Personal Account Application Form Sole Current, Demand Deposit and CustomSaver Account

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1 Personal Account Application Form Sole Current, Demand Deposit and CustomSaver Account Please select required accounts: NSC 9 0 Purpose of A/c (Mandatory: Box must show an understanding of purpose and likely operation of account.) Current Account Demand Deposit Account CustomSaver Account Title Mr Mrs Ms First Name Surname Existing Bank of Ireland Customer No If Existing Bank of Ireland Customer - Sole A/c number Time with Bank Years Months Will your salary be mandated to this account? (New Current Account only) No Current legislation requires us to verify the true name and address of all new customers. You will therefore be requested to submit formal identification documents with this application e.g. current passport or driving licence and current utility bill. If you do not have any of the above please contact us and we can discuss alternative documentation. Ask for our leaflet Your account and the implications of legislation (37-831RU). Is this account for personal (rather than business) purposes? (Current Account only) No Are you switching your bank account from another financial institution? No (If yes please complete Switching your personal bank accounts made easy brochure Ref RU Standard Personal Current Account Fee Options Pay as You Go: 28c for each transaction (For greater than 40 transactions per quarter, Flat Fee is cheaper). Customers can switch options by contacting their branch, changes will take effect from start of the next fee quarter. Flat Fee per quarter (Covers up to 90 transactions. More than 90 cost 28c each) SECTION A: TO BE COMPLETED BY ALL CUSTOMERS Address Date of Birth Post Code Employment Status Employee Employer Self Employed Homemaker Student Retired Other Occupation Address Annual Gross Income E Tel (Home) Tel (Work) Tel (Mobile) SECTION B: TO BE COMPLETED FOR CURRENT ACCOUNT APPLICATIONS ONLY Residential Details Home Owner With Parents Tenant Other Year moved to address Monthly Rent/Mortgage E Previous Address (if tenant) Marital Status Married Single Widowed Divorced Separated Other Employment Details Net Monthly Pay Employer s Name E SECTION C: TO BE COMPLETED FOR CARD APPLICATIONS ONLY To Bank of Ireland - In consideration of your issuing me from time to time the card(s) specified below. I agree to the conditions of use, a copy of which I have received and read by which I agree to be bound. Customer Name (to appear on Card) Date 2 0 (Max 22 characters) Current A/c ATM/Debit Bank of Ireland ATM Card Demand Deposit A/c (only) Bank of Ireland ATM Card (Bank of Ireland only) SECTION D: TO BE COMPLETED FOR CUSTOMSAVER APPLICATIONS ONLY CustomSaver: Please tick preferred frequency box and insert the amount of each Direct Debit payment. Fortnightly (Min 20 Max 750) Monthly (Min 20 Max 1,500) Amount E Commencement Date 2 0 (Your first payment will be debited on or within 14 days of this date). Destination of Interest: Interest will be credited to the CustomSaver account typically in March. The Governor and Company of the Bank of Ireland, incorporated by charter in Ireland with limited liability. A tied agent of New Ireland Assurance Company plc. trading as Bank of Ireland Life. Bank of Ireland is regulated by the Central Bank of Ireland. Registered No. C-1. Head Office, 40 Mespil Road, Dublin 4, Ireland. Page 1 of 6

2 AUTHORISATION & APPLICATION FOR ACCOUNT(S) SELECTED IN THE COMBINED APPLICATION FORM Please read the following carefully before signing this form: (i) this section Authorisation and Application for account(s), (ii) Consent to Use of Personal Data (Data Protection Act), (iii) CustomSaver Account Interest rate information (if applicable). Direct Marketing Consent (Optional) I consent to the details, that I am being asked to supply, being used to provide me with information about other products and services, either from the Bank of Ireland Group or which the Bank of Ireland Group has arranged for me with a third party. Please tick this box if you would not like to receive this information I understand that at any time I can ask you to stop or change the methods by which the bank may send me marketing materials. This can be done free of charge by writing to my branch of the Bank. Customer Consents. 1. Where this application is an application for facilities, I confirm that I am not less than 18 years of age. 2. I certify the accuracy of the information given above together with the continued accuracy of such information in the event of any future applications by me (whether oral or written) for a facility, unless I expressly advise you to the contrary at the time of any such future application. 3. I understand that you reserve the right to decline this or any future application without being required to state any reason and that no correspondence will be entered into it in such circumstances. 4. By signing this form I consent to the Bank of Ireland Group and its contracted agents storing, using and processing my personal details: (a) to manage and administer my accounts, policies or other financial products; (b) to process my applications for credit or financial services and any requests for payment services made by me; (c) to carry out business and market research and compile statistics; (d) to help detect and prevent fraud and dishonesty including through the use of information technology; (e) to form a single view of my entire relationship with the Bank of Ireland Group (whether as a consumer or in connection with my trade, business or profession) to enable it manage and develop the relationship; (f) to enable business units in the Bank of Ireland Group share or access my personal details for the purposes set out in this consent (but not for the purposes of direct marketing where I have indicated to the Bank of Ireland Group I do not want it); (g) to contact me by post, telephone, text message, electronic mail, facsimile or other means but not in a way contrary to my instructions to the Bank of Ireland Group or contrary to law or regulation; (h) (where I apply for or avail of a credit facility) to carry out credit reviews including automated credit decision processes and to obtain details of my credit history from the Irish Credit Bureau ( ICB ) or other credit rating agency; (i) (where I have not indicated otherwise to the Bank of Ireland Group) to directly market the products and services of the Bank of Ireland Group or of suppliers selected by the Bank of Ireland Group using a form of communication permitted by me under paragraph (g) above; and (j) to establish my identity, residence and tax status in order to comply with law and regulation concerning taxation and the prevention of money laundering or terrorist financing. I consent to the Bank of Ireland Group disclosing my personal details: 1) (where I apply for or avail of a credit facility) to the ICB or other credit rating agency and I also consent to the ICB or other credit rating agency disclosing details of my credit history (and using those details for credit scoring purposes) to the Bank of Ireland Group or other institutions to which I apply for credit facilities; 2) to facilitate a potential or actual transfer of any loan or product provided to me or in connection with a securitisation; 3) to its contracted agents and to recipients abroad but only for purposes indicated in this consent and only where the Bank of Ireland Group complies with Irish data protection law in doing so. This consent does not limit any other consent I have given (or may give) to the Bank of Ireland Group to process or disclose my personal details. In this consent: Bank of Ireland Group means the Bank of Ireland and its present and future subsidiaries. contracted agents means entities which have contracted with the Bank of Ireland Group to assist it in the conduct of its business or in providing services to me. I, me, my is a reference to each of us where more than one of us have signed this form. personal details means information concerning me which Bank of Ireland Group has including information given by me or others verbally or in writing, information contained in application forms and records of my transactions with the Bank of Ireland Group. 5. In the event of a facility being approved I authorise you to make the facility available and to put the appropriate repayment schedule into effect. 6. I agree that the facility (and any other facilities as may be granted by you at your discretion) shall be subject to the terms and conditions and specific provisions detailed in your Facility Letter or Credit Agreement, once issued. 7. I understand that in opening the account(s) that I may be automatically registered for Bank of Ireland 365 services as outlined in the terms and conditions attached. 8. In consideration of my application for an account, I agree to the Terms and Conditions and Schedule of Fees and Charges for Personal Customers Brochure (where applicable). I hereby confirm that each authorisation above to hold, use, disclose, copy and process information constitutes consent for the purposes of the Data Protection Acts, 1988 and 2003 and any amending or extending legislation or any European Union regulation or directive. I received and read a copy of the Terms and Conditions and I agree to be bound by them No I received and read a copy of the Terms of Business No I received and read a copy of the Schedule of Fees and Charges for Personal Customers Brochure No I have received and read a copy of the Personal Current Account Guide No I have received and read the details of debit interest outlined in the table of Personal Overdraft Interest Rates sheet No NOTE: YOU MUST SIGN THIS SECTION Customer Consent: I hereby authorise you to open an account in the name set out overleaf and to honour all withdrawal forms and orders drawn on the account and to act on all instructions relating to the account signed: BY ME Customer Signature Date 2 0 BRANCH CHECKLIST - BANK USE ONLY Purpose of Account Was the account requested on a non face to face basis? No Is the customer resident in a high/very high risk country? No Is it evident from purpose of account that the customer intends transacting with a high/very high risk country? No *If to any of the above questions, relationship should be of higher risk. All higher risk rated accounts must be referred to Network Governance and Control for sign off prior to account opening. Overall Risk Rating* Standard High Signed (Staff Member) Date 2 0 Staff Number Page 2 of 6

3 IDENTIFICATION AND CONSENT FORM PART A Name of Customer To: The Governor and Company of the Bank of Ireland (the Bank, which term includes and shall be construed to include Bank branches) Customer Consent: I hereby agree that any information and/or original documents and/or any copy documents supplied by me or on my behalf to the Bank are accurate so as to enable the Bank to comply with any and all of the obligations of the Bank under law and regulations concerning the prevention of money laundering and terrorist financing and to comply with taxation requirements. Such information or documentation may at any time be disclosed by the Bank to, transferred to, or copies thereof sent by the Bank to any Bank branch, any other member of the Bank of Ireland Group, or any other designated body (as defined in The Criminal Justice Act 1994 as amended or in any provision which replaces it) which may at any time provide or be requested to provide any services to me. I hereby further agree that any information and/or any original documents and/or any copy documents that have been supplied by or for me to any Bank of Ireland Group member to enable such Bank of Ireland Group member and/or Bank of Ireland Group to comply with any and all obligations under or pursuant to the 1994 Act and/or the 1997 Act may at any time, by such Bank of Ireland Group member, be disclosed to any other Bank of Ireland Group member, or be transferred to, or copies thereof sent to any other Bank of Ireland Group member, so as to enable such other Bank of Ireland Group member to comply with the 1994 Act and /or the 1997 Act, and for the benefit of any Bank of Ireland Group member to which I have supplied any such information, documents and/or copy documents aforesaid, I hereby confirm that such Bank of Ireland Group member may act on this authorisation and consent as if it was specifically addressed to such Bank of Ireland Group member. I hereby confirm that each authorisation contained herein to hold, use, disclose, copy and process information constitutes a consent for the purpose of the Data Protection Acts 1988 and 2003 and any amending or extending legislation or any related European Communities regulation or directive. For the purposes of this consent the terms Bank of Ireland Group and Bank of Ireland Group member each mean and shall be construed to mean any and all of the following: the Bank; ICS Building Society; any branch of the Bank or ICS Building Society; the separate legal entities that constitute the Bank of Ireland Group; any respective successors, assigns and transferees of the Bank, ICS Building Society or entities aforesaid. Customer Signature Date 2 0 MANDATORY SECTION FOR ALL INTEREST BEARING ACCOUNTS PPSN or TIN Number PPSN - applies to Residents of the ROI PPSN not provided PPSN provided but no proof attached PPSN provided and proof attached TIN - applies to customers resident outside ROI TIN provided If Passport: Date of Birth I do not have official details or an official document with my name, address and PPSN but I shall try to let you have this documentation as soon as I can. I declare the foregoing to be true and accurate. I do not have an official document with my name, address and PPSN but I confirm that the PPSN outlined above is my PPSN. I shall try to let you have this documentation as soon as I can. I declare the foregoing to be true and accurate. OR PASSPORT and Place of Birth Customer Signature Date 2 0 BANK USE ONLY Is person to be identified an existing Bank of Ireland Group Customer? No PART B If Name of Branch/Group Entity Method used to check (Servicelink, etc.) Existing customer as at 2/5/95 NSC 9 0 Date opened Create/Print off Money Laundering Documentation Screen. Money Laundering Documentation Screen has been completed for above account Existing customer after 2/5/95 NSC 9 0 Date opened ID Documentation for the person named overleaf must be held. Money Laundering Documentation Screen Completed for above account With the person s consent as detailed overleaf, you can request the Branch/Group Entity who has established his/her identity to update the Money Laundering Documentation Screen OR provide copies of the ID documentation for your records OR you can request him/her to provide the necessary documentation and create Money Laundering Documentation Screen. If No Name and current permanent Address of person named overleaf must be verified in line with procedures. Face to face contact with person being identified? No If no, specify method of contact (Two forms of Address Verification must be obtained) Address Verification 2 x Method(s) used For Non Face to Face only Money Laundering Documentation Screen has been completed for the person named above PPSN Proof No Proof Provided (Document) Signed (Staff Member) Staff Number Copies of ID material(s) must be attached to this Form Date Page 3 of 6

4 BANK OF IRELAND INSTRUCTIONS TO PAY DIRECT DEBIT MANDATE FOR CUSTOMSAVER ACCOUNT To the Manager (Bank/Building Society) Originators Address Bank of Ireland, Deposit Service Centre, Operations Centre, Block A, Ground Floor, Cabinteely, Dublin 18. Name of Account Holder to be debited Bank Account No. Bank Sort Code Your instruction to the Bank and Signature(s) I instruct you to pay Direct Debits from my account at the request of Bank of Ireland Deposit Service Centre. The amounts are variable and may be debited on various dates. I understand that the Bank may change the amounts and dates only after giving me prior notice. I shall inform the Bank in writing if I wish to cancel this instruction. I understand that if any Direct Debit is paid which breaks the terms of the instruction, the Bank will make a refund. Originator s No. Deposit Service Centre Reference Banks may decline to accept instructions to pay Direct Debits from some type of Accounts. Signature Date 2 0 Bank of Ireland is regulated by the Central Bank of Ireland. Page 4 of 6

5 Please give this rate sheet to the customer to retain. TABLE OF PERSONAL OVERDRAFT INTEREST RATES SHEET CURRENT RATE TABLE Flat Rate APR without Fee APR with E25 fee Standard Overdraft Rate 13.25% 13.9% 15.9%* The current variable standard overdraft interest rate (including the overdraft facility fee is 15.9% APR. The Annual Percentage rate quoted above is correct as at 25th of August 2011 and is subject to change. The rate quoted is based on a representative example of 1,500 over a 12 month period. Total cost of credit is Graduate Overdraft Rate 9.40% 9.7% N/A The current variable overdraft interest rate for Graduate Current Account is 9.7% APR. The Annual Percentage Rate quoted above is correct as at 24th February 2010 and is subject to change. The rate quoted is based on a representative example of 1,500 over a 12 month period. Total cost of credit is PENDING RATES Flat Rate APR without Fee APR with Fee Standard Overdraft Rate None None None Graduate Overdraft Rate None None None Pending Rates effective on NOTIFICATION TO ALL PERSONAL CURRENT ACCOUNT CUSTOMERS The following changes will come into effect from the fee quarter beginning 19th November Personal Current Account No Transaction Fees Offer - revised qualification criteria Personal Current Account transaction fees will not apply if over the course of a fee quarter, you maintain a minimum credit balance of 3,000 in your Personal Current Account throughout the full fee quarter. Credit interest is not payable on current account balances, and potential interest may be foregone as a result of maintaining a minimum credit balance. The previous qualifying criteria to lodge at least 3,000 throughout the fee quarter and make 9 debit transactions using 365 phone or online will no longer qualify you for the No Transaction Fees Offer. Personal and Business ATM/Debit Cards The charge for replacement of a lost, stolen or damaged current or deposit account card will change from 5.90 to This charge does not apply to Second Level Student or Golden Years account cards. Bank of Ireland is regulated by the Central Bank of Ireland. Page 5 of 6

6 PAYROLL LETTER - FOR SALARY MANDATE To: The Accounts/Payroll Department Company Name Company Address Employee Name Employee Address Date 2 0 Request to credit my salary to my new bank account. My Staff/Employee Number Dear Sir/Madam Please note from 2 0 I wish to have my salary paid direct into the account detailed below. Bank Branch Name Branch N.S.C. Name of Account Account Number Yours faithfully, Customer signature Bank of Ireland is regulated by the Central Bank of Ireland. Page 6 of 6

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