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BOILER REPLACEMENT SCHEME

(BRS)

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Table of Contents

Section 1 – Introduction ... 3

Section 2 – Eligibility Criteria ... 4

Section 3 – The Allowance ... 5

Section 4 – The Process ... 8

Section 5 – The Fine Print ... 9

Section 6 – Documentation ... 15

Section 7 – Application of VAT ... 17

Section 8 – Building Control Requirements ... 19

NI Building Control Information Note No. 01 ... 19

NI Building Control Information Note No. 02 ... 26

Appendix 1- Sample Application Form ... 31

Appendix 2- Sample Certificate of Earnings ... 47

Appendix 4- Sample Approval Pack ... 59

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Section 1 – Introduction

A new Boiler Replacement Scheme was launched by the Department for Social Development in September 2012. The Scheme, funded by the Northern Ireland Executive is managed by the Northern Ireland Housing Executive.

This Installers guide has been developed following consultation on the scheme design with a number of key Stakeholders including Installers groups and the gas companies.

The administration of the scheme has been developed taking into account lessons learned from the pilot Boiler Replacement Scheme which was completed in March 2012.

This document will give a brief guide to scheme eligibility, the process used to administer the scheme, and is part of a pack designed to help installers with administration.

While processes have been designed to make the scheme as straightforward as possible, it is important for Installers to understand that the Housing Executive must ensure that all reasonable steps have been taken to meet governance requirements and that proper processes have been put in place to prevent fraudulent claims.

Therefore a number of checks have been built into the system.

Installers are requested to note the importance of submitting the correct documentation to the Housing Executive, at the right time. This will hopefully minimise administration of the scheme and provide a better service to both you and our Boiler Replacement Scheme applicants.

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Section 2 – Eligibility Criteria

The following eligibility criteria will be applied for the Scheme Applicants must be Owner Occupiers

 Owner occupiers include those people who have their ‘day in the house’

 The property must be the applicants sole or main home (not a holiday home or bed and breakfast establishment)

 The allowance is not available to private sector tenants, NIHE or Housing Association tenants

Total gross income must be less than £40,000

 Total gross income is the total earnings and benefits of both the owner and their partner. We will also take into account all earnings and benefits of any other owners and their partners who areliving in the property

 Income includes self employed earnings and other income the applicant may receive such as pension payments

 We will NOT take into account savings or investments, or capitalise any land which the applicant may own.

The Existing Boiler must be at least 15 years old

 The Installer will be asked to note the age of the boiler on the Boiler Installer Form

 All oil, gas, and LPG (Liquid Petroleum Gas) Boilers which are at least 15 years old are eligible for the scheme

 While it is possible to replace an LPG Boiler at least 15 years old with a new LPG Boiler, it is not possible to convert from oil or natural gas to LPG.

 Stoves or ranges used exclusively for cooking are not eligible for replacement under the scheme

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Section 3 – The Allowance

Boiler Replacement Scheme Allowances:

The Boiler Replacement allowance is available to those with a joint annual income of under £40,000. However, there is an increased allowance for those who earn under £20,000. Therefore, the amount of allowance depends on two factors;

1. The total income earned by the applicant and their partner 2. The type of boiler they intend to install

Total, gross, annual income of all owner occupiers and

spouses/partners Option 1 Option 2 Option 3

Less than £20,000 £700 £1,000 £1,000

£20,000 - £39,999 £400 £500 £500

Boiler Replacement Options Replacement Option1:

Where a new boiler is to be provided that uses the same fuel type as the existing boiler. No controls are provided in this option.

The options are:

Oil to Oil – replacean existing oil boiler with a new oil boiler.

LPG to LPG – replace an existing boiler that runs on LPG (Liquefied Petroleum Gas, which is usually provided in bottles or tanks), and is more than 15 years old, with a new LPG boiler.

Natural Gas to Natural Gas – replace an existing natural gas boiler with a new natural gas boiler. In this scenario, the existing controls are retained. Replacement Option 2:

Where a new boiler is to be provided that uses the same fuel type as the existing boiler. Under this option, new controls are provided.

The options are:

Oil to Oil with Minimum Controls LPG to LPG with Minimum Controls

Natural Gas to Natural Gas with new controls fitted to minimum standards If an existing oil, LPG or natural gas boiler is to be replaced with a new boiler that uses the same fuel type but with the addition of full dual controls, the minimum standards we will expect to see are:

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 Pumped System:

The hot water and space heating should be fully pumped (gravity

circulation is not acceptable). A bypass valve should also be fitted at the boiler.

 Time Control Of Space And Water Heating:

The hot water has to be heated independently and a two channel time clock has to be provided.

 Temperature Control Of Space Heating:

Space heating zones shall be provided by fitting thermostatic radiator valves (TRVs) on all radiators (except heat leak radiators linked to solid fuel appliances).

 Temperature Control Of Hot Water:

1. A thermostatically controlled motorised valve with a cylinder stat on the hot water circuit shall be provided, or

2. A thermostatically controlled mechanical valve shall be fitted on the hot water circuit at the hot water cylinder or

3. A combination boiler providing instantaneous hot water shall be installed

to provide temperature control to the hot water.

 Carbon Monoxide detectors shall be installed in accordance with Building Regulations.

Replacement Option 3:

Where a new boiler is to be provided that uses a different fuel type to the existing boiler.

The options are:

Oil to Natural Gas with Full Controls Oil to Wood Pellet with Full Controls LPG to Oil with Full Controls

LPG to Natural Gas with Full Controls LPG to Wood Pellet with Full Controls

If the fuel type is to be changed, the minimum standards we will expect to see are:

 Boiler Interlock:

Boiler-based systems should have boiler control interlock in which controls are wired so that when there is no demand for either space heating or hot water, the boiler and pump are switched off.

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All dwellings should have a separate hot water zone in addition to space heating zones. A separate hot water zone is not required if the hot water is produced instantaneously, such as a combination boiler.

 Temperature Control Of Space Heating:

Space heating zones shall be divided into at least 2 zones by using 1. Room thermostats or programmable room stats in all zones or 2. A room thermostat or programmable stat in the main zone and

individual radiator controls such as TRVs on all radiators in the other zones or a combination of 1 and 2 above.

 Temperature Control Of Hot Water:

Domestic hot water systems should be provided with a cylinder thermostat and a zone valve or a three port valve to control the temperature of the hot water.

 Carbon Monoxide detectors shall be installed in accordance with Building Regulations.

Further Financial Assistance

Phoenix Natural Gas have withdrawn their financial support for the Scheme. If an applicant proposes converting to natural gas, in the Firmus Energy licence area, additional financial help may still be available from Firmus Energy. Applicants should contact Firmus directly by telephoning 08456 08 00 88.

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Section 4 – The Process

APPLICANT AND GRANTS OFFICE INSTALLER

INITIAL CONTACT The applicant contacts the Grants Office

Applicant asked Showstopper Questions: No input

1. Are you the Owner/Occ. (or have your day in the house)? 2. Is this address your sole or main home (not a holiday home, a

B&B, or a houseboat)?

3. Is the total gross annual income of you and your partner combined less than £40,000?

4. Is your existing central heating boiler at least 15 years old? 5. What fuel does it run on: Oil/Gas/LPG?

GRANTS OFFICE ISSUES APPLICATION FORM No input

APPLICANT SUBMITS APPLICATION FORM Installer may submit Application form, but Grants Office will deal directly with Applicant. A Boiler Installer form may also be submitted at this time if the Applicant has already chosen an Installer

App. must provide: Grants Office will;

Recent mortgage statement OR evidence of current house insurance policy

Check for any previous grants or applications Most recent utility bill (rates,

electricity, gas, telephone)

Check owner occupation Recent payslip or cert. of earnings

(if working)

Check Income

BOILER INSTALLER FORM ISSUED TO APPLICANT

(Applicant gives to Installer to Complete)

Installer MUST include: 1. Applicant Details 2. Installer Details 3. Current Boiler Details 4. Details of new Boiler GRANTS OFFICE RECEIVES BOILER INSTALLER FORM

1. Record Boiler Information on System

2. Select for pre-approval inspection No input

GRANTS OFFICE ISSUES APPROVAL See Appendix C

Applicant notified of amount of allowance payable and that work should be completed within 3 months

GRANTS OFF. NOTIFIED OF COMPLETION OF WORK Documents for Payment: 1. Detailed Final invoice 2. Building Control

Completion certificate 3. Commissioning cert.

for new boiler 4. Copy of planning

approval (if required) 5. Minimum Standards

checklist

6. BACS if appropriate

1. Request outstanding documentation 2. Select for post completion inspection

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Section 5 – The Fine Print

The Housing Executive has provided important information about the scheme in notes on both the Application Form and the Boiler Installer Form. It is essential that both you and the applicant are aware of these notes.

Notes to the Applicant on the Application Form:

1. The Housing Executive accepts no duty of care for any works carried out under this Scheme.

2. The Housing Executive accepts no responsibility for the quality/standard of any work carried out under this Scheme.

3. The installer you choose to install your new boiler is responsible for carrying out the works in a competent manner. If you have any problems with your new boiler, or if your property is damaged during the boiler replacement works, you should contact your installer.

4. The boiler manufacturer will issue a specific warranty for the boiler. The installer should make clear to you that he will provide a separate guarantee for his workmanship. He should make clear to you what aspects of the works he will guarantee and for how long he will guarantee them. You should talk to your installer before any works begin to agree a warranty period for his workmanship.

5. We would advise that all electrical works carried out should be carried out by a competent electrician registered with NICEIC, ECA or an equivalent body.

6. If you are converting from oil to natural gas, your chosen installer MUST be Gas Safe registered and he MUST provide you with a Landlord/Home Owner Gas Safety certificate on completion of the works.

7. You must ensure that all works carried out in your home comply with all statutory requirements.

8. A Building Regulations Application MUST be made to the Building Control department of your local council BEFORE any boiler replacement works are started. A fee of £72 will have to be paid with the application. If the

application is not made before the works start, the fee will be higher. The application to Building Control must clearly specify the nature of boiler replacement works planned, particularly if you intend installing full dual controls.

9. If you replace an existing oil, LPG or natural gas boiler with a new boiler of the same fuel type and provide full dual controls, the minimum standards we will expect to see are:

 Pumped System:

The hot water and space heating should be fully pumped (Gravity circulation is not acceptable)

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 Time Control Of Space And Water Heating:

The hot water has to be heated independently and a two channel time clock has to be provided

 Temperature Control Of Space Heating:

Space heating zones shall be provided by fitting thermostatic radiator valves (TRVs) on all radiators (except heat leak radiators linked to solid fuel appliances)

 Temperature Control Of Hot Water:

1. A thermostatically controlled motorised valve with a cylinder stat on the hot water circuit shall be provided, or

2. A thermostatically controlled mechanical valve shall be fitted on the hot water circuit at the hot water cylinder or

3. A combination boiler providing instantaneous hot water shall be installed

to provide temperature control to the hot water.

 Carbon Monoxide detectors shall be installed in accordance with Building Regulations.

10. If you change the fuel type, the minimum standards we will expect to see are:

 Boiler Interlock:

Boiler-based systems should have boiler control interlock in which controls are wired so that when there is no demand for either space heating or hot water, the boiler and pump are switched off.

 Time Control Of Space And Water Heating:

All dwellings should have a separate hot water zone in addition to space heating zones. A separate hot water zone is not required if the hot water is produced instantaneously, such as a combination boiler.

 Temperature Control Of Space Heating:

Space heating zones shall be divided into at least 2 zones by using 1. Room thermostats or programmable room stats in all zones or 2. A room thermostat or programmable stat in the main zone and

individual radiator controls such as TRVs on all radiators in the other zones or a combination of 1 and 2 above.

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 Temperature Control Of Hot Water:

Domestic hot water systems should be provided with a cylinder thermostat and a zone valve or a three port valve to control the temperature of the hot water.

 Carbon Monoxide detectors shall be installed in accordance with Building Regulations.

11. The Housing Executive will not pay any allowance under this Scheme until we have received the following documents:

 Notification of Completion of Works form;

 a final, detailed invoice, signed and dated by the installer (or if you have already paid your installer, a copy of his signed and dated receipt);

 clear instructions on paying the allowance (BACS 01 or BACS 02);

 a Boiler Installation Minimum Standards Checklist appropriate to the type of new boiler installed;

 A Building Control completion certificate;

 A Commissioning Certificate for the new boiler;

 Landlord/Home Owner Gas Safety record;

 Copy of Planning Approval where necessary.

12. All information provided by you may be subject to verification. We reserve the right to refuse to make payment if you supply false information and you will be prosecuted.

Notes to Installer on the Installer Form

1. The Housing Executive accepts no duty of care for any works carried out under this Scheme.

2. The Housing Executive accepts no responsibility for the quality/standard of any work carried out under this Scheme.

3. The boiler manufacturer will issue a specific warranty for the boiler. The installer should make clear to the householder that he will guarantee his workmanship. He should make clear what aspects of the works he will guarantee and for how long he will guarantee them.

4. All electrical works carried out under this Scheme should be carried out by a competent electrician registered with NICEIC, ECA or an equivalent body.

5. If you are installing a natural gas boiler, you MUST be Gas Safe registered and you MUST provide a Landlord/Home Owner Gas Safety certificate to the householder on completion of the works.

6. The installer must ensure that all works carried out under this Scheme comply with all statutory requirements.

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7. A Building Regulations Application MUST be made to the Building Control department of your local council BEFORE any boiler replacement works are started. A fee of £72 will have to be paid with the application. If the application is not made before the works start, the fee will be higher. Your application to Building Control must clearly specify the nature of boiler replacement works planned, in line with section 6 of this form.

8. The Housing Executive will not pay any allowance under this Scheme until we have received the following documents:

 Notification of Completion of Works form;

 a final, detailed invoice, signed and dated by the installer (or if you have already paid your installer, a copy of his signed and dated receipt);

 clear instructions on paying the allowance (BACS 01 or BACS 02);

 a Boiler Installation Minimum Standards Checklist appropriate to the type of new boiler installed;

 A Building Control completion certificate;

 A Commissioning Certificate for the new boiler;

 Landlord/Home Owner Gas Safety record;

 Copy of Planning Approval where necessary.

9. It is permissible to replace an existing LPG boiler with a new LPG boiler or to convert from LPG to oil or natural gas. However, we will not fund

conversion from oil or natural gas to LPG.

10. If you replace an existing oil, LPG or natural gas boiler with a new boiler of the same fuel type and provide full dual controls, the minimum standards we will expect to see are:

 Pumped System:

The hot water and space heating should be fully pumped (Gravity circulation is not acceptable)

A bypass valve should also be fitted at the boiler

 Time Control Of Space And Water Heating:

The hot water has to be heated independently and a two channel time clock has to be provided

 Temperature Control Of Space Heating:

Space heating zones shall be provided by fitting thermostatic radiator valves (TRVs) on all radiators (except heat leak radiators linked to solid fuel appliances)

 Temperature Control Of Hot Water:

1. A thermostatically controlled motorised valve with a cylinder stat on the hot water circuit shall be provided, or

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2. A thermostatically controlled mechanical valve shall be fitted on the hot water circuit at the hot water cylinder or

3. A combination boiler providing instantaneous hot water shall be installed

to provide temperature control to the hot water.

 Carbon Monoxide detectors shall be installed in accordance with Building Regulations.

11. If you change the fuel type, the minimum standards we will expect to see are:

 Boiler Interlock:

Boiler-based systems should have boiler control interlock in which controls are wired so that when there is no demand for either space heating or hot water, the boiler and pump are switched off.

 Time Control Of Space And Water Heating:

All dwellings should have a separate hot water zone in addition to space heating zones. A separate hot water zone is not required if the hot water is produced instantaneously, such as a combination boiler.

 Temperature Control Of Space Heating:

Space heating zones shall be divided into at least 2 zones by using 1. Room thermostats or programmable room stats in all zones or 2. A room thermostat or programmable stat in the main zone and

individual radiator controls such as TRVs on all radiators in the other zones or a combination of 1 and 2 above.

 Temperature Control Of Hot Water:

Domestic hot water systems should be provided with a cylinder thermostat and a zone valve or a three port valve to control the temperature of the hot water.

 Carbon Monoxide detectors shall be installed in accordance with Building Regulations.

The above notes are included on the Boiler Application and Installer forms. While shown here for emphasis they should be read in conjunction with the forms themselves which include other important information. Installers should pay particular attention to Note 4 on the Application form and Note 3 on the Installer Form.

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Work must not commence on the boiler replacement before the Housing Executive issues formal approval to do so. The Boiler Replacement Allowance will not be paid if works are started before formal approval is issued.

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Section 6 – Documentation

The Housing Executive is aware of the need, particularly in the current economic climate, to process payments as quickly as possible. However, I am sure that Applicants and Installers will appreciate that we also need to ensure that robust governance procedures are in place to ensure that public funds are paid in accordance with legislation and policy.

Therefore, it is important for Installers to be aware of the documentation required to process an application and payment, and the need for this documentation to be provided as quickly as possible in the correct format. Below is a quick guide to the information we will be requesting:

FROM THE APPLICANT – THE APPLICATION FORM: -

Form completed and submitted to the Grants Office with the following documentation:

1. Latest mortgage statement OR

Evidence of current house insurance policy (if applicant doesn’t have a current mortgage statement)

2. Most recent utility bill (eg. Rates Demand, electricity, gas, telephone)

3. A copy of most recent pay slip or certificate of earnings (if working)

PLEASE NOTE THAT APPLICATION FORMS NOT PROPERLY COMPLETED, OR NOT ACCOMPANIED BY THE ABOVE DOCUMENTATION, WILL BE RETURNED TO THE APPLICANT.

FROM THE INSTALLER – THE BOILER INSTALLER FORM

All sections of the Installer form must be completed. Eligibility for the Boiler Replacement Allowance will be based on information provided by the Installer on this form. Installers should note that the Installer Form must be signed. An unsigned form will be returned.

Installers undertake to comply with Building Control and statutory requirements for works to be carried out under the Boiler Replacement Scheme. (See Section 8)

INSTALLERS MUST BE GAS SAFE REGISTERED TO WORK ON NATURAL GAS INSTALLATIONS. YOU MUST PROVIDE YOUR GAS SAFE REGISTRATION NUMBER ON THE FORM.

You are not required to be OFTEC registered to work on oil fired installations, but if you are, please include your OFTEC registration number in the box provided. FROM THE GRANTS OFFICE TO THE APPLICANT – APPROVAL DOCUMENTS

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1. Covering letter;

2. Formal approval to start work, stating allowance payable; 3. Notification of Commencement of Works form;

4. Notification of Completion of Work form BRS 18; 5. Payment forms BACS 01 and BACS 02;

6. Boiler Installation Minimum Standards Checklists; 7. Installers invoice template.

FROM THE APPLICANT & INSTALLER - PAYMENT DOCUMENTATION

The following documents will be required before payment can be processed; 1. Notification of Completion of Works form - please return to the

Housing Executive as soon as the works have been completed – do not wait until you have received all the other documents detailed below;

2. a final detailed invoice signed and dated by you (or if you have already been paid by the householder, a copy of your signed and dated

receipt);

3. clear instructions from the householder on paying the allowance (BACS 01 or BACS 02);

4. a Boiler Installation Minimum Standards Checklist appropriate to the type of new boiler installed;

5. a Building Control completion certificate in every case;

6. a commissioning certificate or a Gas Safe certificate in every case appropriate to the type of boiler newly installed under the Scheme; and 7. a copy of planning approval where necessary.

An electrical completion certificate will not be required, but all electrical work carried out under this Scheme should be completed by a competent electrician registered with NICEIC, ECA or an equivalent body.

On receipt of the above documentation the Grants Office will select a number of applications for inspection.

The Housing Executive accepts neither a duty of care for the works carried out, nor accepts responsibility for the quality/standard of any work carried out under the scheme.

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Section 7 – Application of VAT

It is important that Installers apply the correct level of VAT to works carried out under the Boiler Replacement Scheme. The Boiler Replacement Allowance itself is ‘outside scope’ for VAT purposes and therefore the allowance given by the Housing Executive will be the same, whether VAT is charged or not.

However, while VAT is not taken into account by the Housing Executive in assessing the allowance, it is important in relation to the amount the applicant will have to pay to the Installer.

Installers should read the relevant sections of the VAT legislation to ensure they charge the correct amount. You may wish to consult the following issued by HM Revenue and Customs in November 2011;

Notice 708/6 Energy Saving Materials Section 3.9(Grant funded Schemes)

Section 3.11 (Contributions from Householders own Resources)

Section 3.9 indicates that work carried out under the Boiler Replacement Scheme is eligible for the reduced rate of VAT.

Section 3.11 indicates that where schemes are only part grant aided, such as the Boiler Replacement Scheme, only the proportion of the work which is grant aided is eligible for the reduced VAT rate.

Example;

A Householder is eligible under the Boiler Replacement Allowance to convert from oil to gas. As the Householder has income of less than £20,000, they are entitled to a £1,000 Boiler Replacement Allowance.

Installer does not apply reduced VAT Boiler Replacement Allowance

Cost of Works £2,000

VAT @ 20% £ 400

Total Cost to Householder £2,400 £1,000

Installer applies reduced VAT for grant portion of the works Boiler Replacement Allowance

Cost of Works £2,000

VAT @ 20% on £1,000 not grant aided £ 200 VAT @ 5% on £1,000 grant aided £ 50

Total Cost to Householder £2,250 £1,000

This example shows that, although there is no financial advantage to the Installer, the applicant will pay £150 more where the correct VAT rate has not been applied.

This can be a significant amount to a Household with earnings of less than £20,000 per year, and may be the deciding factor on whether an applicant

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carries out the works. This in turn could have an impact on the level of uptake for the scheme.

Therefore Installers should include details of the VAT applied on their Final Invoice (See Appendix 4 Sample Approval Pack).

As stated above, the rate of VAT charged will not affect the allowance paid, but the Housing Executive will monitor how VAT has been applied as the scheme progresses.

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Section 8 – Building Control Requirements

Installers undertake to comply with relevant Building Control and other statutory requirements. Building Control Completion Certificates will be required for all Boiler Replacement applications.

The following information notes are set out below:

 Building Control (NI) Information Note No. 1 – Procedural information for Building Regulations application for domestic boiler replacements & associated works.

 Building Control (NI) Information Note No. 2 – Boiler Replacement Scheme 2012 – Information note for contractors & applicants.

NI Building Control Information Note No. 01

NI Building Control Information Note No. 01

Subject:

PROCEDURAL INFORMATION FOR BUILDING REGULATIONS APPLICATION FOR DOMESTIC BOILER REPLACEMENTS & ASSOCIATED WORKS

Issued Sept. 2012

Revision

02 Page 01 Of 08

It is a legal requirement under The Building Regulations (Northern Ireland) 2000 that an application be made to the relevant local council for work in

connection with boiler replacements. The Building Control Northern Ireland website may be of further assistance:

www.buildingcontrol-ni.com MAKING AN APPLICATION STEP 1.

Establish which council area the property lies in. The following page in the website shows a map of the current council boundaries in Northern Ireland.

Building Control NI – Council boundaries

If you click on any area, you will get useful information about that council, including contact details, and a more detailed map of the borough, which should help confirm that it is the local council that covers the property. See also the contact details in this document.

If the property is too near a boundary to determine, confirm by phoning one or both of the councils; their Building Control Departments are probably best equipped to answer this, as they usually deal with postal numbering.

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STEP 2.

Fill out an application form:

Building Control NI application form

The form can be filled out online and printed out. Hard copies of standard Northern Ireland Building Control forms are available from any local Council Building Control office. Tick the ‘Building Notice’ box. The sections for details of applicant, agent, and works location should be filled in. The applicant can be the person occupying the dwelling, although it can be any other associated party. The agent is usually the installer.

In Section A:

Fill in description of work. It is important that the person filling out the

application form inserts the correct wording to reflect the option as detailed on the NIHE application forms, as this is what will be printed on the Building

Regulation Completion Certificate:

Option 1: Existing Oil to new Oil (no additional controls)/ Existing Natural Gas to new Natural Gas (retaining existing controls)

Option 2: Existing Oil to new Oil with full NIHE requirement dual controls Option 3: Existing LPG to new LPG (no additional controls)

Option 4: Existing LPG to new LPG with full NIHE requirement dual controls Option 5: Existing LPG to new Oil with full NIHE requirement dual controls Option 6: Existing Oil (or LPG) to Natural Gas with full NIHE requirement dual

controls

Option 7: Existing Oil (or LPG) to Wood Pellet with full NIHE requirement dual controls

Option 8: Existing Natural Gas to new Natural Gas with full NIHE requirement dual controls

In section B:

A brief description of the materials, components and construction should be entered.

In Section C:

Ignore unless the work has already been carried out & you now wish to legitimise it. (ie; Regularisation Application)

In Section D:

Provide an estimated cost of the works proposed. (See Step 3 for further guidance)

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The applicant/ installer must complete, sign and submit the Building Regulation Application, to the relevant council prior to works commencing with the

relevant fee.

A site location plan at either 1:1250 or 1:2500 scale may be requested at application stage.

STEP 3.

Legislation requires that a fee be paid for works in connection with a boiler replacement. The fee for the replacement of an existing combustion

appliance is £72, irrespective of the cost of the works. A fee of £86.40 will be payable in those cases where the building control application is not made before the boiler replacement works are carried out.

A number of councils also accept applications electronically via the council’s website or email. Payment may alternatively be made by using most major credit/debit cards. Contact your local Council Building Control department for further advice.

NOTIFICATION OF WORKS.

After a Building Regulation application has been submitted, the applicant/ installer will receive acknowledgement of receipt of the application.

As the installation works commence the applicant/ installer must notify Building Control to arrange suitable date/time for access to inspect the works.

Please refer to the Information Note No.2 regarding what the Building Control Officer may be looking for during the completion inspection.

When the Building Control inspector is satisfied that the works comply with the Building Regulations, the Council will issue a Building Regulation Completion Certificate.

If you have any queries either before or during the process, please call your local Council Building Control department.

All contact details for Building Control Offices can be found at the following web site:

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CONTACT DETAILS FOR COUNCILS: Antrim Borough Council

Antrim Civic Centre, 50 Stiles Way Antrim BT41 2UB

Co. Antrim

Telephone: 028 9446 3113

Ards Borough Council 2 Church Street

Newtownards BT23 4AP Co. Down

Telephone: 028 9182 4034 Armagh City & District Council

The Palace Demesne Armagh BT60 4EL Co. Armagh

Telephone: 028 3752 9616

Ballymena Borough Council Ardeevin

80 Galgorm Road Ballymena BT42 1AB Co. Antrim

Telephone: 028 2566 0300 Ballymoney Borough Council

Riada House 14 Charles Street Ballymoney BT53 6DZ

Telephone: 028 2766 0200

Banbridge District Council Civic Building

Downshire Road Banbridge BT32 3JY

Telephone: 028 4066 0603 Belfast Building Control Service

5th Floor 9 Lanyon Place Belfast BT1 3LP

Telephone: 028 9027 0650 Helpline: 028 9027 0432

Carrickfergus Borough Council Building Services Department Museum & Civic Centre 11 Antrim Street

Carrickfergus BT38 7DG Co. Antrim

Telephone: 028 9335 8000 Castlereagh Borough Council

Castlereagh Civic & Administrative Offices

1 Bradford Court Upper Galwally Castlereagh BT8 6RB Telephone: 028 9049 4610

Coleraine Borough Council Cloonavin

66 Portstewart Road Coleraine BT52 1EY

Telephone: 028 7034 7252 Cookstown District Council

Burn Road Cookstown

Co. Tyrone BT80 8DT Telephone: 028 8676 2205

Craigavon Borough Council Civic Centre

Lakeview Road Craigavon BT64 1AL Telephone: 028 3831 2486 Derry City Council

98 Strand Road Derry BT48 7NN Co. Londonderry

Telephone: 028 7137 6521

Down District Council 24 Strangford Road Downpatrick BT30 6SR Co. Down

Telephone: 028 4461 0829 Dungannon and South Tyrone

Borough Council Circular Road Dungannon

Co. Tyrone BT71 6DT Telephone: 028 8772 0357

Fermanagh District Council Town Hall

Enniskillen

Co. Fermanagh BT74 7BA Telephone: 028 6632 1807

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Larne Borough Council Smiley Buildings Victoria Road Larne BT40 1RU Co. Antrim Telephone: 028 2827 2313

Limavady Borough Council 7 Connell Street

Limavady BT49 0HA

Telephone: 028 7776 0301 Lisburn City Council

Building Control Services,

Environmental Services Department ISLAND CIVIC CENTRE

1 The Island Lisburn BT27 4RL

Telephone: 028 9250 9372

Magherafelt District Council 50 Ballyronan Road

Magherafelt BT45 6EN Telephone: 028 7939 7979

Moyle District Council Sheskburn House 7 Mary Street

Ballycastle BT54 6HQ Telephone: 028 2076 2225

Newry & Mourne District Council O´Hagan House

Monaghan Row Newry BT35 8DJ

Telephone: 028 3031 3000 Newtownabbey Borough Council

Mossley Mill

Newtownabbey BT36 5QA Co. Antrim

Telephone: 028 9034 014

North Down Borough Council Town Hall, Castle Park Avenue Bangor BT20 4BT

Co. Down

Telephone: 028 9127 8015 Omagh District Council

The Grange Mountjoy Road Omagh

Co. Tyrone BT79 7BL

Telephone: 028 8224 5321

Strabane District Council 47 Derry Road

Strabane

Co. Tyrone BT82 8DY Telephone: 028 7138 1315

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Version Date Who Detail

0.1 02.09.12 T L. SGBC 1st issue

0.2 20.09.12 T L. SGBC Page 1 - Amendments from 4 to 7

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NI Building Control Information Note No. 02

This information note is intended to provide awareness & information to

householders, plumbers & agents regarding the issues surrounding the recently launched (2012) Department of Social Development (DSD) Boiler Replacement Scheme across Northern Ireland. This information note aims to give awareness of the legal duty to comply with the Northern Ireland Building Regulations (currently Building Regulations (NI) 2000), & the practical implication for this & similar schemes. Information is based on the legislation presently enforced & upon information available at the time of issue & may be subject to change. The Building Regulations (NI) 2000 & associated Department of Finance & Personnel (DFPNI) guidance documents should always be consulted for full details in any particular case.

Why do I need to make a Building Regulation application?

The Building Regulations are necessary to ensure that an acceptable standard of construction is achieved to protect the health & safety of people in &

around buildings & to improve energy conservation. For the vast majority of domestic boiler replacement1, it is a legal requirement that a Building

Regulation application must be made to the Local Council, which may take the form of a Building Notice.

How do I comply with the NI Building Regulations?

Whether or not a Building Regulation application is required for the boiler

replacement works, it is a legal requirement that all the works must comply with the Building Regulations.

The Building Regulations are legislative requirements to ensure that the health & safety of people in or about buildings is not compromised.

1 generally the only exception being where an existing boiler is being replaced without any works such as new flue etc.

NI Building Control Information

Subject:

Boiler Replacement Scheme 2012 Information Note for Contractors & Applicants

Note No. 02 Issued

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With regards to boiler replacements, the main requirements are that; a) it operates safely

b) its operation does not cause damage by heat or fire c) the products of combustion do not cause a risk to health d) it receives sufficient air for its safe operation

e) the system is efficient.

Under the Building Regulations (NI) 2000, there are a number of items that should be checked for compliance. These include;

1. New flue arrangement to comply with guidance in Building Regulations Technical Booklet L, 2006.

2. Any new thermostatic controls generally to comply with “reasonable provisions” as suggested in the DCLG (2008) guide.

3. NB. Care must also be taken when working on existing systems that have back boilers or solar panels etc., to ensure that the safety & efficiency of the system are not compromised (boiler warranty also to be considered). 4. Correct fitting of existing/new fire valve.

5. Any new replacement circulation pump.

6. Any new installation of programmer/timer as per DCLG (2008) guide. 7. Adequate permanent supply of combustion air. (see Building Regulations

Technical Booklet L, 2006, for guidance)

8. Boiler efficiency. (see guidance below for performance standards) 9. Insulation of pipes & fittings. (see Building Regulations Technical Booklet

L,2006, for guidance)

10. Safe storage of fuel. (see Building Regulations Technical Booklet L, 2006, for guidance)

11. Safe disposal of condensates.

12. All heating and hot water systems need to be fully commissioned to ensure they are operating at maximum efficiency and that all controls work as intended. The person who carries out the commissioning must provide a certificate confirming that it has been carried out properly to both the client and the Building Control Surveyor.

13. Proper instructions to owners should be provided to inform them of how to operate the system efficiently including what routine maintenance is required.

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What are the performance standards for central heating boilers?

For domestic oil & gas fired boilers you are required to have a minimum SEDBUK 20052seasonal efficiency rating 90% from 31st Oct. 2012 (current requirement min. 86% applies until then).

For domestic wood pellet boilers you are required to have a minimum SEDBUK 2005 seasonal efficiency rating 70/75% from 31st Oct. 2012 (current

requirement min 65% applies until then).

All values are minimum values and apply to new and existing buildings, except where stated. The boiler efficiency should meet either the SEDBUK 2005 or SEDBUK 2009 standard.

If the SEDBUK efficiency given in boiler literature is not dated, it should be assumed to be the SEDBUK 2005 value.

Efficiency is heat output divided by calorific value of fuel. The net calorific value of a fuel excludes the latent heat of water vapour in the exhaust, and so is lower than the gross calorific value. Efficiency test results and European standards normally use net calorific values. SAP 2009, which uses gross values, gives factors in Table E4 for converting net efficiency to gross efficiency (e.g. 0.901 for natural gas, 0.921 for LPG, 0.937 for oil).

Controls etc. for heating and hot water systems

Given the potential variety & complexity of existing heating & hot water systems, there may well be various solutions to providing controls etc. which could comply with the requirements of the Building Regulations.

Space heating controls, zone controls, timing controls, boiler control

interlocks etc. should be designed to comply with the principles as set out in the DFPNI Technical Booklet F1, 2006 & DCLG Domestic Heating Compliance Guide 2008.

These include:

1. Areas with differing heating needs (such as separate sleeping and living areas) should have individual temperature control - by the use of room thermostats or individual radiator valves.

2. Separate timing controls should be provided for space heating and hot water (except for combination boilers and solid fuel appliances). The system design must allow the provision of only space heating, only water heating, or both when required.

3. Boiler interlock should include (i.e.; anti-cycling devices) to ensure that when there is no demand for either space heating or hot water, the boiler & pump will switch off.

2

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4. Pipes and ducts should also be insulated, particularly where they run

through unheated areas or outside. Hot pipework connecting to boilers and hot water storage vessels (including the vent pipe) should be insulated for at least 1m from the point where they connect.

5. All heating and hot water systems need to be fully commissioned to ensure they are operating at maximum efficiency and that all controls work as intended. The person who carries out the commissioning must provide a certificate confirming that it has been carried out properly to both the client and the Building Control Surveyor.

6. Proper instructions to owners should be provided to inform them of how to operate the system efficiently, what routine maintenance is required and the benefits of conserving fuel and power

Building Regulation Completion Certificate.

Ensure you receive your Building Regulation Compliance Certificate from your local Council Building Control Department on satisfactory completion of the works.

NB

The new Building Regulations for Northern Ireland were introduced on 31st October 2012 & as result any information given in this document will be subject to review & possible update.

It is the responsibility of installers to ensure that all works comply with the current Building Regulations.

http://www.legislation.gov.uk/nisr/2012/192/contents/made Useful links and advisory leaflets.

1. Building Regulations (NI) 2000, Technical Booklet F1, 2006: Conservation of Fuel and Power in Dwellings.

2. Building Regulations (NI) 2000, Technical Booklet L, 2006: Conservation of Fuel and Power in Dwellings.

3. Guide to the Condensing Boiler Installation Assessment Procedure for Dwellings ODPM 2005.

4. Domestic Building Services Compliance Guide 2008 DCLG.

All leaflets can be downloaded from http://www.dfpni.gov.uk/index/buildings-energy-efficiency-buildings/building-regulations.htm

Version Date Who Detail

0.1 Aug. 2012 TL (SGBC) Draft 01

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Boiler Replacement Scheme Installers Guide

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Boiler Replacement Scheme

Application

Form

Ref. No._______________________

Please read carefully all notes, including the

additional notes on page 10 of the Form. Please return this Form when completed to: Please contact the Grants Office if you

need advice or guidance on completing this Form. All information provided on this Form will be treated in strictest confidence.

YOU MUST NOT INSTALL YOUR NEW BOILER UNTIL THE HOUSING EXECUTIVE ISSUES YOU WITH FORMAL APPROVAL TO DO SO.

IF YOU DO, THE BOILER REPLACEMENT ALLOWANCE WILL NOT BE PAID.

Tick () answer boxes where appropriate.

FRAUD WARNING

YOU WILL BE PROSECUTED IF YOU PROVIDE FALSE INFORMATION

If this form is not properly completed, we will return it to you. You will not be considered for the Scheme until the form is properly completed and returned to us.

Boiler Replacement Scheme Eligibility Criteria

A. Applicant Eligibility.

To be eligible for the Boiler Replacement Scheme you must:

Own your home and occupy it as your sole or main residence (you may also be eligible if you are entitled to have your day in the house or if you are in the co-ownership scheme);

And

The total, gross, annual income of the owner occupier/s and his/her spouse/partner must be less than £40,000;

B. Boiler Eligibility.

To qualify for the Boiler Replacement Scheme:

Your existing boiler must be at least 15 years old.

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1.

Applicant Details

. Title:

First Name: Surname: Date of Birth:

National Insurance Number:

2.

Details of Spouse/Partner

. Title: First Name: Surname: Date of Birth:

National Insurance Number:

3.

Address of Property where

the boiler is to be replaced

Post Code:

To be eligible for the Boiler Replacement Scheme, this address must be your sole or main home. Holiday homes or bed and breakfast establishments are not eligible for consideration under this Scheme.

The Boiler Replacement Scheme is NOT available to private sector tenants nor to tenants of the Housing Executive or Registered Housing Associations.

4. Do you own your home, or are you entitled to your day in the house, or

are you currently in the co-ownership scheme; and do you occupy

your home as your sole or main residence?

Yes

No

Is this property a holiday home or a bed and breakfast establishment?

Yes

No

You must provide your latest mortgage statement. If you do not have a recent mortgage statement, we may accept evidence of house buildings insurance. You must also submit a recent utility bill (rates demand, electricity, gas, mobile or landline telephone bill).

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5. Contact Details

. Please indicate () your preferred contact method.

Home telephone number: Mobile telephone number: Work telephone number: Email address:

6. Representative/Correspondence Details

If someone will be acting on your behalf, or if you want us to send correspondence to another address, please provide details below. Name of Representative:

Representative’s relationship to you:

Address:

Post Code:

Preferred Telephone number Email Address

7. Is your existing boiler at least 15 years old?

Yes

No

If you have an existing natural gas boiler, it must have been connected to the natural gas network at least 15 years ago.

8. Are the works currently the subject of

Yes

No

any other application to the Housing

Executive for grant aid or assistance?

If “Yes”, please give details

9. Have the works ever been included in

Yes

No

any other application to the Housing

Executive for grant aid or assistance?

If “Yes”, please give details

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10. Apart from the additional funding that may be available as part

of this scheme from Firmus Energy, are you applying for any

other financial help to replace your boiler?

Yes

No

If you are applying for other help, the Housing Executive will not pay an allowance under this Scheme.

To be eligible for the Boiler Replacement Scheme, your total, gross,

annual income must be less than £40,000.

Income consists of:

Earnings from your job (including self-employment);

Benefit income;

Any other income including income from a pension, property rental,

maintenance or similar.

11. Is your total, gross, annual, income less than £40,000?

Yes

No

12. Income Details

If you answered “yes” at 11 above, please provide details on the next page of your total, gross, income and the total, gross, income of your spouse/partner. You must confirm, under the

categories listed, all sources of income or benefits that you or your spouse/partner receive.

If you and your partner are employed, you must enclose with this form a recent payslip or have the enclosed certificate of earnings form completed by your employer.

Anyone else who may be registered as an owner of this property and who occupies it as their sole or main residence must also provide details of their income. If necessary, please continue on the additional sheets at page 11.

If you require any help or clarification, please contact your Grants Office on the telephone

number on the front of this form.

When entering amounts in the boxes below, please indicate whether payments are

received on a weekly (w), fortnightly (f), monthly (m), 4 weekly (4) or annual (a)

basis

For Example: a = Annual income

You Spouse/Partner

(Amount) (Frequency) (Amount) (Frequency)

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(a) Earned Income

You Spouse/Partner

Amount Frequency Amount Frequency

Gross Salary/Wages £ £

(b) Self Employment

You Spouse/Partner

*Net Profit from Self- Amount FrequencyAmount Frequency

Employment £ £

(*Gross Profit less business expenses)

(c) Benefits

(d) Other Income/Benefits (please specify and show amounts and frequency of payment)

Type of Benefit You Spouse/Partner

Amount Frequency Amount Frequency

Attendance Allowance £ £ DLA £ £ PIP £ £ Incapacity Benefit £ £ Retirement Pension £ £ Pension Credit £ £

Occupational Pen. (Gross) £ £

Income Support £ £

Job Seeker’s Allowance £ £

Employment/Support Allow. £ £

Child Benefit £ £

Child Tax Credit £ £

Working Tax Credit £ £

Housing Benefit £ £

Rates Relief £ £

Other Income/Benefits You Spouse/Partner

Amount Frequency Amount Frequency

£ £

£ £

£ £

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I/we declare that I/we have accurately recorded all sources of income received.

I/we understand that we may be liable to prosecution if we make false statements.

I/we understand that the Housing Executive may share my details with other agencies as appropriate.

I/we understand that the Housing Executive will contact us and/or other agencies as appropriate to verify the information provided.

Signature of

applicant Date

Signature of

spouse/partner Date

13.

Boiler Replacement Allowance

The amount of allowance you might get will depend on your total household income, and the works you propose to carry out.

Total, gross, annual income of all owner

occupiers and spouses/partners

Option 1* Option 2** Option 3***

Less than £20,000 £700 £1,000 £1,000

£20,000 - £39,999 £400 £500 £500

*Boiler Replacement Option 1 is where a new boiler is to be provided that uses the same fuel type as the existing boiler. No controls are provided in this option.

You may replace an existing oil boiler with a new oil boiler; an existing LPG boiler with a new LPG boiler or an existing natural gas boiler with a new natural gas boiler (in which case the existing controls are to be retained).

**Boiler Replacement Option 2 is also where a new boiler is to be provided that uses the same fuel type as the existing boiler. Under this option, however, new controls are provided.

It is more energy efficient and it may help reduce the overall cost of your fuel bills if you have controls fitted. Your installer can better advise on the benefits of including controls. If you claim additional money for the installation of controls under option 2 above, the boiler installation must comply with the minimum standards set out at note 9 on page 10 of this form.

***Boiler Replacement Option 3 is where a new boiler is to be provided that uses a different fuel type to the existing boiler.

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You may convert an existing oil boiler to natural gas with full controls or to wood pellet with full controls.

You may convert an existing LPG boiler to oil with full controls or to natural gas with full controls or to wood pellet with full controls. However, you may not convert an existing oil or natural gas boiler to LPG. LPG stands for Liquefied Petroleum Gas, which is usually provided in bottles or tanks. Please contact your local Grants Office for advice.

If you claim additional money to change the fuel type under option 3 above, the boiler installation must comply with the minimum standards set out at note 10 on page 11 of this form.

If you live in the Firmus Energy licence area and you wish to convert to natural gas, you may be eligible to receive additional financial help.

You should contact Firmus Energy on 08456 08 00 88.

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14.

Declaration.

To be completed by the Applicant.

I authorise the Housing Executive to obtain information from any source which may be relevant to my application and to share this information with other agencies.

I declare that to the best of my knowledge the details provided on this form are correct.

I understand that if I give information that is incorrect or incomplete, I will be liable to prosecution.

I declare that I own and occupy as my sole or main residence the property at the address shown at section 3.

I declare that the property at the address shown at section 3 is not a holiday home; bed and breakfast establishment; static caravan, nor a houseboat.

I declare that my existing boiler is at least 15 years old.

I enclose the following:

1. Latest mortgage statement or

Current evidence of house buildings insurance (I do not have a current mortgage statement)

2. Most recent utility bill (rates demand or electricity, gas, mobile or landline telephone bill)

3. Most recent pay slip or certificate of earnings (if working)

Please tick the boxes appropriate to the documents you intend sending to us. You must provide either of the documents at 1 plus one of the documents at 2 and, if you are working, one of the documents at 3.

Signature Date

Please ensure that you and your spouse/partner have also signed your names on the financial declaration on page 6. You must also ensure that any other owner occupiers who have provided details of their income have signed the relevant declaration on page 13.

Warning: Anyone knowingly making a false statement to fraudulently obtain monies is liable to prosecution.

You must not commence work on the boiler replacement before the Housing Executive issues you with formal approval to do so. If you do commence the works without formal approval, the boiler replacement allowance will not be paid.

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15.

Fair Processing Code and Data Protection Act 1998:

The Housing Executive must collect personal details for the purpose of establishing eligibility, facilitating the processing of the application, if eligibility is established, and enabling us to pay the Boiler Replacement Allowance, if approved, to a specified bank account.

In order to comply with the requirements of the “Fair Processing Code” and other obligations under the Data Protection Act 1998, the Housing Executive has prepared an information leaflet which is available at your local grants office, or by visiting our website:

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Notes to Applicant

1. The Housing Executive accepts no duty of care for any works carried out under this Scheme.

2. The Housing Executive accepts no responsibility for the quality/standard of any work carried out under this Scheme.

3. The installer you choose to install your new boiler is responsible for carrying out the works in a competent manner. If you have any problems with your new boiler, or if your property is damaged during the boiler replacement works, you should contact your installer.

4. The boiler manufacturer will issue a specific warranty for the boiler. The installer should make clear to you that he will provide a separate guarantee for his

workmanship. He should make clear to you what aspects of the works he will guarantee and for how long he will guarantee them. You should talk to your installer before any works begin to agree a warranty period for his workmanship. 5. We would advise that all electrical works carried out should be carried out by a

competent electrician registered with NICEIC, ECA or an equivalent body.

6. If you are converting from oil to natural gas, your chosen installer MUST be Gas Safe registered and he MUST provide you with a Landlord/Home Owner Gas Safety certificate on completion of the works.

7. You must ensure that all works carried out in your home comply with all statutory requirements.

8. A Building Regulations Application MUST be made to the Building Control department of your local council BEFORE any boiler replacement works are started. A fee of £72 will have to be paid with the application. If the application is not made before the works start, the fee will be higher. The application to Building Control must clearly specify the nature of boiler replacement works planned,

particularly if you intend installing full dual controls.

9. If you replace an existing oil, LPG or natural gas boiler with a new boiler of the same fuel type and provide full dual controls, the minimum standards we will expect to see are:

Pumped System:

The hot water and space heating should be fully pumped (Gravity circulation is not acceptable)

A bypass valve should also be fitted at the boiler Time Control Of Space And Water Heating:

The hot water has to be heated independently and a two channel time clock has to be provided

Temperature Control Of Space Heating:

Space heating zones shall be provided by fitting thermostatic radiator valves (TRVs) on all radiators (except heat leak radiators linked to solid fuel appliances) Temperature Control Of Hot Water:

1. A thermostatically controlled motorised valve with a cylinder stat on the hot water circuit shall be provided, or

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2. A thermostatically controlled mechanical valve shall be fitted on the hot water circuit at the hot water cylinder or

3. A combination boiler providing instantaneous hot water shall be installed to provide temperature control to the hot water.

Carbon Monoxide detectors shall be installed in accordance with Building Regulations.

10. If you change the fuel type, the minimum standards we will expect to see are: Boiler Interlock:

Boiler-based systems should have boiler control interlock in which controls are wired so that when there is no demand for either space heating or hot water, the boiler and pump are switched off.

Time Control Of Space And Water Heating:

All dwellings should have a separate hot water zone in addition to space heating zones. A separate hot water zone is not required if the hot water is produced instantaneously, such as a combination boiler.

Temperature Control Of Space Heating:

Space heating zones shall be divided into at least 2 zones by using 1. Room thermostats or programmable room stats in all zones or

2. A room thermostat or programmable stat in the main zone and individual radiator controls such as TRVs on all radiators in the other zones or a combination of 1 and 2 above.

Temperature Control Of Hot Water:

Domestic hot water systems should be provided with a cylinder thermostat and a zone valve or a three port valve to control the temperature of the hot water.

Carbon Monoxide detectors shall be installed in accordance with Building Regulations.

11. The Housing Executive will not pay any allowance under this Scheme until we have received the following documents:

Notification of Completion of Works form;

a final, detailed invoice, signed and dated by the installer (or if you have already paid your installer, a copy of his signed and dated receipt);

clear instructions on paying the allowance (BACS 01 or BACS 02);

a Boiler Installation Minimum Standards Checklist appropriate to the type of new boiler installed;

A Building Control completion certificate;

A Commissioning Certificate for the new boiler; Landlord/Home Owner Gas Safety record; Copy of Planning Approval where necessary.

12. All information provided by you may be subject to verification. We reserve the right to refuse to make payment if you supply false information and you will be

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This section is to be completed only where there are additional owners

living in the property.

Please record the total, gross, income details of additional owner occupiers

Earned Income Additional Owner Occupier 1 Additional Owner Occupier 2 Additional Owner Occupier 3 Gross Salary/Wages £ £ £ Self Employment

Gross Earnings from Self

Additional Owner Occupier 1 Additional Owner Occupier 2 Additional Owner Occupier 3 Employment £ £ £ Benefits

Type of Benefit Additional Owner Occupier 1 Additional Owner Occupier 2 Additional Owner Occupier 3 Attendance Allowance £ £ £ DLA £ £ £ PIP £ £ £ Incapacity Benefit £ £ £ Retirement Pension £ £ £ Pension Credit £ £ £

Occupational Pen. (Gross) £ £ £

Income Support £ £ £

Job Seeker’s Allowance £ £ £

Employment/Support Allow. £ £ £

Child Benefit £ £ £

Child Tax Credit £ £ £

Working Tax Credit £ £ £

Housing Benefit £ £ £

Rates Relief £ £ £

Other Income/Benefits (please specify and show amounts and frequency of payment)

Additional Owner Occupier 1 Additional Owner Occupier 2 Additional Owner Occupier 3 £ £ £ £ £ £ £ £ £ £ £ £ Please Note:

The partner/spouse of an additional owner/occupier must also provide details of all income received. Please ask for additional income sheets if you need them.

References

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