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IncomeExpense

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									                                                      KBC Homeloans
                                              Income & Expenditure Form
The information collected will be utilised by KBC Homeloans to assist us with the review of your current financial situation.
Please complete all sections relevant to your household income.


KBC HL Reference No:

Borrower Information                                         Borrower 1                                           Borrower 2
Name
Marital Status
Age Next Birthday
No of dependent children
Employed Y/N
Nature of Employment
Occupation
Name of Employer
Length of Service



Reason for Financial Distress




Your Monthly Income                                          Borrower 1                                           Borrower 2
Net Monthly Salary
Monthly Social Welfare Benefits
Monthly Child Benefits
Monthly Rental Income
Mortgage Income Supplement
Monthly Total                                                                                             0
Your Current Monthly Debt              Current       Proposed

Repayments
                                                     If proposed repayment amount is
                                                     different to current repayment
                                                     amount, type it here.
KBC Monthly Mortage Repayments
Credit union repayments
Unsecured Loan Monthly payments
Personal loan
2
Credit Card Monthly Repayments
Other Monthly Debt commitments n o t
s p ec ified ab o v e
Charity
Total                                            0                                     0
Your Monthly Income After Debt
Repayments                                       0                                     0

                                                     Proposed -
                                                     Type in proposed changes to
Your Monthly Household Expenditure     Current       expenditure in this column


Household
Childcare
Groceries
Clothing Adults
Clothing Children

Utilities
Phone (Landline & Mobile)
Gas /Oil
Electricity
Refuse Charges
TV Cable

Travel
Petrol
Rail/Bus/Taxi Costs
Car Maintenance/Parking
Insurance
Motor / Tax
Home
Life
Health

Other- please specify

Leisure Expenses
Alcohol & cigarettes
Eating out
Club membership
Other - please specify

Regular Savings
Monthly Savings
Non Salaried Pension
Total Monthly Expenditure                                                                                            0                                                             0

Monthly Difference                                                                                                   0                                                             0
Personal data collected from you in respect of your mortgage will be retained by KBC Homeloans and will be stored on computer and used for the purpose of processing your
mortgage and any resulting service. KBC Homeloans may disclose your Information to members of the KBC Group, their successors in title, any person acting as its or their agents,
any third parties/sevice providers engaged by it or them in connection with the provision to you of products and services, third party suppliers of products and services arranged by
KBC Homeloans on your behalf and your request, regulatory bodies and law enforcement agencies, credit reference agencies and any other party to whom you have agreed KBC
Homeloans may disclose your information. You have the right to receive a copy of all personal data held by KBC Bank Ireland following a written request, and to have any inaccuracies
in that personal data corrected in accordance with the provisions of Data Protection legislation.


                               KBC Homeloans Sandwith St Dublin - www.kbchomeloans.ie infohomeloans@kbc.ie
                              KBC Bank Ireland plc trading as KBC Homeloans is regulated by the Financial Regulator

								
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