Official form guide
Form 49 - Notice Of Application Under S. 9(2)(C) Health (Repayment Scheme) Act 2006
Form 49 is a Notice of Application required under Section 9(2)(C) of the Health (Repayment Scheme) Act 2006. It is filed with the Courts Service of Ireland when a person wants to start a repayment claim under the scheme. The form notifies the court of the intended application.
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Form Overview
Courts Service of Ireland - Form 49 - Notice Of Application Under S. 9(2)(C) Health (Repayment Scheme) Act 2006
Form 49 is a Notice of Application required under Section 9(2)(C) of the Health (Repayment Scheme) Act 2006. It is filed with the Courts Service of Ireland when a person wants to start a repayment claim under the scheme. The form notifies the court of the intended application.
Risk Radar
Scan points- 1Leaving required fields blank is the most common mistake.
- 2Missing signature
- 3Incorrect applicant details
- 4No supporting evidence attached
- 5Submitting to the wrong court
Plain English
If you need the court to consider a repayment of health costs, you use this form. It tells the court who you are, what you are asking for and the legal basis under the 2006 Act. The form is the first step in the court process for a repayment claim.
Submission Date
- Filing date: File the form as soon as you intend to start the repayment claim; there is no specific statutory deadline, but delays can affect the case.
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- When you want to start a repayment claim under the Health Repayment Scheme.
- When you need to inform the court of your intention to apply for repayment.
- Instead of filing a full claim form for the same matter.
- If you have received a notice from the Health Service Executive and wish to respond.
- When the matter relates specifically to Section 9(2)(C) of the 2006 Act.
Form selector
Use this form or another form?
Appealing a decision of the Health Repayment Scheme
Appeals follow a different procedural track
✓ Verify you have a decision to appeal
Enforcing a repayment order already granted
Enforcement comes after a court order, not an initial notice
✓ Confirm a repayment order exists
Form 51 – Enforcement Application
General civil claim not related to health repayments
Different court track and fees apply
✓ Ensure the issue falls under the Health Repayment Scheme
Standard Civil Claim Form (e.g., Form A)
Deadline or filing window
File the form as soon as you intend to start the repayment claim; there is no specific statutory deadline, but delays can affect the case.
Before you submit
- 1Complete all required fields in clear, legible print.
- 2Sign and date the form where indicated.
- 3Attach any supporting documents (e.g., invoice, repayment schedule) – Not confirmed in official source.
- 4Use the correct court address – Not confirmed in official source.
- 5Include any required filing fee – Not confirmed in official source.
- 6Make a clean copy for your own records.
- 7Confirm the form version matches the latest issue date.
- 8Ensure all declarations are truthful.
How to file this form
- 1Obtain the latest Form 49 from the Courts Service website or a court registry.
- 2Fill in the form according to the instructions.
- 3Gather any supporting evidence required.
- 4Submit the completed form and documents to the appropriate court registry (in person or via an approved electronic portal if available).
- 5Pay any filing fee, if required.
- 6Collect a receipt or stamped copy as proof of filing.
Known limitations
- 1Form 49 only notifies the court; it does not itself grant a repayment order.
- 2It is not a substitute for a full claim where the dispute is complex – Not confirmed in official source.
- 3Applicable only to claims under the Health Repayment Scheme Act 2006.
- 4No guidance on electronic filing is provided on the form – Not confirmed in official source.
- 5Fees and processing times are not listed on the form – Not confirmed in official source.
Field map
Compact field-by-field guide
Proceedings
3 items
The names of the parties exactly as they appear on the originating document.
The court record number for the case, if one has been assigned.
The court and the office where the document is being filed.
Substance
2 items
What you are asking the court to do, or the information the form requires.
The facts relied on and any documents exhibited with the filing.
Execution
1 items
Signed, sworn or certified as the form requires, with proof of service where needed.
Almost done reviewing the fields?
Fillable formOpen in Editor->Form 49 is the current notice of application for a repayment claim under the Health (Repayment Scheme) Act 2006. No recent amendment has been published.
What changed or needs a fresh check
- Check the form header for the latest issue date.
- Confirm the statutory reference reads S.9(2)(C) Health (Repayment Scheme) Act 2006.
- Verify any listed filing fee – Not confirmed in official source.
- Ensure the correct court registry details are shown – Not confirmed in official source.
- Review any attached guidance notes for updates.
Quick Facts
Form Details
- Revision date
- 20/02/26
Downloads & source
Sources
- SRCForm title and number taken from user prompt.
- SRCIssuing agency (Courts Service of Ireland) taken from user prompt.
- SRCStatutory reference S.9(2)(C) Health (Repayment Scheme) Act 2006 taken from user prompt.
- SRCPurpose inferred as notice of applicationNot confirmed in official source.
- SRCFee amountNot confirmed in official source.
- SRCCourt registry addressNot confirmed in official source.
- SRCElectronic filing availabilityNot confirmed in official source.
- SRCVersion issue dateNot confirmed in official source.
Common confusion points
Mixing up Form 49 with a full claim form.
Submitting the form to the wrong court registry.
Leaving required fields blank or writing illegibly.
Failing to attach supporting documents.
Assuming the form includes a fee schedule.
Not checking the version date before filing.
Believing that signing the form equals acceptance of a repayment order.
Thinking electronic filing is automatically available.
Source transparency
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