Please complete ALL applicable questions below, if you have purchased loft insulation.

 Please provide the VAT number from your Earthwool receipt.
Are you, or is anyone living at your home in receipt of income or disability related benefits?
Yes No
If in domestic premises, where will you insulate?
Gas Oil LPG Electricity Coal
How many rolls of loft insulation did you buy?
Which product was it?
What thickness did you purchase?
Did you have any insulation in your loft already?
Yes No
If yes what thickness?
Do you intend to install the insulation?
Yes No
Will you use it to insulate domestic or business premises?
If in domestic premises, where will you insulate?
Whole Loft Part Loft Walls Floors Garage Out Building Other Conversion
Will the insulation be installed in a new extension to your house?
Yes No
Will you single or double lay the insulation?
(a) Is there any insulation left over?
Yes No
(b) If yes, what do you intend to do with it?
(c) If yes, is it
a part roll whole roll
   
 
Mr/Mrs/Miss/Ms
 
 
First Name Surname
 
 
Address
 
 
Postcode
 
 
Telephone Email Address
 
     
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