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S.I. No. 228/2022 - Personal Insolvency Act 2012 (Prescribed Financial Statement) (Amendment) Regulations 2022

S.I. No. 228/2022 - Personal Insolvency Act 2012 (Prescribed Financial Statement) (Amendment) Regulations 2022 Skip to content Disclaimer Feedback Helpdesk Gaeilge Léim go dtí an t-ábhar Séanadh Aiseolas Deasc chabhrach English Gaeilge English Produced by the Office of the Attorney General Táirgthe ag Oifig an Ard-Aighne Home Legislation Acts of the Oireachtas Statutory Instruments Pre-1922 Legislation Constitution External Resources Bills (Houses of the Oireachtas) Iris Oifigiúil / Official Gazette Revised Acts (LRC) Classified List of Legislation (LRC) Translations (acts.

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  3. s)or rangeBliain nó blianta nó raon TypeCineál All Legislation Acts Statutory Instruments Advanced SearchCuardach Casta HomeBaile Statutory InstrumentsIonstraimí Reachtúla 2022 S.I. No. 228/2022 - Personal Insolvency Act 2012 (Prescribed Financial Statement) (Amendment) Regulations 2022 S.I. No. 228/2022 - Personal Insolvency Act 2012 (Prescribed Financial Statement) (Amendment) Regulations 2022 AmendmentsLeasuithe Download PDF Íoslódáil PDF Notice of the making of this Statutory Instrument was published in “Iris Oifigiúil” of 13th May, 2022. The Insolvency Service of Ireland, in exercise of the powers conferred on it by section 3 and section 136 of the Personal Insolvency Act 2012 (No. 44 of 2012), and with the consent of the Minister for Justice, hereby makes the following regulations: 1. These Regulations may be cited as the Personal Insolvency Act 2012 (Prescribed Financial Statement) (Amendment) Regulations 2022. 2. In these Regulations “Principal Regulations” means the Personal Insolvency Act 2012 (Prescribed Financial Statement) Regulations 2014 (S.I. No. 259 of 2014). 3. The Principal Regulations are amended by substituting the form set out in Schedule 1 to these Regulations for the form set out in Schedule 1 to the Principal Regulations. 4. The Principal Regulations are amended by substituting the form set out in Schedule 2 to these Regulations for the form set out in Schedule 2 to the Principal Regulations. SCHEDULE 1 Case Ref No.: PRESCRIBED FINANCIAL STATEMENT Debt Relief Notice Name of Debtor: Address: Assets & Liabilities – Summary Total Assets € Principal Private Residence (PPR) Investments (real property) Investments (other than real property) Plant, Equipment, Tools Vehicles Stock in trade Money owed to you Bank/Building Society Accounts Credit Union (net asset) Cash on hand Prospective assets Contingent assets Other __________ Total Assets __________ Liabilities (debts) Qualifying debts Non-Qualifying debts Total € € € Principal Private Residence lender Financial Institutions Credit Union (net liability) Excludable Debts - Revenue Excludable Debts - Other than Revenue Employees Trade creditors Connected creditors Other debts Prospective debts Contingent debts Excluded debts Total debts __________ __________ Assets less Liabilities __________ __________ All assets/debts are stated net of offsets __________ Income & Expenditure – Summary Income (monthly) € Salary/Wages - gross Pension income Income from self employment (before tax) Rental income (net of expenses) Income from Investments Contribution from household members Income from boarders/lodgers Income from State agencies Child or Spousal Maintenance Department of Social Protection Income - Other __________ Total income __________ Expenditure (monthly) € Income Tax / Social Insurance/Mandatory Pension Reasonable Living Expenses - set costs per guide Reasonable Living Expenses - rent/mortgage Reasonable Living Expenses – Motor Vehicle Insurance Reasonable Living Expenses – Home Insurance Reasonable Living Expenses - childcare costs Reasonable Living Expenses - special circumstances Payments in respect of Excluded Debts Payments in respect of Excludable Debts not permitted __________ Total Monthly Expenditure __________ __________ Net disposable income __________ Assets – Detail 1 Principal Private Residence 1.1 Address (note 1) 1.2 Current market value 1.3 Debtor ownership % 1.4 Debtor’s interest (derived field) 1.5 Comment 2 Investment Property 2.1 Description/Type* Description/Type* 2.2 Address (note 1) Residential buy to let - apartment 2.3 Current market value Residential buy to let - house 2.4 Debtor ownership % Commercial buy to let 2.5 Debtor’s interest (derived field) Commercial premises 2.6 Monthly income Holiday home 2.7 Monthly expenditure (excluding debt repayment) Land 2.8 Comment Other - provide details 3 Investments (other than real property) 3.1 Description/Type* Description/Type* 3.2 Name of security issuer Stocks/shares 3.3 Address (note 1) Bonds 3.4 Current market value Endowment policies 3.5 Debtor ownership % Pension 3.6 Debtor’s interest (derived field) Antiques 3.7 Monthly income Precious metals/Jewellery 3.8 Is the asset located in the State? Yes □ No □ Prize Bonds 3.9 Comment Livestock Other - provide details 4 Plant, Equipment, Tools 4.1 Description 4.2 Current market value 4.3 Debtor ownership % 4.4 Debtor’s interest (derived field) 4.5 Is the asset located in the State? Yes □ No □ 4.6 Comment 5 Vehicles 5.1 Make 5.2 Model 5.3 Year 5.4 Registration number 5.5 Kilometres 5.6 Need for vehicle 5.7 Current market value 5.8 Subject to finance? Yes □ No □ 5.9 Balance outstanding 5.10 Monthly instalment 5.11 Adapted for disabled use? Yes □ No □ 5.12 Is the asset located in the State? Yes □ No □ 5.13 Comment 6 Stock in trade 6.1 Current market value 6.2 Is the asset located in the State? Yes □ No □ 6.3 Comment 7 Money owed to you 7.1 Name of debtor 7.2 Address (note 1) 7.3 Book value 7.4 Realisable amount 7.5 Comment 8 Bank/Building Society Accounts 8.1 Name of bank/building society 8.2 Address (note 1) 8.3 Account name 8.4 Account number 8.5 Balance 8.6 Debtor ownership % 8.7 Debtor’s interest (derived field) 8.8 Comment 9 Credit Union Shares/Investment 9.1 Name of credit union 9.2 Address (note 1) 9.3 Account name 9.4 Account number 9.5 Current market value (less loan) 9.6 Debtor ownership % 9.7 Debtor’s interest (derived field) 9.8 Comment 10 Cash on hand 10.1 Amount 10.2 Is the asset located in the State? Yes □ No □ 10.3 Comment 11 Prospective assets 11.1 Description 11.2 Estimated value 11.3 Estimated date of receipt 11.4 Is the asset located in the State? Yes □ No □ 11.5 Comment 12 Contingent assets 12.1 Description 12.2 Estimated value 12.3 Estimated date of receipt 12.4 Is the asset located in the State? Yes □ No □ 12.5 Comment 13 Other 13.1 Description 13.2 Estimated value 13.3 Is the asset located in the State? Yes □ No □ 13.4 Comment Liabilities – Detail Questions common across all debt headings (except excluded debts): 1 Is this debt secured? Yes □ No □ If yes, security type: Mortgage/Charge Other - if other please give details What is the debt secured on? 1 Principal Private Residence Lender 1.1 Account Number 1.2 Account Name 1.3 Contact details (note 2) 1.4 Current monthly payment due 1.5 Monthly repayments - actual 1.6 Remaining term (months) 1.7 Amount due 1.8 Is the liability joint and several? Yes □ No □ 1.9 If no, state % of liability 1.10 Amount of debtor’s liability (derived field) 1.11 Restructured? Yes □ No □ If yes please provide details 1.12 Current interest rate 1.13 Comment 2 Financial Institutions 2.1 Account Number 2.2 Account Name 2.3 Contact details (note 2) 2.4 Account Type* Account Type* 2.5 Current monthly payment due Mortgage 2.6 Monthly repayments - actual Personal loan 2.7 Purpose of loan Overdraft 2.8 Amount due Credit card 2.9 Is the liability joint and several? Yes □ No □ Store card 2.10 If no, state % of liability Other – provide details 2.11 Amount of debtor’s liability (derived field) 2.12 Restructured? Yes □ No □ If yes, please provide details 2.13 Comment 3 Credit Union 3.1 Account Number 3.2 Account Name 3.3 Contact details (note 2) 3.4 Current monthly payment due 3.5 Monthly repayments - actual 3.6 Purpose of loan 3.7 Amount due (net liability) 3.8 Is the liability joint and several? Yes □ No □ 3.9 If no, state % of liability 3.10 Amount of debtor’s liability (derived field) 3.11 Restructured? Yes □ No □ If yes, please provide details 3.12 Comment 4 Excludable Debts - Revenue 4.1 Description/Type* Description/Type* 4.2 Contact details (note 2) Income Tax 4.3 Permitted? Yes □ No □ Vat 4.4 If yes, creditor consent or deemed consent PAYE/PRSI 4.5 If creditor consents, please scan letter of consent Relevant Contracts Tax 4.6 If deemed consent, scan letter requesting consent Local Property Tax 4.7 Amount due Interest & penalties 4.8 Preferential amount included in amount due (where known) Other – provide details 4.9 Instalment arrangement? Yes □ No □ 4.10 Amount of instalment 4.11 Comment 5 Excludable Debts - Other than Revenue 5.1 Description/Type* Description/Type* 5.2 Contact details (note 2) Local Government (Charges) Act 2009 5.3 Permitted? Yes □ No □ Rates - Local Government Act 2001 5.4 If yes, creditor consent or deemed consent HSE (Nursing Homes Support Scheme Act 2009) 5.5 If creditor consents, please scan letter of consent Service charges/contributions under MUD Act 2011 5.6 If deemed consent, scan letter requesting consent Social Welfare Consolidation Act 2005 5.7 Amount due Other – provide details 5.8 Preferential amount included in amount due (where known) 5.9 Comment 6 Employees 6.1 Description/Type* Description/Type* 6.2 Contact details (note 2) Arrears of wages 6.3 Amount due Minimum notice 6.4 Preferential amount included in amount due (where known) Holiday pay 6.5 Comment Redundancy 7 Trade creditors 8.1 Contact details (note 2) 8.2 Amount due 8.3 Comment 8 Connected creditors 9.1 Contact details (note 2) 9.2 Purpose of loan 9.3 Amount due 9.4 Please specify the connection 9.5 Comment 9 Other debts 10.1 Description 10.2 Contact details (note 2) 10.3 Purpose of debt 10.4 Amount due 10.5 Comment 10 Prospective debts 11.1 Description 11.2 Contact details (note 2) 11.3 Amount due 11.4 Payment date 11.5 Comment 11 Contingent debts 12.1 Description 12.2 Contact details (note 2) 12.3 Estimated amount 12.4 Estimated payment date 12.5 Comment 12 Excluded debts 13.1 Amount due 13.2 Comment Note 1 Address Country Street (line 1) Street (line 2) Street (line 3) Town Zip/Postal code County Note 2 Contact details: Legal name of creditor Country Street (line 1) Street (line 2) Street (line 3) Town Zip/Postal code County Email Address Telephone Number Monthly Income – Detail € Type of income Amount 1 Salary/Wages - gross Comment 2 Pension income Comment 3 Income from self employment (before tax) Comment 4 Rental income (net of expenses) Comment 5 Income from investments Comment 6 Contribution from household members Comment 7 Income from boarders/lodgers Comment 8 Income from State agencies Comment 9 Department of Social Protection 9.1 Jobseekers Allowance/Benefit Comment 9.2 Disability Allowance Comment 9.3 Carer’s Allowance Comment 9.4 Family Income Supplement Comment 9.5 Rent Supplement Comment 9.6 One Parent Family Payment Comment 9.7 Child Benefit Comment 9.8 Mortgage Interest Supplement Comment 9.9 Other –Please specify Details Comment 10 Child or Spousal Maintenance Comment 11 Income - Other Comment Total monthly income Monthly Expenditure – Detail € Type of expenditure Amount 1 Income Tax / Social Insurance/Mandatory Pension 1.1 Income Tax Comment 1.2 PRSI Comment 1.3 Universal Social Charge Comment 1.4 Mandatory Pension Comment 1.5 Other - please specify Details Comment 2 Reasonable Living Expenses - set costs (derived) 3 Reasonable Living Expenses - rent/mortgage 4 Reasonable Living Expenses – motor vehicle insurance 5 Reasonable Living Expenses – home insurance 6 Reasonable Living Expenses - childcare costs 7 Reasonable Living Expenses -special circumstances 8 Payments in respect of Excluded Debts 9 Payments in respect of Excludable Debts not permitted Total monthly expenditure Signature of Debtor__________________________________ Printed Name of Debtor _______________________________ Date________________ Note: This document will be completed in electronic format on such electronic platform that the Insolvency Service may from time to time make available or otherwise specify for such purpose, following which, the information will be processed into an output format which may be in electronic form or printed on paper. Where any item in this document is completed to the effect of ‘no’, or any item in this document is not completed, that information may not appear on such output format and any person reviewing the output format should proceed on the basis that, where the output format does not refer to such information, the relevant item was either completed by selecting ‘no’ or the relevant item was not applicable in that instance. In this document, where an asterisk (*) is used and a choice is provided of the appropriate response, the response selected will appear in the output format. This note will not appear on the output format. SCHEDULE 2 Case Ref No.: PRESCRIBED FINANCIAL STATEMENT Debt Settlement Arrangement/Personal Insolvency Arrangement Name of Debtor(s): Address: Assets & Liabilities - Summary Total Assets € Principal Private Residence (PPR) Investments (real property) Investments (other than real property) Plant, Equipment, Tools Vehicles Stock in trade Money owed to you Bank/Building Society Accounts Credit Union (net asset) Cash on hand Prospective assets Contingent assets Other __________ Total Assets __________ Liabilities (debts) Specified Debts Unspecified Debts Total € € € Principal Private Residence lender Financial Institutions Credit Union (net liability) Excludable Debts - Revenue Excludable Debts - Other than Revenue Employees Trade creditors Connected creditors Other debts Prospective debts Contingent debts Excluded debts Total debts __________ __________ __________ __________ Assets Less Liabilities __________ __________ All assets/debts are stated net of offsets Income & Expenditure - Summary Total Income (monthly) € Salary/Wages -gross Pension income Income from self employment (before tax) Rental income (net of expenses) Income from investments Contribution from household members Income from boarders/lodgers Income from State agencies Child or Spousal Maintenance Other Income Department of Social Protection Total income __________ __________ Expenditure (monthly) Income Tax / Social Insurance/Mandatory Pension € General Expenses Rent Total Monthly Expenditure before debt repayment __________ __________ Net disposable income/available for debt service/arrears __________ __________ Monthly Repayments-Actual Current Monthly Payment Due Payments in relation to debt repayments/arrears € € Assets - Detail 1 Principal Private Residence 1.1 Address (note 1) 1.2 Current market value 1.3 Debtor ownership % 1.4 Debtor’s interest (derived field) 1.5 Comment 2 Investment Property 2.1 Description/Type* Description/Type* 2.2 Address (note 1) Residential buy to let - apartment 2.3 Current market value Residential buy to let - house 2.4 Debtor ownership % Commercial buy to let 2.5 Debtor’s interest (derived field) Commercial premises 2.6 Monthly income Holiday home 2.7 Monthly expenditure (excluding debt repayment) Land 2.8 Comment Other - provide details 3 Investments (other than real property) 3.1 Description/Type* Description/Type* 3.2 Name of security issuer Stocks/shares 3.3 Address (note 1) Bonds 3.4 Current market value Endowment policies 3.5 Debtor ownership % Pension 3.6 Debtor’s interest (derived field) Antiques 3.7 Monthly income Precious metals/Jewellery 3.8 Is the asset located in the State? Yes □ No □ Prize Bonds 3.9 Comment Livestock Other - provide details 4 Plant, Equipment, Tools 4.1 Description 4.2 Current market value 4.3 Debtor ownership % 4.4 Debtor’s interest (derived field) 4.5 Is the asset located in the State? Yes □ No □ 4.6 Comment 5 Vehicles 5.1 Make 5.2 Model 5.3 Year 5.4 Registration number 5.5 Kilometres 5.6 Need for vehicle 5.7 Current market value 5.8 Subject to finance? Yes □ No □ 5.9 Balance outstanding 5.10 Monthly instalment 5.11 Adapted for disabled use? Yes □ No □ 5.12 Is the asset located in the State? Yes □ No □ 5.13 Comment 6 Stock in trade 6.1 Current market value 6.2 Is the asset located in the State? Yes □ No □ 6.3 Comment 7 Money owed to you 7.1 Name of debtor 7.2 Address (note 1) 7.3 Book value 7.4 Realisable amount 7.5 Comment 8 Bank/Building Society Accounts 8.1 Name of bank/building society 8.2 Address (note 1) 8.3 Account Name 8.4 Account Number 8.5 Balance 8.6 Debtor ownership % 8.7 Debtor’s interest (derived field) 8.8 Comment 9 Credit Union Shares/Investment 9.1 Name of credit union 9.2 Address (note 1) 9.3 Account Name 9.4 Account Number 9.5 Current market value (less loan) 9.6 Debtor ownership % 9.7 Debtor’s interest (derived field) 9.8 Comment 10 Cash on hand 10.1 Amount 10.2 Is the asset located in the State? Yes □ No □ 10.3 Comment 11 Prospective assets 11.1 Description 11.2 Estimated value 11.3 Estimated date of receipt 11.4 Is the asset located in the State? Yes □ No □ 11.5 Comment 12 Contingent assets 12.1 Description 12.2 Estimated value 12.3 Estimated date of receipt 12.4 Is the asset located in the State? Yes □ No □ 12.5 Comment 13 Other 13.1 Description 13.2 Estimated value 13.3 Is the asset located in the State? Yes □ No □ 13.4 Comment Liabilities - Detail Questions common across all debt headings (except excluded debts): 1 Is this debt secured? Yes □ No □ If yes, security type: Mortgage/charge Other - if other please give details What is the debt secured on? 2 Has any of this debt been incurred within 6 months of the application date? Yes □ No □ If yes, please state amount. 1 Principal Private Residence Lender 1.1 Account Number 1.2 Account Name 1.3 Contact details (note 2) 1.4 Current monthly payment due 1.5 Monthly repayments - actual 1.6 Remaining term (months) 1.7 Balance outstanding 1.8 Is the liability joint and several? Yes □ No □ 1.9 If no, state % of liability 1.10 Amount of debtor’s liability (derived field) 1.11 Restructured? Yes □ No □ If yes please provide details 1.12 Current interest rate 1.13 Comment 2 Financial Institutions 2.1 Account Number 2.2 Account Name 2.3 Contact details (note 2) 2.4 Account Type* Account Type* 2.5 Current monthly payment due Mortgage 2.6 Monthly repayments - actual Personal loan 2.7 Purpose of loan Overdraft 2.8 Balance outstanding Credit card 2.9 Is the liability joint and several? Yes □ No □ Store card 2.10 If no, state % of liability Other – provide details 2.11 Amount of debtor’s liability (derived field) 2.12 Restructured? Yes □ No □ If yes please provide details 2.13 Comment 3 Credit Union 3.1 Account Number 3.2 Account Name 3.3 Contact details (note 2) 3.4 Current monthly payment due 3.5 Monthly repayments - actual 3.6 Purpose of loan 3.7 Balance outstanding (net liability) 3.8 Is the liability joint and several? Yes □ No □ 3.9 If no, state % of liability 3.10 Amount of debtor’s liability (derived field) 3.11 Restructured? Yes □ No □ If yes, please provide details 3.12 Comment 4 Excludable Debts - Revenue 4.1 Description/Type* Description/Type* 4.2 Contact details (note 2) Income Tax 4.3 Permitted? Yes □ No □ VAT 4.4 If yes, creditor consent or deemed consent PAYE/PRSI 4.5 If creditor consents, please scan letter of consent Relevant Contracts Tax 4.6 If deemed consent, scan letter requesting consent Local Property Tax 4.7 If no, have you sought consent from Revenue to have this debt permitted? Yes □ No □ Interest & penalties 4.8 Current monthly payment due Other – provide details 4.9 Monthly repayments - actual 4.10 Balance outstanding 4.11 Preferential amount included in balance outstanding (where known) 4.12 Instalment arrangement? Yes □ No □ 4.13 Amount of instalment 4.14 Comment 5 Excludable Debts - Other than Revenue 5.1 Description/Type* Description/Type* 5.2 Contact details (note 2) Local Government (Charges) Act 2009 5.3 Permitted? Yes □ No □ Rates - Local Government Act 2001 5.4 If yes, creditor consent or deemed consent HSE (Nursing Homes Support Scheme Act 2009) 5.5 If creditor consents, please scan letter of consent Service charges/contributions under MUD Act 2011 5.6 If deemed consent, scan letter requesting consent Social Welfare Consolidation Act 2005 5.7 If no, have you sought consent from this creditor to have this debt permitted? Yes □ No □ Other – Provide details 5.8 Current monthly payment due 5.9 Monthly repayments - actual 5.10 Balance outstanding 5.11 Preferential amount included in balance outstanding (where known) 5.12 Comment 6 Employees 6.1 Description/Type* Description/Type* 6.2 Contact details (note 2) Arrears of wages 6.3 Current monthly payment due Minimum notice 6.4 Monthly repayments - actual Holiday pay 6.5 Balance outstanding Redundancy 6.6 Preferential amount included in balance outstanding (where known) 6.7 Comment 7 Trade creditors 8.1 Contact details (note 2) 8.2 Current monthly payment due 8.3 Monthly repayments - actual 8.4 Balance outstanding 8.5 Comment 8 Connected creditors 9.1 Contact details (note 2) 9.2 Purpose of loan 9.3 Current monthly payment due 9.4 Monthly repayments - actual 9.5 Balance outstanding 9.6 Please specify the connection 9.7 Comment 9 Other debts 10.1 Description 10.2 Contact details (note 2) 10.3 Purpose of debt 10.4 Current monthly payment due 10.5 Monthly repayments - actual 10.6 Balance outstanding 10.7 Comment 10 Prospective debts 11.1 Description 11.2 Contact details (note 2) 11.3 Estimated amount 11.4 Estimated payment date 11.5 Comment 11 Contingent debts 12.1 Description 12.2 Contact details (note 2) 12.3 Estimated amount 12.4 Estimated payment date 12.5 Comment 12 Excluded debts 13.1 Current monthly payment due 13.2 Monthly repayments - actual 13.3 Balance outstanding 13.4 Comment Note 1 Address Country Street (line 1) Street (line 2) Street (line 3) Town Zip/Postal Code County Note 2 Contact details: Legal name of creditor Country Street (line 1) Street (line 2) Street (line 3) Town Zip/Postal Code County Email Address Telephone Number Monthly Income - Detail € Type of income Amount 1 Salary/Wages - gross Comment 2 Pension income Comment 3 Income from self employment (before tax) Comment 4 Rental income (net of expenses) Comment 5 Income from investments Comment 6 Contribution from household members Comment 7 Income from boarders/lodgers Comment 8 Income from State agencies Comment 9 Child or Spousal Maintenance Comment 10 Other Comment 11 Department of Social Protection 11.1 Jobseekers Allowance/Benefit Comment 11.2 Disability Allowance Comment 11.3 Carer’s Allowance Comment 11.4 Family Income Supplement Comment 11.5 Rent Supplement Comment 11.6 One Parent Family Payment Comment 11.7 Child Benefit Comment 11.8 Mortgage Interest Supplement Comment 11.9 Other –Please specify Details Comment Total income Monthly Expenditure - Detail € Type of expenditure Amount 1 Income Tax/ Social Insurance/Mandatory Pension 1.1 Income Tax Comment 1.2 PRSI Comment 1.3 Universal Social Charge Comment 1.4 Mandatory Pension Comment 1.5 Other - please specify Details Comment 2 General Expenses 2.1 Food Comment 2.2 Clothing Comment 2.3 Personal Care Comment 2.4 Health Comment 2.5 Household Goods Comment 2.6 Household Services Comment 2.7 Communications Comment 2.8 Social Inclusion & Participation Comment 2.9 Education Comment 2.10 Transport Comment 2.11 Household Electricity Comment 2.12 Home Heating Comment 2.13 Personal Costs Comment 2.14 Savings & Contingencies Comment 2.15 Home Insurance Comment 2.16 Motor Vehicle Insurance 2.17 Childcare Costs Comment 2.18 Other Expenses Comment 3 Rent Comment Total Monthly Expenditure before debt repayment/arrears 4 Payments in relation to debt repayments/arrears - Actual Monthly Repayments € Current Monthly Payment Due 4.1 Principal Private Residence Lender Comment € 4.2 Financial Institutions Comment 4.3 Credit Union Comment 4.4 Excludable Debts -Revenue Comment 4.5 Excludable Debts- other than Revenue Comment 4.6 Employees Comment 4.7 Trade Creditors Comment 4.8 Connected Creditors Comment 4.9 Other Debts Comment 4.10 Excluded Debts Comment Signature of Debtor __________________________________ Printed Name of Debtor _______________________________ Date ________________ Note: This document will be completed in electronic format on such electronic platform that the Insolvency Service may from time to time make available or otherwise specify for such purpose, following which, the information will be processed into an output format which may be in electronic form or printed on paper. Where any item in this document is completed to the effect of ‘no’, or any item in this document is not completed, that information may not appear on such output format and any person reviewing the output format should proceed on the basis that, where the output format does not refer to such information, the relevant item was either completed by selecting ‘no’ or the relevant item was not applicable in that instance. In this document, where an asterisk (*) is used and a choice is provided of the appropriate response, the response selected will appear in the output format. This note will not appear on the output format. The Minister for Justice consents to the making of the foregoing Regulations. GIVEN under the Official Seal of the Minister for Justice, 5 May, 2022. HELEN MCENTEE, Minister for Justice. GIVEN under the seal of the Insolvency Service of Ireland, 10 May, 2022. MICHAEL MCNAUGHTON, Director of the Insolvency Service of Ireland. EXPLANATORY NOTE (This note is not part of the Instrument and does not purport to be a legal interpretation) These Regulations amend the Personal Insolvency Act 2012 (Prescribed Financial Statement) Regulations 2014 ( S.I. No. 259 of 2014 ) by substituting the form set out in Schedule 1 to these Regulations for the form set out in Schedule 1 to the Personal Insolvency Act 2012 (Prescribed Financial Statement) Regulations 2014 ( S.I. No. 259 of 2014 ) and by substituting the form set out in Schedule 2 to these Regulations for the form set out in Schedule 2 to the Personal Insolvency Act 2012 (Prescribed Financial Statement) Regulations 2014 ( S.I. No. 259 of 2014 ). Privacy Statement Accessibility European Legislation Identifier (PDF) Open Data License Ráiteas Príobháideachais Inrochtaineacht Aitheantóir Eorpach Reachtaíochta (ELI) Ceadúnas Sonraí Oscailte Liosta Fianán © Government of Ireland. 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