Permanent Tsb Statement Form PDF Details

Navigating financial struggles, especially with mortgage repayments, can be a daunting prospect for any homeowner. In a concerted effort to support customers during such challenging times, Permanent TSB offers a comprehensive tool known as the Standard Financial Statement (SFS). The primary aim of the SFS is to provide a structured way for customers to present their financial situations accurately. This practice is fundamental in facilitating a mutual agreement on any alternative repayment arrangements that might be necessary. Acknowledging the seriousness of financial difficulties, Permanent TSB is committed to guiding customers throughout the process, advocating for open communication through various channels and ensuring access to trained personnel equipped to handle such sensitive circumstances. Customers are urged to meticulously document their income, expenses, debts, and assets within the SFS, including all basic living expenses and any applicable social welfare entitlements. Furthermore, the institution stresses the importance of submitting a thorough and accurate SFS accompanied by any relevant documentation to aid in the assessment of each individual case. Depending on this assessment, conducted by the Arrears Support Unit, a tailor-made alternative repayment plan may be devised to cater to the unique needs of the customer. In instances where an alternative arrangement cannot be offered, customers are provided with a written explanation and are informed of their right to appeal the decision, initially with Permanent TSB and subsequently with the Financial Services Ombudsman if needed. Additionally, support materials and advice from various sources, including independent agencies, are readily available to assist customers in navigating through this process.

QuestionAnswer
Form NamePermanent Tsb Statement Form
Form Length12 pages
Fillable?No
Fillable fields0
Avg. time to fill out3 min
Other namespermanent tsb e statement, permanent tsb standard financial statement, permanent tsb sfs form, permanent tsb bank statement

Form Preview Example

Standard Financial Statement (SFS)

Guiding Principles for completing the SFS

1.We at permanent tsb are fully committed to working with customers who are in, or are facing, inancial dificulties with their mortgage repayments in order that a mutually-acceptable arrangement can be agreed. We will actively encourage contact with such customers through web sites, media and printed material.

2.We have specially-trained personnel in our ofices and branches, including specialised telephone contact points, to deal with customers facing or in inancial dificulties.

3.This Standard Financial Statement (SFS) is designed to assist you in setting out your current inancial circumstances.

4.We consider that the completion of the SFS is a serious undertaking and we will work with you to ensure that the information is accurate, enabling us to work with you to determine the most appropriate and viable option in each particular customer case.

5.The easiest way to see where you stand inancially is to gather all the relevant information and documents so that you can write down all the money you have coming in and going out each month and complete an SFS. (If your income is weekly, multiply it by 52 and divide the result by 12 to get your monthly income.)

6.In the SFS you will have to provide information on your current income, expenses and other amounts you owe and any assets you own. It is important that you include all of your basic living expenses. You are also encouraged to ensure that you are maximising your income, including what social welfare entitlements you may be eligible for such as Mortgage Interest Supplement (see www.keepingyourhome.ie).

7.It is important to ill out the SFS fully and accurately and to provide any relevant documentation that we may need to assess your situation; we will only seek information that is relevant to this assessment.

8.Your completed SFS and other factors relating to your case will be assessed by our Arrears Support Unit which will decide whether or not an alternative repayment arrangement is necessary and, if so, what type(s) of alternative repayment arrangement(s) appropriate to your circumstances can be made available.

9.If an alternative repayment arrangement is not offered to you, we will give you a reason for that decision in writing. You will have the right to appeal that decision; you may appeal to us initially and subsequently to the Financial Services Ombudsman.

10.If you require further information, you can avail of support material available through a number of sources including our website www.permanenttsb.ie, www.keepingyourhome.ie. You can also seek independent advice from MABS (www.mabs.ie) or an appropriate alternative. If you give us your written consent we will liaise with a third party, nominated by you, to act on your behalf.

1

Section A: Account & Borrower Details

 

Borrower Information

Borrower 1

 

Borrower 2

 

 

 

 

 

 

 

 

A1

Name

 

 

 

 

 

 

 

 

 

 

 

 

A2

Mortgage Account Reference No.(s)

 

 

 

 

 

 

 

 

 

 

 

 

A3

Outstanding Mortgage Balance (€)

 

 

 

 

 

 

 

 

 

 

 

 

A4

Estimated Current Value of Primary Residence (€)

 

 

 

 

 

 

 

 

 

 

 

 

A5

Monthly Mortgage Repayments Due (€)

 

 

 

 

 

 

 

 

 

 

 

 

 

Correspondence Address

 

 

 

 

A6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Property Address

 

 

 

 

 

(if different to Correspondence Address)

 

 

 

 

A7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please put tick beside preferred contact method

 

 

 

 

 

 

 

 

 

 

 

 

A8

Home Telephone

 

 

 

 

 

 

 

 

 

 

 

 

A9

Mobile

 

 

 

 

 

 

 

 

 

 

 

 

A10

Work Telephone

 

 

 

 

 

 

 

 

 

 

 

 

 

E-mail*

 

 

 

 

A11

( *Any correspondence via email is not secure. We recommend

 

 

 

 

 

that you indicate at least one other method of contact.)

 

 

 

 

 

 

 

 

 

 

 

 

A12

Marital Status

 

 

 

 

 

 

 

 

 

A13

Date of birth

DD/MM/YYYY

 

DD/MM/YYYY

 

 

 

 

 

 

 

 

 

 

 

Child 1

 

 

 

 

 

 

 

 

 

 

 

 

 

No. and age of dependent children

Child 2

 

 

 

 

A14

 

 

 

 

 

Child 3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Child 4

 

 

 

 

 

 

 

 

 

 

 

 

A15

Total number in household

 

 

 

 

 

 

 

 

 

 

 

A16

Employed Y/N; if self-employed give details

 

 

 

 

 

 

 

 

 

 

 

A17

Occupation (if unemployed give previous occupation)

 

 

 

 

 

 

 

 

 

 

 

A18

In Permanent employment Y/N

 

 

 

 

 

 

 

 

 

 

 

A19

Name of Employer & Length of Service

 

 

 

 

 

 

 

 

 

 

A20

Reason(s) for

 

 

 

 

 

 

Review/Arrears

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

Section B: Your Monthly Income

 

Borrower Information

Borrower 1

Borrower 2

Total

 

 

 

 

 

 

 

 

Gross Monthly Salary

 

 

 

 

B1

(before tax and any other

 

 

 

 

 

deductions at source)

 

 

 

 

 

 

 

 

 

 

 

 

Net Monthly Salary

 

 

 

 

B2

(after tax and any other deductions

 

 

 

 

 

at source)¹

 

 

 

 

 

 

 

 

 

 

 

B3

Monthly Social Welfare Beneits

 

 

 

 

Please list

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B3(a)

Beneit-

 

 

 

 

 

 

 

 

 

 

 

 

B3(b)

Beneit-

 

 

 

 

 

 

 

 

 

 

 

 

B3(c)

Beneit-

 

 

 

 

 

 

 

 

 

 

 

 

B4

Child Beneit

 

 

 

 

 

 

 

 

 

 

B5

Mortgage Interest Supplement

 

 

 

 

 

 

 

 

 

 

B6

Family Income Support

 

 

 

 

 

 

 

 

 

 

B7

Maintenance

 

 

 

 

 

 

 

 

 

 

B8

Other, e.g. Pension, room rent,

 

 

 

 

grants (please specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Monthly Income from Property

 

 

 

 

B9

assets (other than primary

 

 

 

 

 

residence) (see E5)

 

 

 

 

B10

Monthly income from non-property

 

 

 

 

assets (see F8)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B11

Total Monthly Net Income

 

 

 

G1

(sum of B2 to B10)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

¹Do not include any deductions made from your salary at source (e.g., pension contribution, health insurance etc.) anywhere else on this form.

3

Section C: Monthly Household Expenditure

 

Utilities

Average Charge ²

Arrears

 

(Where Applicable)

 

 

 

 

 

 

 

C1

Electricity

 

 

 

 

 

 

C2

Gas/Oil

 

 

 

 

 

 

C3

Phone (Landline & Internet) ³

 

 

 

 

 

 

C4

TV/Cable 3

 

 

C5

Mobile Phone

 

 

 

 

 

 

C6

Refuse Charges

 

 

 

 

 

 

C7

TV Licence

 

 

 

 

 

 

 

Household

 

 

 

 

 

 

C8

Childcare

 

 

 

 

 

 

C9

Elderly care (e.g., carer, nursing home fees, etc)

 

 

 

 

 

 

C10

Food/Housekeeping/Personal Care

 

 

 

 

 

 

C11

Clothing and Footwear

 

 

 

 

 

 

C12

Household Repairs/Maintenance

 

 

 

 

 

 

 

Transport Costs

 

 

 

 

 

 

C13

Petrol

 

 

 

 

 

 

C14

Motor Insurance /Tax/NCT

 

 

 

 

 

 

C15

Rail/Bus/Taxi Costs (including school transport

 

 

costs for children)

 

 

 

 

 

C16

Car Maintenance/Repairs

 

 

 

 

 

 

C17

Car Parking and Tolls

 

 

 

 

 

 

 

Primary Residence Mortgage-related Costs

 

 

 

 

 

C18

Mortgage Protection/Endowment Premium

 

 

 

 

 

 

C19

Payment Protection

 

 

 

 

 

 

C20

House Insurance

 

 

 

 

 

 

 

Education

 

 

 

 

 

 

C21

Books

 

 

 

 

 

 

C22

School/ College Fees

 

 

 

 

 

 

C23

Uniforms

 

 

 

 

 

 

C24

Extra Curricular activities (e.g. school outings)

 

 

 

 

 

 

²Average charge calculated by totalling last three utility bills and dividing by the number of months to get the average monthly cost.

³Please identify if these bills are bundled.

4

Section C: Monthly Household Expenditure

C25 Other (e.g. voluntary contributions)

 

Medical

 

 

 

 

 

 

 

 

C26

Medical Expenses and Prescription Charges 4

 

 

 

C27

Health Insurance 5

 

 

 

 

 

 

 

 

 

Social

 

 

 

 

 

 

 

 

C28

Lifestyle Expenses (e.g., family events,

 

 

 

Christmas, Birthdays, eating out etc.)

 

 

 

 

 

 

 

 

 

 

 

 

C29

Club membership

 

 

 

 

 

 

 

 

C30

Other - please specify

 

 

 

 

 

 

 

 

 

Other

 

 

 

 

 

 

 

 

C31

Life Assurance

 

 

 

 

 

 

 

 

C32

Pension Contribution 6

 

 

 

 

 

 

 

 

 

 

 

 

 

C33

Maintenance paid to spouse/child (if applicable)

 

 

 

 

 

 

 

 

C34

Rent

 

 

 

 

 

 

 

 

C35

Property Service/Management Charges

 

 

 

 

 

 

 

 

C35(b)

Other - please specify

 

 

 

 

 

 

 

 

C35(c)

Other - please specify

 

 

 

 

 

 

 

 

C36

Monthly expenditure on property assets (see E5)

 

 

 

 

 

 

 

 

C37

Monthly Savings

 

 

 

 

 

 

 

 

C38

Total Monthly Expenditure

 

G2

 

(sum of C1 to C37)

 

 

 

 

 

 

 

 

 

 

 

4Medical expenses include dentist, optician, and any other costs related to health.

5Do not include if Health Insurance is deducted from your wages at source, (i.e., if it has already been deducted from B2)

6Do not include if Pension Contribution is deducted from your wages at source, (i.e., if it has already been deducted from B2)

5

Please provide details of any steps you have already taken to reduce your monthly expenditure and the savings you have achieved:

Please provide details of any steps you propose to take to reduce your monthly expenditure and the savings you expect to achieve:

6

Section D: Your Current Monthly Debt Payments

 

 

Monthly Repayments

 

 

Total

 

 

 

 

Currently

Payment

 

Debt Type

 

 

 

 

 

 

Protection

 

 

 

 

 

Remaining

Outstanding

Arrears

 

Purpose of

Secured?

Restructured?

 

 

 

 

 

Lender

Insurance?

 

Due

Being Paid

 

 

 

 

Term

Balance

Balance

Loan

Y/N

Y/N

 

 

 

Y/N

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D1

Mortgage for

 

 

 

G4

 

 

 

 

 

 

 

 

Primary Residence

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D2

Court Mandated Debt 7

 

 

 

 

 

 

 

 

 

 

 

 

(please specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D3

Court Mandated Debt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D4

Credit Union

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D5

Credit Union

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D6

Overdraft

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D7

Hire Purchase

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D8

Store Card

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D9

Catalogue Debt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D10

Credit Card 1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D11

Credit Card 2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D12

Credit Card 3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D13

Personal Loan 1 (please specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D14

Personal Loan 2 (please specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D15

Personal Loan 3 (please specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D16

Loans from family/friends

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D17

Mortgage Debt on property other

 

 

 

 

 

 

 

 

 

 

 

 

than primary residence (see E5)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D18

Other Debt (please specify)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D19

Other Debt

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D21

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

D22

Total Monthly Debt

 

 

 

G5

 

 

 

 

 

 

 

 

(Sum of D2 to D21)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7 e.g., ines, instalment orders, judgements.

7

Section E: Property Assets (other than Primary Residence)

 

Property

 

 

 

 

 

Monthly

 

Monthly Mortgage

 

Property

 

Current

Loan

Arrears

Monthly

Re-

Payments

For

Type

Ownership

Expenditure

(give details

Value

Balance

Balance

Rental

structured

 

Lender

Sale

(e.g. Buy to

Type 8

(e.g., upkeep,

 

below)

(est) 9

Income

Y/N

 

 

Y/N

let)

 

maintenance)

Due Being Paid

 

 

 

 

 

 

 

 

E1 1

E2 2

E3 3

E4 4

Total

B

C

D

9

36

17

 

 

 

 

 

Property Assets (other than Primary Residence)

 

Property

Address

Date of

 

Purchase

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Monthly income and expenditures related to property assets should also be included in sections B and C respectively

Monthly mortgage repayments relating to property assets should be included in section D

8For example, sole or joint ownership. Where a property/ premises is not 100% owned by customer(s), please state the % amount that is owned.

9Please provide a reasonable estimate of the current value of these assets.

8

Section F: Non-Property Assets

 

 

Original

Current

Net Monthly

 

Please Give Any

 

Asset Type

Estimated

 

 

Cost/Value

Income

 

Relevant Details

 

 

Value

 

 

 

 

 

 

 

 

 

 

 

 

 

 

F1

Savings/deposits/current account

 

 

 

 

 

 

 

 

 

 

 

 

F2

Shares

 

 

 

 

 

 

 

 

 

 

 

 

F3

Motor Vehicle(s)

 

 

 

 

 

 

 

 

 

 

 

 

F4

Redundancy Payment(s)

 

 

 

 

 

 

 

 

 

 

 

 

F5

Long-term investment(s)

 

 

 

 

 

 

 

 

 

 

 

 

F6

Other investment(s)

 

 

 

 

 

 

 

 

 

 

 

 

F7

Other Assets (e.g., stock, machinery etc)

 

 

 

 

 

 

 

 

 

 

 

 

F8

Total (Sum of F1 to F7)

 

 

 

B10

 

 

 

 

 

 

 

 

Please list all other liabilities, for example any guarantees given with respect to company borrowing or borrowing by a family member.

Please provide any other information which you believe to be relevant to above:

9

I/we understand that the information provided will only be used for the purpose of assisting permanent tsb to assess my/our inancial situation under its Mortgage Arrears Resolution Process (where applicable) or/and to assess my/our inancial situation for other debt restructuring.

Protecting Your Information

permanent tsb will keep your information conidential and will only use this information for the purpose of assisting you in accordance with our Mortgage Arrears Resolution Process (where applicable) or/and other debt restructuring arrangements in accordance with permanent tsb’s obligations under the Data Protection Acts 1988 and 2003. For more information on your rights under the Data Protection Acts, see the Data Protection Commissioner’s website at www.dataprotection.ie”

I/we declare that the information I/we have provided represents my/our inancial situation, and commit to informing permanent tsb if my/our situation changes.

I/we consent to permanent tsb conducting a credit reference check.

permanent tsb p.l.c. is regulated by the Central Bank of Ireland.

10

Date:Signed:

_____________________________________________________

_____________________________________________________

Date:Signed:

 

____________________ ____________________

Section G: Financial Statement Summary (for ofice use only)

G1

Total Monthly Net Income (B11)

G2

Less Total Monthly Expenditure (C38)

G3

Sub-Total (G1 minus G2)

G4

Less Mortgage Repayments Being Paid (D1)

G5

Less Other Monthly Debt Being Paid (D22)

G6

Total Surplus/Deicit (subtract G4 and G5 from G3)

11

For Branch Use Only

I have reviewed & discussed the information supplied by the customer in the Standard Financial Statement. Based on the information provided, I recommend the following alternative repayment arrangement for this customer:

Capital Payment Holiday*

Partial Moratorium*

Capital Payment Minus*

Managed Arrangement*

Capital Payment Plus*

Capitalising the Arrears*

Moratorium*

Term Extension*

Other relevant information

*3 months most recent primary bank statements are required for all applicants.

Proof of your income in the form of 2 recent payslips, most recent P60, Social Welfare, Mortgage Interest Supplement, Family Income Supplement receipts/conirmation etc.

Self employed customers also need to supply 6 months up to date Business Bank Account Statements and fully completed permanent tsb’s Accountant Certiicate or the most recent 2 years audited accounts.

Name of Branch Advisor: ____________________

Signature: _______________________

Branch: ______________________________

Date: __________________________

12

BMK2045 Rev 08/12