Is your boiler over 10 years old?

Yes     No     I don't know

Do you own or rent your own home?

Homeowner Tenant (Private) Tenant (Social) Landlord

Do you receive any of these benefits?

Pension credit Child tax credit with income below £15,850

Or do you have a child under 16; receive disability allowance; receive pension credit plus one of the following:

Employment support allowance Job seekers allowance Income Support Working tax credit with an income below £15,850