1) Company Details. Trading/Contact Address. Registered Address (Limited Companies only) Firm Principal Contact Details

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1 AR FIRM APPLICATION FORM Please note for AR applications; only one principal at your firm is required to complete this. All principals and advisers, (including yourself) must also complete an individual adviser application form. 1) Company Details Current Company / Trading Name: Intended Company / Trading Name: Company Type: Sole Trader Partnership Limited Liability Company Limited Liability Partnership Year company established: Registration Number (Ltd companies): Website Address: Country of Incorporation: Telephone Trading/Contact Address These are the details that we will use to register you with the FCA and will appear on the FS Register. Post Code When did you start trading from this address? Month Year Office Telephone: : Registered Address (Limited Companies only) Is your registered address the same as your trading address? If not, please provide your registered address below. Post Code Firm Principal Contact Details Telephone Fax Number Contact Address Post Code

2 2) License Details What do you wish your firm to be authorised for? 3) Bank Details If you have a limited liability company, you will need the bank account to be in the name of the company. Bank Name Account Number 4) Financial Details Account Name Sort Code Last 3 years gross commission (Year 1 is most recent): Budgeted annual income Year 1 Year 2 Year 3 Lender Fees Broker Fees Protection Commission Gen. Insurance Commission Other (Specify) Mortgage Products Protection Products Business Protection Private Medical Insurance General Insurance Please indicate the product types your company have advised on, in the last 24 months: MORTGAGE PRODUCT TYPE. of Completions INSURANCE PRODUCT TYPE. of Policies Last Previous Last Previous 12 Months 12 Months 12 Months 12 Months Residential Mortgage Protection Buy to Let Term Assurance Bridging Private Medical Insurance Equity Release Business Protection Commercial Lending Home Insurance- Buildings & Second Charge Loans Contents Income Protection Payment Protection Insurance Motor Insurance Liabillity Insurance (Public and Employer) Personal Accident Insurance Travel Insurance Please list any other details in the additional notes, section 18. Forecasted income for the next 12 months: Income from Mortgage Broking Income from General Insurance Income from PMI Income from Business Protection Income from Protection

3 5) Details of Directors, Principals and Partners Please provide details of all the Directors, Principals and Partners of the business. Continue on the extra notes page if it doesn t all fit below. At least one Principal must hold full industry qualifications and experience. All Directors, Principals and Partners must complete an Adviser Application form, even those who do not sell. Director/Principal/Partner 1 % Shares Owned Role in the company: Executive Director n-executive Director Principal Partner Manager Administrator Is this person an adviser? Director/Principal/Partner 2 % Shares Owned Role in the company: Executive Director Manager n-executive Director Administrator Principal Partner Is this person an adviser? Director/Principal/Partner 3 % Shares Owned Role in the company: Executive Director Manager n-executive Director Administrator Principal Partner Is this person an adviser? Director/Principal/Partner 4 % Shares Owned Role in the company: Executive Director n-executive Director Principal Partner Manager Administrator Is this person an adviser? Please list any additional persons in the additional notes, section 18. Do/have any of the Partners / Directors / Shareholders (advising or non-advising) hold/held a Directorship or a Partnership in any other firm / business / company in the past 10 years? If yes, please provide full details in the additional notes, section 18. Has the firm ever been, or has an application been submitted to be, an Appointed Representative of any other firm? If yes, please provide full details in the additional notes, section 18. Who will be reponsible for Insurance Mediation at the Firm?

4 6) Branch Personnel Details Please list below details of all the advisers to be authorised; put extra names on the additional notes, section 18. Please note you will also need to complete individual adviser application forms for each adviser. Also include details of any administration staff. Person 1 Person 2 Person 3 Person 4 Person 5 Person 6 7) Current Regulatory Status of your Company How are you currently regulated? Directly Authorised Appointed Representative Name of authorised firm Name of Network FCA Number FCA Number Please list all of the Networks your company has been regulated through in the past 5 years and their FCA numbers. In what manner does your firm offer advice? Face to face Telesales Will financial Services be the firms main activities? In, please provide full details of the firm s main activity on the additional notes page, section 18. Data Protection Licence Number

5 8) Introducers Please supply the full names of anyone who is, or will be introducing business to your company. A Right Mortgage Introducer Application Form and Introducer agreement must be completed for all introducers. Introducer 1 Firm Name Purpose of Introductions: (Include details of the type of products permitted to sell and details of any commission share) Introducer 2 Firm Name Purpose of Introductions: (Include details of the type of products permitted to sell and details of any commission share) Introducer 3 Firm Name Purpose of Introductions: (Include details of the type of products permitted to sell and details of any commission share) Please list any additional introducer details in the additional notes, section 18.

6 9) Credit Details Has the company been the subject of a receiving order? Has the company entered into an agreement with creditors? Has the company been the subject of a court order for outstanding debt? Has the company had other institution/insurance company applications refused? Has the company had authorisations or approvals withdrawn by another regulator, including revocations of Consumer Credit Licence? Has the company/any Partner/Director, or any business they have been associated with, previously held agencies with any other institutions or insurance companies? 10) Other Details Where did you hear about The Right Mortgage? Eg) Website, , The Right Will, Referral, BDM, Magazine (Please give as much detail as possible) If you were introduced to us by a BDM or referred to us please write the person s name below who introduced you to us

7 11) Fitness Fitness and Propriety These questions relate to the existing company and any previous financial services companies. This information relates to the UK, but information should also be given in respect to any related business overseas. If you tick yes for any of the below questions, please provide more detail on the extra notes section at the end of this application. Criminal or civil proceedings Is the firm currently engaged in or the subject of (other than in a professional legal capacity or as a witness) any criminal or civil proceedings or arbitration? Judgements, debts etc. Has the firm ever had judgements or debts entered against it, or been put into compulsory liquidation? Has the firm ever had its estate sequestered, had a receiver, administrative receiver, or administrator appointed or entered into any arrangements with its creditors, made any compromise or arrangement with its creditors, or ceased trading in circumstances in which its creditors did not receive full payment? Has the firm ever been refused, or had revoked, any licence or authorisation under the Prevention of Fraud (Investments) Act 1958 or the Prevention of Fraud (Investments) Act (rthern Ireland) 1940, or the Consumer Credit Act 1974? Authorisation Has the firm ever been refused, or had revoked, any authorisation to carry on investment, banking, mortgage or insurance business? Has the firm ever been refused, or had revoked, membership of, or authorisation or registration by; FCA, FSA, PIA, LAUTRO, SIB or any recognised self-regulating organisation or recognised professional body, or any association of dealers and securities, or any Stock Exchange or any other professional body; and has the firm ever resigned from any such organisation, body or association after making an application to become a member, or to be authorised, or to be registered, not to proceed with it? Disciplinary Proceedings Has the firm ever been publicly censured, disciplined, suspended or expelled by the Financial Conduct Authority, Financial Services Authority, Personal Investment Authority, Life Assurance and Unit Trust Regulatory Organisation, Securities and Investments Board, or any recognised self-regulating organisation or recognised professional body or by any other organisation, body or association? Is the firm currently the subject of any disciplinary proceedings by the FCA or any recognised self -regulating organisation or recognised professional body or by any other organisation, body or association; or is the firm aware of any such proceedings which are pending? Has the firm ever been the subject of a formal investigation under powers in the Insurance Companies Act 1982, the Companies Acts or the Financial Services Act 1986 or the Financial Services and Markets Act 2000? Historical Tradings Are there any previous firms still trading? If yes what role do common directors have in this firm? If no, what action was taken when the firm ceased trading? Agency Agreements Has the firm ever had an Agency Agreement terminated or suspended or has any application been rejected? (For example, removal from a lender, insurer or other supplier panel).

8 Complaints Has the firm ever been or is it likely to be subject to any of the following? a) Verbal or Formal Warning/ Suspension/Termination/ Dismissal c) Investigation d) Complaints e) Removal or suspension from any lender panel (whether upheld or not). If yes please detail: Details if yes: Investment Business Has your firm ever advised or authorised the sale of Arch Cru or Key Data Business? If yes, please provide on a separate sheet: a. The number and pound amount of sales made; b. A full breakdown detailing the above information by customer; and c. The amount, if any, of compensation paid by FSCS (by customer). Please provide a schedule for each client invested in Arch Cru or Keydata containing the following information: i. The proportion of that total investment allocated to Arch Cru or Keydata funds (in monetary and percentage terms); ii. The client s attitude to risk; iii. The total amount invested by each client upon advice by the candidate; iv. The proportion of that total investment allocated to products other than Arch Cru or Keydata funds (in monetary and percentage terms); v. The risk classification for those other products; vi. The total value of assets owned by the client; vii. The amount (in monetary and percentage terms) that the Arch Cru or Keydata investment represents as a proportion of the total assets owned by the client. 12) Regulatory Supervision Has the firm ever had a Financial Conduct Authority visit or a visit from any other regulator? If so please provide a copy of their report and associated response. If you are currently directly authorised, please provide copies of your two most recent RMAR submission 13) vations Does your firm intend to request permission to novate protection agencies? If yes, please request the vation process details

9 14) Compliance and Procedural Declaration and Undertaking The directors and officers understand it is a term of engagement of the Firm that; 1) We agree to comply with the Statement of Principles and FCA Rules. 2) We agree to cooperate in order to enable the Firm to comply properly with any restriction or prohibition as to its business, which may be imposed under FCA rules. 3) We agree to comply with the requirements as to the acceptance of Mandates and Powers of Attorney and (where acceptance is permitted by this rule) notify the Firm before any such acceptance. 4) We agree not to act on any inside information that may come to our attention, nor pass on such information, except informing the individual responsible for compliance within the Firm. 5) We agree to abide by the procedural processes and requirements of the Firm and those applicable to our roles. We understand that we must undertake our roles with due regard to these processes, as detailed in the various guides available on The Right Mortgage Adviser website. We agree we will conduct business on behalf of the Firm only in the areas that The Right Mortgage authorises us to advise in. I authorise the Firm to make such enquiries and seek further information as it thinks appropriate. This could include the taking up of references. Furthermore, I authorise the Firm to verify any of the information/statements provided within this declaration on an ongoing basis. I declare that the information provided within this declaration and within an application is complete and accurate and I undertake to immediately inform the Firm of any changes in the information provided. Signature Print Name Date Please complete checklist on next page, then return to: New Applications The Right Mortgage Ltd St Johns Court 70 St Johns Close Knowle West Midlands B93 0NH or to applications@therightmortgage.co.uk If you have any questions regarding how to complete this form please do not hesitate to contact us at: E: applications@therightmortgage.co.uk T:

10 17) Information to be supplied Please provide original documentation; please note we will not process the application until all documentation is received. Checklist: List of all trading / business name(s) and address and other connected business of all Principles/Directors/Partners/Controllers (A controller us a person who holds 10% or more of the capital or the voting rights of a business, which makes it possible to exercise significant influence over its management) If you have had a FCA compliance visit, please include a copy of the latest FCA report and appropriate response Letters of resignation of firm to the FCA or other regulated bodies. Copies of the last 3 (full financial) years accounts, prepared in accordance with the Companies Act 1985 (existing companies only) Companies Memorandum and Articles of Association (for Limited companies only) Certificate of incorporation (Limited or a Limited Liability Partnership companies) For established firms, last 3 years trading accounts Projected accounts for the next 12 months (or opening balance sheet if a new firm) For new business applications include a 12 month business plan and cash flow projection Consumer Credit Licence number if you have one Data protection licence Last RMAR/GABRIEL submission if DA Any copies of compliance visit reports from compliance of former networks, including KPIs. Partnership Agreement (if Partnership company) Individual application forms for all advisers and principals in the firm. If any outstanding debts, proof of payment (e.g. Bank statements, etc.) N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A N/A

11 18) Any other information/ Additional tes