Personal Insolvency Act 2012 (Prescribed Debt Relief Notice Application Form) Regulations 2013

• Jurisdiction: Ireland
• Citation: IR SI 333/2013
• Year: 2013

Notice of the making of this Statutory Instrument was published in

“Iris Oifigiúil” of 3rd September, 2013.

The Insolvency Service of Ireland, in exercise of the powers conferred on it by section 3 of the Personal Insolvency Act 2012 (No. 44 of 2012) (the “Act”), hereby makes the following regulations:

1. These Regulations may be cited as the Personal Insolvency Act 2012 (Prescribed Debt Relief Notice Application Form) Regulations 2013.

2. The form set out in the Schedule to these Regulations is hereby prescribed for the purposes of section 29(2) of the Act.

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Schedule

APPLICATION FOR DEBT RELIEF NOTICE

AN CHÚIRT CHUARDA

THE CIRCUIT COURT

[........................] CIRCUIT COUNTY OF [........................]

IN THE MATTER OF AN APPLICATION UNDER SECTION 31 OF THE PERSONAL INSOLVENCY ACT 2012

AND IN THE MATTER OF [.] OF [..],

A DEBTOR

I

of .

County of

HEREBY APPLY for the making of an order for the issue under section 31 (2)(a) of the Personal Insolvency Act 2012 of a Debt Relief Notice in respect of the debts specified in the application under section 29 of the said Act which the Court is satisfied are qualifying debts.

Dated .20..

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Important Information and Statements

1. Unless otherwise defined in this application form, terms used herein have the same meaning as under the Personal Insolvency Act 2012 (the “Act”).

2. This application form has been prescribed by the Insolvency Service for the purposes of Section 29(2) of the Act.

3. The Insolvency Service may request any further information it requires from an approved intermediary and defer further consideration of the application until such information is furnished to the Insolvency Service. Failure to furnish such information, within 14 days or such longer period as the Insolvency Service may (at its discretion) permit, will mean that the application shall be deemed to have been withdrawn.

4. Where a debtor (the “Debtor”) becomes aware of any inaccuracy or omission in this application or any document accompanying this application, or any material change in his or her circumstances between the date of the application and the date on which the application is reviewed by the appropriate court, he or she is required under section 29(3) of the Act to inform the approved intermediary of these facts as soon as practicable. An approved intermediary who receives such information is required under section 29(4) of the Act to furnish that information to the Insolvency Service without delay.

5. The Insolvency Service hereby agrees to the Debtor communicating with the Insolvency Service by electronic means for the purposes of any communication or notice required or permitted to be sent or given by the Debtor to the Insolvency Service, from time to time, in connection with this Act including for the purpose of any notice referred to in section 134 of the Act. Any such communication or notice should be sent to drn@isi.gov.ie.

6. Notwithstanding any agreement by the Debtor to receiving electronic communication and notices, there may be circumstances in which the Insolvency Service will send documents, information and other communications to the Debtor in hard copy rather than electronically, in which case the Insolvency Service reserves the right to do so, including for the purpose of giving the Debtor any notice referred to in section 134 of the Act.

7. This application may be withdrawn at any time prior to the issue of a Debt Relief Notice in accordance with section 29(5) of the Act.

8. This application shall be accompanied by the prescribed fee and the following documentation—

(a) a copy of the statement made by the approved intermediary under section 27(6) of the Act;

(b) the Debtor’s signed confirmation that he or she satisfies the eligibility criteria specified in section 26(2) of the Act;

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(c) the Prescribed Financial Statement completed under section 27 of the Act and a statutory declaration of the Debtor confirming that the statement is a complete and accurate statement of the Debtor’s assets, liabilities, income and expenditure;

(d) a schedule of the creditors of the Debtor and the debts concerned, stating in relation to each such creditor the information specified in section 29(2)(d) of the Act;

(e) the Debtor’s written consent to the disclosure and processing of his or her personal data as specified in section 29(2)(e) of the Act;

(f) the Debtor’s written consent to the making of any enquiry under section 30 of the Act relating to the Debtor by the Insolvency Service;

(g) the Debtor’s signed statement stating whether, to the best of his or her knowledge, there is any judgment or court order in force against him or her which relates to a debt which is a qualifying debt;

(h) such other documentation as may be requested in this application.

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Application Form

DEBTOR’S DETAILS — Initial Information Has the Debtor confirmed in writing to the approved intermediary that he or she wishes to apply for a Debt Relief Notice? Yes No Does the Debtor agree to receiving by electronic means communications or notices required or permitted to be sent or given to the Debtor by the Insolvency Service, from time to time, in connection with the Act or related rules of court? Electronic communications or notices will be sent to the Debtor’s email address provided in this application form. Yes No The Courts Service may wish to communicate with the Debtor, from time to time, by electronic means in connection with the Act or related rules of court. If such circumstances arise, does the Debtor agree to receiving by electronic means communications or notices required or permitted to be sent or given to the Debtor by the Courts Service in connection with the Act or related rules of court? Electronic communications or notices will be sent to the Debtor’s email address and/or mobile telephone number provided in this application form. Yes No

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DEBTOR’S DETAILS — Personal Details Surname: First name: Name as it appears on birth certificate: Is the Debtor or has the Debtor been known by any other name? If yes, please supply name(s): Yes No Name(s): Title:* Mr Mrs Miss Ms Other (please specify) Gender:* Male Female Other PPS number: Date of birth: Country of birth: Nationality: Current Marital Status:* Single (never married) Married (first marriage, no previous annulment) Married (following previous annulment) Re-married (following death of spouse) Re-married (following divorce/annulment) Civil partnership Separated Divorced Widow/Widower Current...