Date Auditor Qualifying Benefit Yes No Unknown

Title Initials Smart monitor left Yes No TBA

Surname No. of rooms (bed, living, dining)

Address

Postcode Tel: Preferred format of report

Email Electronic Written

Age <5 <16 17-25 25-34 35-49 50-64 65-70 >70 >75
Male
Female

How Energy Efficient is your home?

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Why not better? Why not worse?

Auditor's notes
Property type Annual Usage

House Bungalow Maisonette Flat Electricity Supplier

Built Form Annual Usage

Detached Semi/endterrace Mid-terrace Electricity Tariff

Flat-ground Flat-mid Flat-top Payment Method

Age % income on fuel

Planing Constraints Main Heating System

None Listed Conservation Wet central Room heaters Warm air

Tenure Storage heaters Underfloor Community

Owner Renting LA Renting HA Renting PV Boiler Type

Walls Combi Normal (cylinder) Back Boiler

Solid-Brick Solid-Stone Cavity-Brick Condensing Combi Condensing (cylinder)

Cavity-Timber Timber Frame Other Boiler Model

Wall insulation Boiler Age <5 years 5-10 years 10 + years

None Cavity Internal External Controls

Floor Type Timer Programmer Room Stat TRV's

Suspended Solid Floating Temperature Setting <18 18 21 >21

Floor Insulation Secondary Heating

Unknown None Between Below None Gas Fire Open Fire

Roof Type Closed Heater Portable Electric Portable Gas

Flat Pitched Loft Occupied Electric Radiant Electric Fan

Loft Hatch Annual Usage (if applicable)

None Yes Insulated D'proofed Water Heating

Roof Insulation From main heating From secondary heating

Unknown None 50mm 100mm Elec' immersion (on peak) Instant Electric

150mm 200mm 250mm 250mm+ Elec' immersion (off peak) Back Boiler

Window Condition Gas Multi point Gas single point

Good Fair Poor Temperature setting <60 60- 65 >65

Glazing Cylinder Insulation

Single Double Triple Low-E None Thin jacket Thick jacket Solid foam

Shutters/Blinds Shutters Heavy Curtains Heavy Blinds Water Bath(s) Shower gas Shower elec Power

Window draughtproofing Lighting

Good Fair Poor Standard CFLs Halogen LED

Secondary Glazing Appliances Rating Age No

None Yes-good Yes-fair Yes-poor Fridge A A+ A++ -5 5-10 10+

Mechanical Ventilation Freezer A A+ A++ -5 5-10 10+

None Bathroom Kitchen Other Fridge/Freezer A A+ A++ -5 5-10 10+

General Draughtproofing Dishwasher A A+ A++ -5 5-10 10+

Good Fair Poor Oven Gas Elec Oil -5 5-10 10+

Flues Open Flues Open Fires Hob Gas Elec -5 5-10 10+

Condensation Microwave A A+ A++ -5 5-10 10+

None Minor Moderate Severe WashingMachine A A+ A++ -5 5-10 10+

Main Heating Fuel Tumble Dryers A A+ A++ -5 5-10 10+

Mains Gas Electricity Oil TVs A A+ A++ -5 5-10 10+

Bottled Gas Coal/anthracite Biomass Computer A A+ A++ -5 5-10 10+

Main Fuel Supplier Peripherals A A+ A++ -5 5-10 10+