of benefits or government support you may be entitled to an increased level of property upgrades

Consent form for sharing data with the Energy Saving Trust

We need to check you are eligible for the Energy Company Obligation (EC04) and/ or Great British Insulation schemes. To do this, we would like to share your information with the Department for Work and Pensions (DWP) via the Energy Saving Trust who will verify whether or not you are receiving the relevant benefit(s) to be eligible for either scheme.

Please note that it is not possible for Energy Saving Trust or us, the company using this service, to see which benefits you are on through this service. DWP will only confirm whether you are in receipt of a qualifying benefit, not which one. This will not have any impact on future benefit payments.

If you do not want us to share your data with DWP via Energy Saving Trust, you will be required to provide copies of documents that provide proof of the benefits you are in receipt of from the DWP.

For full information on what will happen to the data we collect about you, please see the Privacy Notice which we will have provided you with separately.

By ticking the box below, and providing your details, you agree to share this data with the DWP via Energy Saving Trust.

You can contact us to withdraw your consent for us to share your data with DWP via Energy Saving Trust. If you withdraw consent, the collected data will continue to be processed, however no new data will be collected or used for further processing.

Energy Saving Trust Data Sharing Consent

Agree

I agree to my information provided being shared with the Department for Work and Pensions via the Energy Saving Trust to confirm whether I am in receipt of the relevant benefit(s) to be eligible for the EC04 and GBIS schemes.

Benefit / Government support recipient details

(as named on benefit correspondence)

Title

Name

First

Last

Date Of Birth

We use this information to confirm your residential status at the address above

Type of customer

Main applicant
Benefit recipient
Other

Please Specify

Full Customer Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Telephone no

Email

Customer's preferred contact method (please tick the relevent box)

Telephone
Email

Comments

Would you like to provide or upload any information to support your application?

Click or drag files to this area to upload. You can upload up to 10 files.

Please upload any supporting documentation relevent to your application (property images, government support evidence etc.)

Lumos Renewables Data Sharing Consent

Agree

I agree to my information provided being shared with Lumos Renewables to process your application.

Signature

Clear Signature