Pepper

Section 1 – Your Details

Please provide all Borrower/s names on account:

Borrower 1 Name:

Please provide all Account number/s:

Please list all account numbers if you have more than one.

Account Number 1:

Question

Please tick the type of Income loss / reduction?

Please confirm your occupation

Please confirm the industry you work in, e.g. Hospitality, Construction, Aviation, etc

Borrower 1

PAYE

Self Employed

Rental

Please provide your email address and mobile phone number for future communications, by providing this you are consenting to us contacting you by email and by text message:

Borrower 1 email:

Borrower 1 mobile no:

Section 2 – Payment Break Acknowledgement and Acceptance of Borrower(s)

All borrowers on the mortgage agreement are required to review the payment break extension
details in the Covid-19 Payment Break letter (the letter).

Important Information – Please read carefully

I/we confirm that I/we continue to be financially impacted as a result of Covid-19.

I/we confirm the impact on my/our financial circumstances is short term as a result of Covid-19.

Short term example – able to resume employment and repayments at the end of the further 3-month extension.

I/we confirm I/we cannot afford to resume payments on my/our mortgage now, and therefore I/we require a further 3-month extension to my/our current payment break.

I/we understand that my/our mortgage repayments will increase after the payment break, or, my/our mortgage term may be extended.

I/we understand the payment break means.

I/we will pay more interest over the life of my/our mortgage loan because there have been no/reduced payments during the break period.
The payment break results in an increased cost of credit.
The increased cost of credit is not a fee, it is because I/we will make no/reduced repayments (capital or interest) during the payment break period but interest will continue to apply to the mortgage.

I/we understand the following in relation to the payment break.

There are no fees charged for this extended payment break.
My/our mortgage will not fall into arrears as a result of the extended payment break.
My/our credit report with the Central Credit Register and the Irish Credit Bureau (where relevant) will not be impacted as a result of an extension of the current payment break.
The Payment Break may have an impact on my/our TRS entitlement for 2020.

I/We acknowledge that this may affect the amount of mortgage protection cover required and that the mortgage protection premiums may increase as a result. (It is important that you check your mortgage protection cover to ensure that it is enough to repay the mortgage in full).

I/We acknowledge that by submitting this completed form, that all borrowers on the mortgage agreement have read the information provided in the letter and agree to accept the terms of the payment break extension outlined above.

Upon receipt of this completed form:

We will review your circumstances and consider whether extending the payment break is the most appropriate option for you.
We will be in contact with you shortly on the outcome of this review.

You have the right to cancel the payment break extension within 10 days from the date you submit this form.
Contact us if you wish to do so.

COVID 19 – Mortgage Payment Break Extension Request Form