Personal Insolvency Act 2012 (Prescribed Protective Certificate Debt Settlement Arrangement Application Form) Regulations 2013

JurisdictionIreland
CitationIR SI 332/2013
Year2013

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 Protective Certificate Debt Settlement Arrangement Application Form) Regulations 2013.

2. The form set out in the Schedule to these Regulations is hereby prescribed for the purposes of section 59(2) of the Act.

ISI Case Reference No.:

Schedule

APPLICATION FOR PROTECTIVE CERTIFICATE

(DEBT SETTLEMENT ARRANGEMENT)

*AN CHÚIRT CHUARDA

*[THE CIRCUIT COURT] *[THE HIGH COURT]

*PERSONAL INSOLVENCY ACT 2012

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

IN THE MATTER OF AN APPLICATION UNDER SECTION 61 OF THE PERSONAL INSOLVENCY ACT 2012

AND IN THE MATTER OF ..]

OF [..],

A DEBTOR

*I/*We ..............

of ..............

County of ..............

*and ..............

of ..............

County of ..............

HEREBY APPLY for the making of an order for the issue under section 61(2)(a) of the Personal Insolvency Act 2012 of a protective certificate.

Dated.20..

* Delete where inapplicable

ISI Case Reference No.:

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 59(2) of the Act.

3. The Insolvency Service may request any further information it requires from a debtor (the “Debtor”) or personal insolvency practitioner 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as the Insolvency Service may (at its discretion) permit, will mean that the application shall be deemed to have been withdrawn.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 the personal insolvency practitioner becomes aware of any inaccuracy or omission in this application or any document accompanying this application, he or she is required under section 59(4) of the Act to inform the Insolvency Service of this fact as soon as practicable.

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 dsa@isi.gov.ie

6. Notwithstanding any agreement by the Debtor to receiving electronic communications 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 protective certificate in accordance with section 59(3) of the Act.

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

(a) a statement of the personal insolvency practitioner prepared under section 54 of the Act;

(b) the Debtor’s signed confirmation that he or she satisfies the eligibility criteria specified in section 57 of the Act;

(c) the Prescribed Financial Statement;

ISI Case Reference No.:

(d) the statutory declaration of the Debtor referred to in section 57(1)(c) of the Act;

(e) a schedule of creditors of the Debtor and the debts concerned, stating in relation to each such creditor the information specified in section 59(2)(e) of the Act;

(f) the Debtor’s written consent to the disclosure and processing of his or her personal data of the Debtor as specified in section 59(2)(f) of the Act;

(g) the Debtor’s written consent to the making of any enquiry under section 60 of the Act relating to the Debtor by the Insolvency Service;

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

ISI Case Reference No.:

Application Form

APPLICATION QUESTIONS

Is this an individual application or a joint application?If this is a joint application each Debtor must complete the “Debtor’s Details” sections.

Individual Joint

Are the total liabilities of the Debtor determined on the basis of the Prescribed Financial Statement completed by the Debtor in respect of this application in excess of €2,500,000?

Yes No

Have 25% or more of the Debtor’s debts (other than excluded debts and secured debts) been incurred during the period of 6 months ending on the date of this application?

Yes No

(DEBTOR’S DETAILS sections to be completed by all debtors in the case of a joint application)

DEBTOR’S DETAILS — Initial Information

Has the Debtor received advice from the personal insolvency practitioner on the matters set out in section 52 of the Act?

Yes No

Was the advice referred to in section 52(1)(c) of the Act confirmed in writing by the personal insolvency practitioner to the Debtor?

Yes No

Has the Debtor instructed the personal insolvency practitioner in writing to make a proposal for a Debt Settlement Arrangement in accordance with Chapter 3 of the Act?

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

ISI Case Reference No.:

DEBTOR’S DETAILS — Initial Information

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

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...

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT