Are you fully authorised by the FCA?:

Please provide your FCA number:

Under the FCA are you acting as a principle for sub agents with Appointed Representative status?

If Yes, please give details or mark N/A:

Under the FCA are you registered as an Appointed Representative?

If Yes, please provide the below details of your Principle Company:

Do you provide wholesaling facilities or place business on behalf of Other brokers/intermediaries?

Do you want us to consider allowing you to cascade risk transfer (if you are provided with this facility for your own business) or to delegate any other authority?