ANNEX
Statement of fees template
\text{Statement of Fees}
Statement of Fees
[Name of the account provider]
[Contact details of the account provider]
[Client name]
[Contact details]
Account
Account identification
Period
From to
Date
·
This document provides you with an overview of all the fees for services linked to your payment account during the period shown above.
·
It also informs you about any interest you may have paid or earned during this time.
·
Information on individual transactions and account balance can be found on your account statements.
Summary of fees and interest
Total fees paid (total package of services fees and total fees paid)
Total interest paid
Total interest earned
Comprehensive cost indicator
\text{Not a mathematical formula}
Detailed statement of fees paid on the account
Service
Fee
Service
Number of times the service was used
Unit fee
Number of times the fee was charged
Total
General account services
Includes a package of services consisting of:
Services beyond these quantities have been charged separately
Payments (excluding cards)
Cards and cash
Overdrafts and related services
Other services
Total fees paid
Detail of the fees included in the package of services
Package of services
Fee
Number of times the fee was charged
‘Package service’ [brand name, if applicable]
Includes:
Services beyond these quantities have been charged separately.
Detail of interest paid on the account
Interest rate
Interest
Total interest paid
Detail of interest earned on the account
Interest rate
Interest
‘Account name’
Total interest earned
Additional information