Basic Details Country Select Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belau Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Cook Islands Costa Rica Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo (Kinshasa) Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Ivory Coast Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao S.A.R., China Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Republic of the Congo (Brazzaville) Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (Dutch part) Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia/Sandwich Islands South Korea South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom (UK) United States (US) United States (US) Minor Outlying Islands United States (US) Virgin Islands Uruguay Uzbekistan Vanuatu Vatican Venezuela Vietnam Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Trading Status of the Business Is the company authorised and/or regulated by the FCA? Are you an Appointed Representative of another Principal? Are you regulated by an alternative Professional Body / Regulator? Have you ever had an appointment as an Introducer or Appointed Representative terminated? Are you a Member of a Network? Are you a Member of any Professional Trade Organisations/Bodies? Have you ever been investigated, publicly censored, disciplined, suspended or expelled by the FCA, another regulator, a professional body? Are you currently the subject of any disciplinary proceedings by the FCA, another regulator, a professional body, a trade body or a government body or agency? Are you currently or have you been the subject of any investigation by the FCA, another regulator, a professional body, a trade body or a government body or agency which has led to a requirement or undertaking significant remedial action, a past business review, customer remediation programme or the engagement of skilled persons? Have you had any application for membership of any Professional Trade Organisations/Bodies refused, cancelled, declined or withdrawn? Please state which one and the reason: Are you exempt from authorisation and regulation by the Financial Conduct Authority? Are you a member of a Designated Professional Body (DPB)? Please state DPB and Reference Number: Do you have external compliance support (e.g. from a consultant, service provider or similar)? Do you have Network permission to introduce cases outside of the Network? Does your firm or network have the permissions and service to undertake Pension Transfer advice? As you or your network can provide Transfer advice, please give reasons why you are looking to outsource DB transfers. Please briefly describe your business model, including the services you provide and how these are distributed: Please describe how you generate new clients (e.g. use of lead generators, word of mouth recommendations, etc.) and confirm how these apply to the clients you intend to introduce to Pensionhelp. Does your firm have a Centralised Investment Proposition (CIP)?
Please indicate which of the following (if any) you have advised on or provided services in the last 2 years and the approximate percentage of your total revenue generated by each:
Evaluate the following statements.
Structured Products (Geared Downside) Any Investments for Tax Structuring Unregulated Collective Investment Schemes/ Non Mainstream Pooled Investments Viatical Settlements / Life Settlement Products Traded Endowment Policies Other Geared or Leveraged Investments Own Branded Collective Investment Schemes / DIFs Commodities or Commodity Funds Does your firm have a preferred Platform Provider or Providers? Please indicate which one(s) and indicate the reason(s): Does your firm have any preferred product providers? Please indicate which one(s) and indicate the reason(s): Do you have your own Professional Indemnity Insurance in place? If you have provided advice on any of the investments on previous page, are any of these investments specifically excluded from your Professional Indemnity Insurance? Please provide details of any exclusions Has any Claim ever been made under your PI or D&O policy(ies) in the past two years? Has any Claim ever been made under your PI or D&O policy(ies) in the past two years? Please provide brief details: Has it been necessary for you to advise your PI Insurers of any circumstances which you believed might give rise to a Claim under the policy, even if this subsequently did not happen? Please provide brief details: Complaints
Please confirm the number of complaints received by your firm in the last 2 years.
About Your People
Please provide details of all Relevant Directors, Partners, Executives, Senior Employees (including Advisers and the Person Responsible for Compliance). Where relevant, please provide the person's FCA Individual Reference Number (IRN): Please indicate if the individual will refer business to Pensionhelp so we can set up a Login for our introducer website.
Person Two Person Three If you would like to add more people please provide their details below. Has any Director, Partner, Executive or Senior employee been convicted of any dishonest or fraudulent act, or implicated in such an act by a legally constituted court by Court of Justice? Has any Director, Partner, Executive or Senior employee subject to any current criminal proceeding? Has any Director, Partner, Executive or Senior employee ever been given a caution in relation to any criminal offence? Has any Director, Partner, Executive or Senior employee ever had a County Court Judgement (“CCJ”) or other judgement debt, whether satisfied or not and whether discharged or not, or aware of any proceeding that have begun, or anybody’s intention to begin proceedings? Has any Director, Partner, Executive or Senior employee ever been, the subject of an action or any bankruptcy proceedings, or proceedings for the sequestration of your/Company estate? Has any Director, Partner, Executive or Senior employee ever been put into liquidation, wound up, ceased trading, had a receiver or administrator appointed or entered into any voluntary arrangement with creditors? Has any Director, Partner, Executive or Senior employee ever been adjudged by a court liable for any fraud, misfeasance, wrongful trading or other misconduct?
Key Contacts (If Applicable)
Please indicate any other key contacts for Pensionhelp:
Key Contact One
Key Contact Two
If you wish to receive an Introducer Payment via BACS, please provide us with the appropriate bank details below. Please also provide a bank statement / crossed cheque for this account. We require this to confirm the details of the account and that it belongs to your firm. We will return the document to you. Do you wish to receive payments for introductions made to Pensionhelp? NMBA Member
Please Note: It should not be assumed that information is known to Pensionhelp Ltd by virtue of the fact it is in the public domain or has previously been disclosed to us. If there is any doubt about the relevance of information, it should be included.
For the purpose of complying with the General Data Protection Register, any personal information provided in this Form will be used by Pensionhelp Ltd only as a means of due diligence as part of the application process to become an introducer. Unless we are obligated to make a disclosure to a regulator or similar authority, the information within this form will not be disclosed for any purpose without the permission of the applicant.
Pensionhelp Ltd may seek to verify the information given in this form including answers relating to the fitness and propriety of the business or its people.
In signing the form below: I warrant that I have the authority to provide the information above and to enter into the application to be an Introducer of Clients to Pensionhelp Ltd, and that I have read and agree with the Pensionhelp Privacy Notice.
I authorise Pensionhelp Ltd to make such enquries and seek information as it believes necessary in the course of verifying the information provided in this form.
I confirm that the information provided in this form is accurate and complete to the best of my knowledge and belief.
I undertake to advise Pensionhelp Ltd in writing of any changes in circumstances in respect of the information provided in this form including but not limited to:
Any changes of address
Any changes of Directors, Partners, Executives or Senior Employees
A change in your regulated status
A change of principal or network
Your Company's insolvency, liquidiation, entering into an arrangement with creditors or a receiver being appointed
The bankruptcy of a Director, Partner, Executive or Senior Employee
If any Director, Partner, Executive or Senior Employee becomes subject to disciplinary or investigatory proceedings at the order of a professional body, trade association or regulatory body
Changes to your Professional Indemnity Insurance (such as a failure to obtain/renew such insurance, significant exclusions, etc.).
Changes to your Directors and Officers Insurance (such as a failure to obtain/renew such insurance, significant exclusions, etc.).
me description about this section
I agree to the declaration statement?