NATIO

NA

L TREA

SURY M

AN

AG

EMEN

T AG

ENCY

Mail th

is form to – State Savin

gs, GPO

, Freepost, Du

blin 1, D

01 F5P2

IMPO

RTA

NT –

Before com

pletin

g this A

pp

lication Form

and

in p

articular Section

6 “D

eclaration

and

Signatu

re” you m

ust read

the G

eneral Term

s and

Con

ditions an

d th

e Specific C

ondition

s issued

on M

onday 16

Ap

ril 2018.

Copies are availab

le on StateSavin

gs.ie and

in every Post O

ffice.

The following extract quotes three of the Conditions from

the “General Term

s and Conditions and the Specific Conditions” dated 16 A

pril 2018. (N

ote: rather than being numbered as 1,2,3 these 3 conditions carry their original reference num

bers (2,3,5) as published within the G

eneral Terms &

Conditions)

2. Evidence of Identity2.1 You

are required to con

firm you

r identity to us (in

cludin

g your su

rnam

e, first nam

e, date of birth an

d address) for the pu

rposes of:

(a) th

e Agreem

ent (inclu

ding an

y Transaction

);

(b) th

e admin

istration of you

r Product(s) an

d any oth

er State Savings Produ

ct(s) that you

may h

old now

or in th

e futu

re, and

(c) associated legal pu

rposes, inclu

ding com

pliance w

ith statu

tory anti-mon

ey laun

dering obligation

s and accou

nt security an

d fraud prevention

,

2.2 We m

ay verify your identity:

(a) electronically (by referen

ce to inform

ation su

pplied by you, in

cludin

g your Person

al Public Service N

um

ber (PPSN)); or

(b) man

ually (by referen

ce to acceptable original or certified copy docu

mentation

supplied by you

, wh

ich m

ay inclu

de docum

ents such

as your cu

rrent passport, cu

rrent EU drivin

g licence, recent u

tility bill, recent account statem

ent from a ban

k, buildin

g society or credit un

ion, an

d/or your Pu

blic Services Card or oth

er official docu

mentation

issued to you

by the Reven

ue C

omm

issioners or th

e Departm

ent of Employm

ent Affairs an

d Social Protection).

2.3 Wh

ere you h

ave not provided eviden

ce of your identity to ou

r satisfaction, w

e will advise you

and w

e will n

ot proceed with

your application

to purch

ase the Produ

ct u

ntil evidence of you

r identity has been

verified to our satisfaction

. For the avoidan

ce of doubt, n

o interest, bonu

s or other am

ount sh

all accrue in

respect of a Product

durin

g the period w

hen

evidence of identity is bein

g verified un

der this con

dition.

3. Personal Data

3.1 The N

TMA

is the D

ata Controller (for th

e purpose of th

e Gen

eral Data Protection

Regulation

(GD

PR)) for all personal data su

pplied by you. Th

e Min

ister for Finan

ce an

d the N

TMA

are each a ‘specified body’ for th

e purposes of section

s 262 to 270 and sch

edule 5 of th

e Social Welfare C

onsolidation

Act 2005, as am

ended, u

nder

wh

ich th

e NTM

A an

d the M

inister for Fin

ance are both

auth

orised to process personal data in

cludin

g PPSNs for certain

purposes.

3.2 We w

ill collect, process and u

se personal data relatin

g to you, in

cludin

g your PPSN

and th

e inform

ation referred to in

condition

2 (Evidence of Identity):

(a) as n

ecessary for the perform

ance of th

e Agreem

ent (inclu

ding an

y Transaction

);

(b) for th

e admin

istration of you

r Product(s) an

d any oth

er State Savings Produ

ct(s) that you

may h

old now

or in th

e futu

re, and

(c) for associated legal pu

rposes, inclu

ding com

pliance w

ith statu

tory anti-mon

ey laun

dering obligation

s and accou

nt security an

d fraud prevention

,

3.3 You ackn

owledge th

e collection, processin

g and u

se of your person

al data (inclu

ding you

r PPSN) for th

e purposes as ou

tlined in

3.2.

3.4 Personal data m

ay be processed by us, ou

r Agents, an

d any th

ird party service providers acting on

our beh

alf for the pu

rposes of the A

greement an

d for associated legal pu

rposes and for an

y other pu

rpose required for or reason

ably incidental to th

e performan

ce of the A

greement.

3.5 We w

ill retain you

r personal data for as lon

g as you h

ave a holdin

g with

State Savings an

d otherw

ise in accordan

ce with

applicable data protection law

and statu

tory obligation

s (inclu

ding u

nder anti-m

oney lau

nderin

g legislation).

3.6 Subject to you

r consent, you

r personal data m

ay be used by u

s, or our A

gents, for the pu

rpose of marketin

g State Savings Produ

cts. Wh

ere you h

old more th

an on

e Produ

ct, the preferen

ces indicated m

ost recently by you w

ill apply to all Products h

eld by you to w

hich

the G

eneral Term

s and C

ondition

s apply.

3.7 You h

ave the right to requ

est access to and a copy of you

r personal data h

eld by us in

accordance w

ith th

e GD

PR, to have you

r personal data corrected w

here it is

inaccu

rate or misleadin

g, to h

ave your person

al data erased, to object to the processin

g of your person

al data by us, to requ

est data portability in relation

to your

personal data. Sh

ould you

wish

to avail of any of th

ese rights, please contact the D

ata Protection O

fficer, State Savings, G

PO, FREEPO

ST, Du

blin 1, D

01 F5P2.

You also h

ave the right to lodge a com

plaint with

the O

ffice of the D

ata Protection C

omm

issioner. See w

ww

.dataprotection.ie for m

ore inform

ation.

5. Registers5.1 O

nce you

r application to pu

rchase a Produ

ct has been

accepted and eviden

ce of your identity h

as been provided to ou

r satisfaction u

nder con

dition 2 (Eviden

ce of Identity), w

e will record you

r nam

e(s) and th

e Principal A

mou

nt of the Produ

ct in th

e Register applicable to that Produ

ct, wh

ich Register sh

all be the official record of

the H

older(s) and th

e Principal A

mou

nt of that Produ

ct.

5.2 We w

ill not be respon

sible for any delay th

at may arise in

the processin

g of your application

to purch

ase due to you

subm

itting an

incom

plete application or you

failing

to provide evidence of identity to ou

r satisfaction u

nder con

dition 2 (Eviden

ce of Identity). In particu

lar, you sh

ould n

ote any su

ch delay cau

sed by you m

ay mean

that

by the tim

e the process referred to in

condition

5.1 has been

completed, th

e Product th

at you applied to pu

rchase m

ay no lon

ger be available. In th

is event, we w

ill contact you

to request you

r new

instru

ctions.

5.3 The Registers m

ay be in paper form

or electronic form

or partly in on

e form an

d partly in th

e other form

, in each

case, at the absolu

te discretion of th

e NTM

A.

SAFE AREA

SAFE AREA

4

NTMA Brochure 1(b)16 April 2018

(ALSO FORCHILD BENEFIT)

NTMA Brochure 1(b)16 April 2018

The State Savings Products are:

For more information on State SavingsWeb: StateSavings.ie Telephone: 1850 30 50 60 / +353 1 705 7200SMS Text: 0852 30 50 60 E-mail: Service@StateSavings.ie Visit: Any Post Office Mail to: State Savings, GPO, Freepost, Dublin 1, D01 F5P2

Actual Before DIRT VARIABLE RATE6

0.15% Deposit Account4

0.50% Prize Bonds5

GROSS State Savings Products NETTotal

Return AER1 FIXED RATE, FIXED TERM AER1 Total Return

1.00% 0.33% 3 year Savings Bonds2 0.33% 1.00%

2.00% 0.50% 4 year National Solidarity Bond2 0.50% 2.00%

5.00% 0.98% 5 year Savings Certificates2 0.98% 5.00%

16.00% 1.50% 10 year National Solidarity Bond2 1.50% 16.00%

5.50% 0.98% 6 year Instalment Savings2,3 0.98% 5.50%(ALSO FORCHILD BENEFIT)

1 AER = “Annual Equivalent Rate”.2 Not subject to tax in Ireland but please see Condition 4 Taxation in Specific Conditions. 3 Save in 12 monthly instalments and leave for 5 years.

AER calculation assumes a 5½ year average life.4 Subject to DIRT (Deposit Interest Retention Tax) at the prevailing rate.5 Prize Bonds – The variable rate used to calculate prize fund is 0.50%. There are two €1

million prizes per annum and thousands of weekly prizes. No interest is paid to Prize Bond holders. Instead the interest is paid into the monthly prize fund, to be distributed to winners in the weekly draw.

6 Variable Rate means that the interest rate paid on this Product may be changed by the NTMA from time to time. Such changes will be notified by at least one of the following methods: direct notification to you by post, publication in a national newspaper, publication on StateSavings.ie or notification by any other means.

Brochures and Application Forms for State Savings Products listed above are available in any Post Office or online at StateSavings.ie. State Savings products are subject to Terms and Conditions and relevant legislation. You may find our Terms and Conditions booklet online and in Post Offices.

An Post is an agent of theNational Treasury Management Agency

Brochure and Application Form

Fixed Rates for 4 & 10 years

103 103

BR1B 3418 [5p].indd 1 06/04/2018 15:23

APP

LIC

ATIO

N F

OR

M

NAT

ION

AL

SOLI

DA

RITY

BO

ND

ISSU

E 6

NAT

ION

AL

TREA

SURY

MA

NA

GEM

ENT

AG

ENCY

Sect

ion

1 –

Savi

ngs

Term

(Ple

ase

sele

ct o

ne o

ptio

n)

Ind

ivid

ual

Am

ou

nts

: M

inim

um

Max

imu

mIn

div

idu

al A

mo

un

ts:

Min

imu

m M

axim

um

€

50

€12

0,0

00

€

50

€12

0,0

00

4 ye

ar N

atio

nal

Sol

idar

ity

Bon

ds (I

ssu

e 6)

10 y

ear

Nat

ion

al S

olid

arit

y B

onds

(Iss

ue

6)

Fill

in P

urc

has

e A

mou

nt

Fill

in P

urc

has

e A

mou

nt

Paym

ent

Met

ho

ds

Paym

ent

Met

ho

ds

Cas

hPe

rson

al C

heq

ue

Tota

l

€€ €

Sect

ion

4 –

Met

hod

of P

aym

ent (

Che

ques

to b

e m

ade

paya

ble

to N

TMA

Sta

te S

avin

gs)

Sou

rce

of

Fun

ds

(Ple

ase

tick

ap

pro

pri

ate

opti

on b

elow

)

Pers

onal

Sav

ings

Inh

erit

ed F

un

ds

Oth

er

(Ple

ase

spec

ify)

Plea

se ti

ck A

ccou

nt t

ype

requ

ired

abo

ve (T

ick

one

box

only

)

Con

sen

t Si

gnat

ure

of

nom

inat

ed P

aren

t/G

uar

dian

for

a M

inor

(age

d le

ss t

han

18)

Sole

M

inor

Join

t

Com

ple

te S

ecti

on 5

Pa

nel

1

Com

ple

te S

ecti

on 5

Pa

nel

s 1,

2N

ame

Sign

atu

re (Blo

ck L

ette

rs)

Sect

ion

3 –

Type

of H

olde

r Not

e-Fo

r app

licat

ion

form

s fo

r Cha

ritie

s, T

rust

s, C

lubs

, oth

er u

ninc

orpo

rate

d bo

dies

or F

riend

ly S

ocie

ties

tele

phon

e St

ate

Savi

ngs

at 1

850

30 5

0 60

/+35

3 1

705

7200

FOR

OFF

ICIA

L U

SE O

NLY

REC

EIPT

NO

. G

ROF

Offi

ce N

ame

PLEA

SE E

ND

OR

SE A

LL C

HEQ

UES

WIT

H T

HE

REC

EIPT

NU

MB

ER

Sign

atu

re o

f O

ffice

r:

Dat

e:

DA

TE S

TAM

P

(A)

(B)

If y

ou a

re a

n ex

isti

ng S

tate

Sav

ings

cus

tom

er p

leas

e en

ter a

ny o

ne

of y

our e

xist

ing

acco

unt

refe

ren

ces

and

the

prod

uct

typ

e be

low

.

Exis

tin

g A

ccou

nt

Nu

mb

er

Exis

tin

g Pr

odu

ct T

ype

Sect

ion

2 –

Oth

er P

rodu

cts

you

may

hol

d

(i.e

. Sav

ings

Cer

tifi

cate

s/Sa

vin

gs B

onds

/Nat

ion

al S

olid

arit

y B

ond/

Dep

osit

Acc

oun

t/Pr

ize

Bon

ds)

NS

B0

14

31

1

Sect

ion

6 –

Dec

lara

tion

and

Sig

natu

re I/

We

have

read

and

acc

ept t

he G

ener

al T

erm

s an

d Co

ndit

ions

and

the

Spec

ific

Cond

itio

ns d

ated

Mon

day

16 A

pril

2018

incl

udin

g th

e us

e of

my/

our P

PSN

. Ple

ase

sign

and

dat

e.

Deb

it C

ard

€ €

Firs

t N

amed

Ho

lder

Seco

nd

Nam

ed H

old

er

Sign

atu

re o

f 1s

t N

amed

Ho

lder

D

ate

Sign

atu

re o

f 2n

d N

amed

Ho

lder

D

ate

* PP

SN

* Fi

rst

nam

e(s)

* Su

rnam

e

* D

ate

of b

irth

* A

ddre

ss li

ne

1

* A

ddre

ss li

ne

2

A

ddre

ss li

ne

3

Ei

rcod

e

* Co

untr

y of

resi

denc

e

* N

atio

nal

ity

* Pl

ace

of b

irth

G

ende

r

C

onta

ct P

hon

e n

o.

E-

mai

l add

ress

DD

MM

YY

YY

Mal

eFe

mal

e

DD

MM

YY

YY

Mal

eFe

mal

e

Unl

ess o

ther

wis

e ag

reed

with

you

all C

orre

spon

denc

e w

ill b

e se

nt to

the

addr

ess i

n Pa

nel 1

–

Pan

el 1

Fir

st n

amed

hol

der

Pan

el 2

Sec

ond

nam

ed h

olde

r

Sect

ion

5 –

Hol

der(

s) D

etai

ls

2 3

Minimum Purchase - €50Maximum Purchase - €120,000 per individual, per Issue.

1 Annual Equivalent Rate.

1 Annual Equivalent Rate.

Your Savings will growas follows:

CumulativeBonus percentage

Encashment value of €1,000 at end period:

AER1

TAX FREE

Year 1 0.05% €1,000.50 0.05%

Year 2 0.25% €1,002.50 0.12%

Year 3 0.50% €1,005.00 0.17%

Year 4 1.00% €1,010.00 0.25%

Year 5 3.00% €1,030.00 0.59%

Year 6 5.00% €1,050.00 0.82%

Year 7 7.00% €1,070.00 0.97%

Year 8 10.00% €1,100.00 1.20%

Year 9 13.00% €1,130.00 1.37%

Year 10 16.00% €1,160.00 1.50%

Minimum Purchase - €50Maximum Purchase - €120,000 per individual, per Issue.

Earn 16% TAX FREE Total Return after 10 years (AER1 1.50%)Where National Solidarity Bonds are encashed before the elapse of 10 years, the AER will be lower.

What are State Savings?

• State Savings form part of the National Debt of Ireland which is managed by the National Treasury Management Agency.

• When you save with State Savings you are placing your money directly with the Irish Government.

• The repayment of all State Savings money is a direct, unconditional obligation of the Irish Government.

• Repayment of your money includes principal, interest and bonus payments if due.

How can I buy State Savings Products?• Call into any Post Office.

• Online at StateSavings.ie

The complete range of State Savings products are listed on our website StateSavings.ie. Customers can buy Fixed Term Products and Prize Bonds online.

To buy, online or by mail, you must be an existing State Savings customer for whom we already have the necessary evidence of identity. Please contact us for further information – contact details are on page 4.

If you are not an existing customer or if your last purchase of State Savings products was prior 05 October 2014 you must first register by completing a purchase at a Post Office or by postal application to State Savings, GPO Freepost, Dublin 1, D01 F5P2.

Your Savings will growas follows:

CumulativeBonus percentage

Encashment value of €1,000 at end period:

AER1

TAX FREE

Year 1 0.05% €1,000.50 0.05%

Year 2 0.55% €1,005.50 0.27%

Year 3 0.90% €1,009.00 0.30%

Year 4 2.00% €1,020.00 0.50%

1. National Solidarity Bond 4 year (Issue 6)

Earn 2% TAX FREE Total Return after 4 years (AER1 0.50%)Where National Solidarity Bonds are encashed before the elapse of 4 years, the AER will be lower.

for

purc

has

es a

fter

16

Apr

il 20

18

All

Pane

ls m

arke

d w

ith

an a

ster

isk

mus

t be

com

plet

ed in

ord

er to

pur

chas

e St

ate

Savi

ngs

Prod

ucts

.

2. National Solidarity Bond 10 year (Issue 6)

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