Off Grid Heating Fuel Support Scheme

Name *

Contact e-mail *

Address *

Council Tax Reduction Scheme Reference *

I wish for the £200 payment to be made to the following bank account: Important: The bank account you provide must be in the name of the person(s) identifiable as liable to pay the council tax bill. If you do not have a bank account, please contact us directly to discuss alternative arrangements.

Name on Bank *

Bank Sort Code (e.g. 11-22-33) *

Bank Account Number *

Attach a copy of your heating oil invoice or receipt from the last 12 months and a copy bank statement clearly showing your bank details.

Attach*

I confirm that I am responsible for the Council Tax Bill and I use heating oil or LPG as my main source of heating. *

I confirm that I have included a heating oil or LPG bill (or copy) dated within the last 12 months alongside this application. *

I confirm that I have supplied a copy of a bank statement dated within the last 6 months alongside this application. *

I have read the Privacy Notice. *

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