Title Page
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Conducted on
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Prepared by
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Location
Details
Name
Address
Telephone
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Unique Ref No:
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QAA Date:
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QAA Inspectors Name
Owner of Home to which the application relates
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Is the applicant the home owner?
Rented Home Tenant, Joint Tenant, Sub Tenant of Private Landlord
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Is the applicant a tenant of a private landlord?
Qualifying Criteria
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Have lived in the property as their only or main home for at least 6 months?
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Is the home a residential mobile home?
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Has the tenants of a private landlord received their landlords permission to have the works done?
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Does the home match all calculations on the EPC Summary Information?
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Residents in a home which does not attain a Standard Assessment Procedure (SAP) rating of 65 or above?
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Has the most appropriate measures been recommended for the dwelling?
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Has the most appropriate mandatory measures been recommended for the dwelling?
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Has the most appropriate highly recommended measures been recommended for the dwelling?
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Is a building warrant required for work to commence (If yes Managing Agent will advise)?
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Member of household was injured or disabled serving in the armed forces and in receipt of benefits? (only for unverified
Priority Service (only if advised by HO)
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Does the house have a working heating system?
APPLICATION QUALIFICATION
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Has the application passed the Pre-Installation criteria
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Does the customer meet the full requirement - If NO Immediate Cancellation call to HO made
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Additional Information:
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Details
Signatures
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For customer reference: The customers signature is required to confirm that our Quality Assurance Inspector has visited your property
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Customer signature
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QAA Inspectors Signature
