Crisis and Resilience Fund - Heating Oil Support form on a new webpage for users to fill out

CRF FORM - Summer Heating Oil Scheme Form

Name *

Council Tax Number *

Address *

Postcode *

Telephone Number

Email Address *

View the eligibility criteria

View the eligibility criteria for the Crisis and Resilience Fund.

Please confirm that you meet the eligibility criteria for the Household Support Fund, and that you are applying on behalf of the household, by ticking this box. *

Please itemise your monthly household income. This could include salary, child benefit, DWP benefits, pension, tax credits, etc. *

Please confirm your current capital. This must include all bank and building society accounts (including savings accounts) and any other assets. *

Please upload a copy of the last two months bank statement

Selected files:

Please provide proof of heating oil use, such as: A recent invoice or delivery receipt, Bank statement showing payment to a heating oil supplier, Tenancy agreement confirming oil‑based heating *

Selected files:

Name of Bank *

Bank Account Name *

Bank Account Number *

Confirm Bank Account Number *

Bank Account Sort Code *

Confirm Bank Account Sort Code *

Do you have anyone under the age of 18 living in your household?

Yes

Are you a Pensioner?

Yes

Would you describe yourself or anyone in your household as Disabled?

Yes

Do you or your partner have any earnings?

Yes

Do you or a member of your household have a certified terminal diagnosis?

Yes

Are you a victim of domestic violence or abuse inflicted, or threatened, upon you?

Yes

Data Protection Statement

Ashford Borough Council is the data controller for any personal information collected in this
application. Working in partnership with Kent County Council and through the Governments, Crisis and Resilience Fund - Summer Heating Oil Scheme, the council is seeking to support vulnerable households in its borough.

Any collected personal information will be used in order to administrate the scheme, offer any
support and monitor the schemes effectiveness. Processing is being conducted relying upon the
public interest legal basis. Your data may be processed by Ashford Borough Council and Kent County Council so we can provide the required service.

Your data may also be shared with other departments within the council for the purpose of improving services, keeping records up-to-date and for the protection of the public fund. Your information will be retained for a period of 6yrs following an application. For more information about your data protection rights please see the Council’s data protection pages which can be found at www.ashford.gov.uk or contact the Data Protection Officer at, The Data Protection Officer, Ashford Borough Council, International House, Ashford, Kent, TN23 1HU

I agree with the above use of my data *

Declaration

By writing my name below I confirm the following statements:

I confirm the above information is correct to the best of my knowledge.

I understand that if this form is not filled in correctly this may cause a delay or even exclusion from the Crisis and Resilience Fund - Summer Heating Oil Scheme.

If I have given information in this application that I know to be false, I understand that Ashford Borough Council may take action against me. This may be court action.

Please write your name to confirm the above statements *

Spam guard *