Foirm Iarratais ar Dheontas/Iasacht

Application for Assistance (Grant/Loan)

Please Note: All information supplied is confidential and is only requested for the purpose of this application.
Please review the PSFS Privacy Policy to ensure you are aware of, and agree with why and how we handle your data.

Please Note:

All information supplied is confidential and is only requested for the purpose of this application.
Please review the PSFS Privacy Policy to ensure you are aware of, and agree with why and how we handle your data.

OLD iPad / iOS Devices: The online signature facility on this form will work on all modern devices. However, if your iOS device is 5 years old or older, the signature may not work – so you will have to use a more recent iOS device or any modern laptop/desktop.

"*" indicates required fields

Step 1 of 3



Personal & Contact Information

Purpose of application*
Name*
MM slash DD slash YYYY


Additional & Financial Information

Are you a member?*
Have you previously applied to the Society for assistance?
MM slash DD slash YYYY
Any Other Income?
IF your application is successful, the Society can pay via cheque or direct lodgement/EFT. If via direct lodgement, please include your BIC and IBAN below.


Supporting Documentation

Please attach a cover note, 3 recent payslips and other supporting documentation (financial statements, utility bills, repair quotes) in the fields below. This will help avoid any delay in processing your application.
If you have any difficulty attaching these documents, please email us directly at info@psfs.ie
Drop files here or
Accepted file types: jpg, png, pdf, doc, docx, xls, xlsx, Max. file size: 2 MB.

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