1.Contact Details | [NOT STARTED] |
2.Permissions and Business Plan | [NOT STARTED] |
3.Firm’s Details | [NOT STARTED] |
4.Regulatory Status | [NOT STARTED] |
5.Trading and Share Structure | [NOT STARTED] |
6.Finances | [NOT STARTED] |
7.Firm’s Assets and Liabilities | [NOT STARTED] |
8.Business Structure | [NOT STARTED] |
9.Business Controllers | [NOT STARTED] |
10.Firm Credit and Regulatory History | [NOT STARTED] |
11.Declaration | [NOT STARTED] |
Name of Main Contact Person: | |
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Position: | |
Telephone Number: | |
Mobile Number: | |
Email Address: |
As an AR we want to: | |
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Operate an electronic platform for lending to businesses | |
Operate an electronic platform for lending to consumers | |
Facilitate lending from retail lenders | |
Facilitate lending from High Net Worth / Sophisticated lenders |
Business Name: |
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Trading Name used or intended to be used by your firm: | |
Please list any other names that your firm has previously used: | |
Legal Status: | |
Incorporation Date (Ltd Co’s Only): | |
Registration Number: | |
Company Accounting Period: | From: To: |
# | Director Name | Director Position / Department |
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1 |
Company Website URL: | |
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Registered Address: | |
Is your trading address different from the above? | |
Trading address: |
Is your company currently directly authorised by the Financial Conduct Authority (FCA) or authorised as an Appointed Representative (AR) of another network or does your firm have a pending application for authorisation currently with the FCA? | |
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FCA Firm reference Number (FRN): | |
Network Name and FRN (AR’s Only): |
Has your firm been denied authorisation or AR status by any other network or regulator in the past? | |
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Please add more information: |
Is your company part of a group or does it have any links with any other businesses? |
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# | Company Name: | Registration Number: |
1 |
# | Name of Shareholder | Shareholding | Share Type |
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1 |
Total budgeted income for the next 12 months: | |
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Income from AR activities: | |
Income from other regulated activities: | |
Income from non-regulated activities: |
Freehold | Debtors | ||
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Motor Vehicles | Investments | ||
Office Equipment | Cash in bank | ||
Goodwill | Other (please specify) | ||
Other | |||
Total Assets: |
Trade Creditors | Loans, HP and Charge Accounts | ||
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Bank Overdraft | Mortgages and Secured loans | ||
Taxation Liability | Other Outstanding Liabilities | ||
Industry debt | Potential Indemnity Liability (If known) | ||
Total Firm Liabilities: |
# | Name: | Job Title: | Role and Responsibilities: | Email Address: |
1 |
Title: | |
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Forename: | |
Middle Name(s): | |
Surname: | |
Job Title: | |
Percentage of Shares owned: | |
Email Address: | |
Role within company: | |
Is this person a director or majority shareholder of any other businesses? |
# | Company Name: | Registration Number: | Role: | Date From: | Date To: |
1 |
1 | Has the company ever been the subject of a receiving order, had a petition presented, or had a meeting called to consider a resolution, for winding up? | |
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2 | Has the company entered into any compromise agreement with its creditors, or proposed to make, a composition or voluntary arrangement with any one of more of its creditors? | |
3 | Has the company been party to any civil proceedings, subject to a court judgement for a debt, had an administrator/trustee in bankruptcy appointed to it or had an application made for such an appointment? | |
4 | Are you aware of any proceedings that have begun or anyone’s intention to begin proceedings against the company for a CCJ or another judgement debt? | |
5 | Has the company had an application refused by another institution or any other insurance company? | |
6 | Has the company ever been refused, had revoked, restricted, been suspended from or terminated, any licence, authorisations, registration, notification, membership or any other permission granted by any such body? | |
7 | Has the company ever been removed from a lender panel or received a warning letter from a lender? | |
8 | Has the company ever been criticised, publicly censured, disciplined, suspended, expelled or fined by the FCA, another regulator or Principal, a clearing house, an exchange, a professional body, or a government body or agency? | |
9 | Has the company ever been the subject of an investigation into allegations of misconduct or malpractice, disciplinary proceedings by the FCA, another regulator or Principal, a clearing house, an exchange, a professional body, or a government body or agency or is aware that such proceedings are pending in connection with any business activity whether or not such an investigation resulted in a finding against the firm? | |
10 | Has the company ever been the subject of a formal investigation under the powers in the Companies Acts 1985 to 2006 or been adjudged by a court civilly liable for any fraud, misfeasance, wrongful trading or other misconduct? | |
11 | Has the company ever been the subject of an application to dissolve it or to strike it off the Register of Companies? | |
12 | Have any firms that your business has links with ever ceased trading in circumstances in which any of its creditors did not receive full payment? | |
13 | Does the company have any outstanding financial obligations arising from regulated activities, which have been carried out in the past (whether or not in the UK or overseas)? |
Title: | |
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Forename: | |
Surname: | |
Date: |