SME Business Lending · CONTENTS Page 1 of 11 PART 1 Business Details PART 2 Personal Details PART 3 Application Details PART 4 (i) Customer Identification and Consent Form PART 4

SME Business LendingApplication Form Republic of Ireland

www.bankofireland.com/business

Bank of Ireland is regulated by the Central Bank of Ireland.

CONTENTS

Page 1 of 11

PART 1 Business Details

PART 2 Personal Details

PART 3 Application Details

PART 4 (i) Customer Identification and Consent Form

PART 4 (ii) Data Protection and Authorisations

Three easy steps to applying for business lending with Bank of Ireland 1. Arrange a meeting with your Business Adviser at the branch2. Complete the enclosed Application Form in full3. Gather any additional supporting documentation or information that may be required by the Bank

(Your Business Adviser will inform you if the Bank have any additional requirements)

Credit Application Assistance To help you with your request for credit, please refer to the following websites:www.businessbanking.bankofireland.com/business-supports/guide-to-obtaining-creditwww.creditreview.ie/Publications.aspx

Definition of Small and Medium-sized Enterprises (SMEs)

The SME Regulations apply to “micro, small and medium sized enterprises” and the SME Regulations define these enterprises as follows:

• “micro and small enterprise” means an enterprise which employs fewer than 50 persons and which has either or both of the following:

(1) an annual turnover which does not exceed €10 million (2) an annual balance sheet total which does not exceed €10 million;

• “micro, small and medium-sized enterprise” means an enterprise which employs fewer than 250 persons and which has either or both of the following:

(1) an annual turnover not exceeding €50 million (2) an annual balance sheet total not exceeding €43 million.

SME Business Lending Application FormRepublic of IrelandPLEASE COMPLETE IN BLOCK CAPITALS

Page 2 of 11

PART 1: BUSINESS DETAILS

Please tell us about your business. This information will assist us in providing a professional timely response.

Business Name Company Registration No.

Trading Name Company incorporated in (Country) (if different from above)

No. of Outlets Business Address

Contact Person Primary Business Activity

Email In Business Since Years Months

Telephone Customer Since Years Months

Mobile No. of Employees As at D D M M Y Y

Best Contact Time Business Premises Status Owned Leased Rented

Business Type DAC (Designated Activity Co.) Unlimited Co. Ltd Co. Sole Trader

Other specify (e.g. Partnership)

Main Bank Account Details

Sort Code

Thank you for your recent enquiry in relation to credit facilities. In order to progress your application you will need to arrange a meeting with your Bank of Ireland Business Adviser and complete this Business Lending Application Form. You can complete this form with the assistance of your Business Adviser during this meeting or with the help of a Business Professional.

Your Business Adviser will inform you of any further documentation that may be required to support your application. Your request for credit will be progressed when your Business Adviser has received these documents along with your signed Business Lending Application Form.

If more fields are required, please photocopy page.

BUSINESS OWNERSHIP DETAILS

List the names of all individuals who ultimately own or control 25% or more of the shares or voting rights in the Company or otherwise exercises control over the management of the Company

1. Owner Name Director Yes No Irish Resident Yes No

Address Date of Birth D D M M Y Y

Occupation Percentage Shareholding %










Page 3 of 11

BUSINESS BORROWING & SAVINGS DETAILS

BORROWINGS Financial Institution Amount Outstanding (000’s) Monthly Repayments

Overdraft

Business Cards

Loans(incl. Credit Union

Leasing/Hire Purchase

Commercial Mortgage

List below any corporate shareholder that ultimately owns or controls 10% or more of the shares or voting rights in this Company or otherwise exercises control over the management of this Company

1. Company Name % of shares owned in the Company %

Registered No.

2. Company Name % of shares owned in the Company %

Registered No. (If more fields are required, please photocopy page)

Other Financial Commitments (e.g. Forward Contracts, Bank Guarantees etc.)

SAVINGS & INVESTMENTS

Financial Institution Amount Held (000’s)

Savings

Deposits

Other

Investments

Investment Accounts

Shares

Other

Property Yes No Current Property Value €

Mortgage Outstanding € Financial Institution

BUSINESS OWNERSHIP DETAILS CONTINUED…

BUSINESS FINANCIAL DETAILS

Period Ending D D M M Y Y Full Year Accounts Yes No

Accounts Type Audited Auditor’s Name Certified Management Other

Value (000’s) Value (000’s)

Sales Turnover Interest

Gross Profit Depreciation

Net Profit Tax

Drawings

Page 4 of 11

BUSINESS FINANCIAL DETAILS CONTINUED…

Assets Value (000’s) Liabilities Value (000’s)

Land & Buildings Creditors

Machinery & Equipment VAT / PAYE / PRSI

Furniture & Fittings Other

Stock

Debtors Other

Cash Tax Status (Tax up to date) Yes No

Deposits Is a Revenue Agreement in place Yes No

Other Monthly Amount of Revenue Agreement

Total Assets

Current Values

Your personal details are also important to us and while it is critical to understand your business,it is also important to understand its owners. These details will help us meet your current needs.

PART 2: PERSONAL DETAILS

PERSONAL DETAILS Principal Business Owner

Name No. of Dependants

Address Age Range From To

Residential Status Owner Tenant

Living with Parents Other

Account Number No. of Years at Address

Sort Code Estimated Value of Home

Contact Details Annual Salary

Email Salary Payment Frequency

Landline Previous Address

Mobile (If less than 3 years at current address)

Best Contact Time

Date of Birth D D M M Y Y

Time with Bank Years Months

PERSONAL FINANCIAL DETAILS Principal Business Owner


Mortgage

Personal Loan

Motor Loan

Overdraft

Credit & Other Cards

Tax Liability

Other

Page 5 of 11



Savings

Deposits

Other

Investments

Investment Accounts

Life Assurance

Shares

Pension

Property(other than family home)

Please indicate current property value €

Other

PERSONAL DETAILS Second Business Owner

Name No. of Dependants

Address Age Range From To

Residential Status Owner Tenant

Living with Parents Other

Account Number No. of Years at Address

Sort Code Estimated Value of Home

Contact Details Annual Salary

Email Salary Payment Frequency

Landline Previous Address

Mobile (If less than 3 years at current address)

Best Contact Time

Date of Birth D D M M Y Y

Time with Bank Years Months

PERSONAL FINANCIAL DETAILS Second Business Owner


Mortgage

Personal Loan

Motor Loan

Overdraft

Credit & Other Cards

Tax Liability

Other

Page 6 of 11



Savings

Deposits

Other

Investments

Investment Accounts

Life Assurance

Shares

Pension(other than family home)Property(other than family home)

Please indicate current property value €

Other

Please tell us about your current financial requirements. If you are unsure, please discuss with your Business Adviser, who will be happy to go through the various options.

PART 3: APPLICATIONS DETAILS

APPLICATION DETAILS

FACILITY 1 Overdraft Loan FACILITY 2 Overdraft Loan

Other Other

Amount Required Amount Required

Repayment Period Years Months Repayment Period Years Months

Purpose of Facility Purpose of Facility (e.g. Working Capital) (e.g. Working Capital)

Loan Repayment Frequency Loan Repayment Frequency (e.g. Monthly) (e.g. Monthly)

Loan First Repayment Date D D M M Y Y Loan First Repayment Date D D M M Y Y

Do you foresee any additional Yes No If yes, please requirement over the coming 12 months? provide details

APPLICATION DETAILS (CONTINUED)

Describe briefly the purpose of Facility 1 and/or Facility 2 and what financial input is being provided by you and the source of these funds. Please let us know if your business is supported by Enterprise Ireland, City & County Enterprise Boards, Business Agents etc. and / or other Specialist Funds.

Page 7 of 11

APPLICATION DETAILS CONTINUED…

ATTACHMENTS SECURITY/COLLATERAL PROPOSED

Additional Information Depending on the purpose of your borrowing further details may be required. For example, if you are purchasing a new business premises the address, property valuation etc will be required. For a machinery purchase the machinery value, expected fit-out costs, expected life etc. will be required. Please provide any additional information which is relevant to your application.

These details may not be required for all applications. Your Business Adviser will tell you what further information is required to ensure a speedy decision.

Management Accounts D D M M Y Y

Certified/Audited Accounts D D M M Y Y

Cash Flow Statement/Projections D D M M Y Y

Business Plan D D M M Y Y

Aged Debtors Listing D D M M Y Y

Aged Creditors Listings D D M M Y Y

Tax Clearance Certificate D D M M Y Y

Other D D M M Y Y

Your Business Adviser will inform you if security is required.

BANK USE ONLY

What is the turnaround time that has been advised to the customer?

Page 8 of 11

PART 4 (I): IDENTIFICATION AND CONSENT FORM – PERSONAL CUSTOMER 1Please photocopy where required This form should be completed by the individual presenting the Identification & Verification Documents. (The Bank may also, at its discretion, require any of the Beneficial Owners to complete this form). Two copies of the Form are enclosed in this Application Pack.

Account Name

Person to be Identified A/c No.

Relationship of this person to the above account (please tick all applicable)

Sole Trader Trustee Elected Officer / Committee Member Partner Authorised Signatory Management Committee Member Director Beneficial Owner 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: Customer Consent: I hereby agree that any information and/or any original documents and/or any copy documents supplied by me or on my behalf to the Bank (whether in its own capacity or as agent of a Bank of Ireland Group member) so as to enable the Bank and/or Bank of Ireland Group to comply with any and all obligations of the Bank and/or Bank of Ireland Group under:

• The laws and regulations concerning the prevention of money laundering and terrorist financing (“anti money laundering provisions”); and/or

• Part 38, Chapter 3A of the Taxes Consolidation Act, 1997, as amended, varied or substituted from time to time (the “1997 Act”)• The Return of Payments Regulations 2008

may at any time be disclosed or transferred by the Bank to, or copies thereof sent by the Bank to, any Bank branch, any other Bank of Ireland Group member, or any other party as defined in, under or pursuant to the anti money laundering provisions and/or the 1997 Act, that may at any time provide or be requested to provide any service(s) 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 anti money laundering provisions 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 anti money laundering provisions and/or the 1997 Act, and for the benefit of any Bank of Ireland Group member to which we 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, any branch of the Bank, the separate legal entities that constitute the Bank of Ireland Group and any respective successors, assigns and transferees of the Bank or entities aforesaid.

Signed Date 2 0

BANK USE ONLY

Is person to be identified an existing Bank of Ireland Group Customer? Yes No

IF YES: Name of Branch/Group Entity

ID Documentation for the person named above must be confirmed in order.

Anti Money laundering Documentation Screen completed for the above account. Yes Date Opened

Is AML ID&V documentation held and in order and has AML Documentation Screen been fully completed? Yes No With the person’s consent as detailed above, you can request the Branch/Group Entity who has established his/her identity to

update the AML Documentation Screen or provide copies of the ID documentation for your records or you can request him/her to provide the necessary ID documentation.

IF NO: Name and current permanent address of person named overleaf must be verified in line with procedures. Has there been face to face contact with the person being identified? Yes No

If NO, specify method of contact (two forms of address verification must be obtained)

Address Verification 2x method(s) used

(for non Face to Face only)

Anti Money laundering Documentation Screen completed for person named above. Yes Signed (Staff Member) Staff Number Date

Copies of ID Material(s) must be attached to this Form

Page 9 of 11

PART 4 (I): IDENTIFICATION AND CONSENT FORM – PERSONAL CUSTOMER 2Please photocopy where required This form should be completed by the individual presenting the Identification & Verification Documents. (The Bank may also, at its discretion, require any of the Beneficial Owners to complete this form). Two copies of the Form are enclosed in this Application Pack.

Account Name

Person to be Identified A/c No.

Relationship of this person to the above account (please tick all applicable)

Sole Trader Trustee Elected Officer / Committee Member Partner Authorised Signatory Management Committee Member Director Beneficial Owner 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: Customer Consent: I hereby agree that any information and/or any original documents and/or any copy documents supplied by me or on my behalf to the Bank (whether in its own capacity or as agent of a Bank of Ireland Group member) so as to enable the Bank and/or Bank of Ireland Group to comply with any and all obligations of the Bank and/or Bank of Ireland Group under:

• The laws and regulations concerning the prevention of money laundering and terrorist financing (“anti money laundering provisions”); and/or

• Part 38, Chapter 3A of the Taxes Consolidation Act, 1997, as amended, varied or substituted from time to time (the “1997 Act”)

• The Return of Payments Regulations 2008 may at any time be disclosed or transferred by the Bank to, or copies thereof sent by the Bank to, any Bank branch, any other Bank

of Ireland Group member, or any other party as defined in, under or pursuant to the anti money laundering provisions and/or the 1997 Act, that may at any time provide or be requested to provide any service(s) 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 anti money laundering provisions 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 anti money laundering provisions and/or the 1997 Act, and for the benefit of any Bank of Ireland Group member to which we 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, any branch of the Bank, the separate legal entities that constitute the Bank of Ireland Group and any respective successors, assigns and transferees of the Bank or entities aforesaid.

Signed Date 2 0

BANK USE ONLY

Is person to be identified an existing Bank of Ireland Group Customer? Yes No

IF YES: Name of Branch/Group Entity

ID Documentation for the person named above must be confirmed in order.

Anti Money laundering Documentation Screen completed for the above account. Yes Date Opened

Is AML ID&V documentation held and in order and has AML Documentation Screen been fully completed? Yes No With the person’s consent as detailed above, you can request the Branch/Group Entity who has established his/her identity to

update the AML Documentation Screen or provide copies of the ID documentation for your records or you can request him/her to provide the necessary ID documentation.

IF NO: Name and current permanent address of person named overleaf must be verified in line with procedures. Has there been face to face contact with the person being identified? Yes No

If NO, specify method of contact (two forms of address verification must be obtained)

Address Verification 2x method(s) used

(for non Face to Face only)

Anti Money laundering Documentation Screen completed for person named above. Yes Signed (Staff Member) Staff Number Date

Copies of ID Material(s) must be attached to this Form

Page 10 of 11

PART 4 (II): BANK OF IRELAND GROUP DATA PROTECTION CONSENT AND AUTHORISATIONThis Form must be completed by all Shareholder(s)/Owner(s) who have completed the Personal Details Section in Part 2.

CONSENT AND AUTHORISATION

DATA PROTECTION ACT (OPTIONAL)

I / We consent to the details, that I/we are being asked to supply, being used to provide me/us 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/us with a third party. If you would not like the information to be utilised for this purpose, please tick this box. I/we understand that at any time I/we can ask you to stop or change the methods by which the Bank may send me/us marketing materials. This can be done free of charge by writing to my/our branch of the Bank.

Where more than one applicant, this declaration is to be signed by all parties. (Note: applicants must sign form if personal details are provided.)

To the Bank of Ireland Group 1. Where this application is an application for facilities, I/we confirm that l/we am/are not less than 18 years of age.

2. I/we certify the accuracy of the information in the event of any future applications by me/us (whether oral or written) for a facility, unless l/we expressly advise you to the contrary at the time of any such future application.

3. By applying for or availing of an account, policy or other financial product from Bank of Ireland Group 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; (c) to carry out business and market research and compile statistics; (d) to help detect fraud and dishonesty; (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.

4. In the event of a facility being approved by the Bank and accepted by me/us and following a request to drawdown the facility by me/us, I/we authorise the Bank to make the facility available and to put the appropriate repayment schedule into effect.

5. I/We agree that the facility (and any other facilities as may be granted by the Bank at your discretion) shall be subject to the terms and conditions and specific provisions detailed in the Bank’s Credit Agreement, once issued.

PART 4 (II): DATA PROTECTION ACT AND AUTHORISATIONS CONTINUED

SIGNATURE(S)

I/We hereby confirm that each authorisation contained herein to hold, use, disclose, copy and process information constitutes a consent for the purposes of the Data Protection Act 1988 and 2003 and any amending or extending legislation or any related European Communities regulation or directive.

1. Date 2 0

2. Date 2 0

3. Date 2 0

4. Date 2 0

BANK USE ONLY

Branch NSC

Witnessed by Date 2 0

Application No.

WARNING: IF YOU DO NOT MEET THE REPAYMENT ON YOUR CREDIT FACILITY AGREEMENT, YOUR ACCOUNT WILL GO INTO ARREARS. THIS MAY AFFECT YOUR

CREDIT RATING, WHICH MAY LIMIT YOUR ABILITY TO ACCESS CREDIT IN THE FUTURE.

WARNING: YOU MAY HAVE TO PAY CHARGES IF YOU REPAY EARLY, IN FULL OR IN PART, A FIXED-RATE CREDIT FACILITY.

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