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Name

Surname

City

Adress

Postcode

Phone number

Mobile number

Mail

Number of family members

Housing type

Individual house

Apartment

Building project

Building site

Type of construction

4 facades

3 facades

2 facades

Construction year

Energetic efficiency

Use

Private

Professional

Mixed

Second home

Yes

No

Private gross surface

Professional gross surface

Surface (lenght)

Surface (width)

Photovoltaic system

Yes

No

Roof terrace

Yes

No

Roof surface

Slanted roof

Yes

No

Orientation of sloping roofs

North

To the east

South

West

Meter type

Mono meter

Hour meter

Annual electricity consumption – day (peak hours)

Annual electricity consumption – night (off-peak hours)

Annual electricity consumption only night

Total power of installed batteries (kW)

Sales representative’s name (if you have been in contact with one of our Sales representatives)

Number of batteries

Battery voltage

Battery type

Type of heating system

Electric

Gas

Heat pump

Others

Your annual consumption

Number of heaters

Means of hot water production

Electric boiler

Gas furnace

Gas furnace (connected to furnace)

Fuel feed for the boiler (connected to boiler)

Number of hybrid cars in the household

Number of electric motorbikes/bicycles in the household

Number of electric bicycles in the household

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