This form can be used to make an internal application for an emergency fuel grant for your client.

The eligibility criteria for the fuel payment is that the client must:

• Be a resident of the borough or placed temporarily in another borough as homeless.

• Have limited or no savings (i.e. less than £10,000 for a single person or couple over State pension age, or less than £8,000 for a single person or couple under State pension age).

• Have shown recent copies (no less than 31 days old) of bank statements dating back at least three months.

• Have shown a copy of a recent fuel bill, showing the actual (and not estimated amount) dating back no more than 31 days.

• Have explored advice options (e.g. benefits check, income and expenditure budgeting support, and/or a debt assessment) to understand medium-to-long-term solutions to energy debt before putting in an application.

• Have taken steps to making repayments, even if small, to show attempts to pay their energy bills (unless they are in a negative budget and cannot reasonably take steps to enter a positive budget following income and expenditure budgeting advice).

The client will be notified of the outcome via their preferred method of contact within five working days. You will also be notified so that you can record the outcome but it will not be incumbent on you to notify the client.

If successful, payments are made directly to the energy company.