Application for Exempt Regulated Activities registration (UK)

Transcription

1 ERA 2019 Applcaton for Exempt Regulated Actvtes regstraton (UK) Ths form should be completed f you wsh your frm to undertake exempt regulated actvtes through ACCA under the Fnancal Servces and Markets Act Please read carefully secton 3 of the Practce Informaton handbook, whch can be found on ACCA s webste ( com/practsng), before completng ths form. Please use BLOCK CAPITALS and black nk throughout and retan a photocopy of the completed form for future reference. Please allow up to 30 workng days for your applcaton to be assessed. Return the form to: Authorsaton, ACCA, 110 Queen Street, Glasgow G1 3BX, Unted Kngdom. (Form PIB(UK) (regstraton of non-acca partners/drectors/employees) s at page 13. One PIB form must be completed by each non- ACCA partner/drector/controller and by each non-partner/drector responsble for exempt regulated actvtes work.) Please note that all confrmatons of regstraton are ssued on a calendar year bass and are vald untl 31 December each year only. Data protecton We may use the personal data provded on ths form for the purposes of; Frm admnstraton and applcaton to regster for exempt regulated actvtes regulaton of the frm, and to contact nomnated ndvduals respondng to enqures and nvestgatng complants complyng wth regulatory oblgatons We may share nformaton wth our supplers and our audtors, and relevant enforcement authortes where authorsed by law. For more nformaton on how your personal nformaton and rghts are respected, please see our prvacy notce ( or contact prvacy@accaglobal.com REGISTRATION DETAILS A Contact partner/drector Full name ACCA membershp number (f known/applcable) B Tradng name of frm Please ensure that ths name agrees wth the name on your letterhead. (Incorporated frms (lmted companes and lmted lablty partnershps) confrmatons of exempt regulated actvtes regstraton wll be ssued n the name of the ncorporated frm, not ts tradng name(s)) of frm Frm s ACCA reference number (f known/applcable) C Regstratons requred Please ndcate whch of the followng servces your frm requres regstraton to undertake on an ncdental bass (frms undertakng these servces as a manstream actvty must be authorsed by the Fnancal Conduct Authorty (FCA)). Further nformaton s avalable on our webste at Regulated mortgages Long-term care nsurance (LTCI) Other nsurance dstrbuton Non-nsurance nvestment busness Credt-related regulated actvtes (Informaton wll be provded to FCA n order for t to mantan a regster of frms elgble to undertake LTCI and/or other nsurance dstrbuton servces. The name of the frm s nomnated contact partner/drector who wll be responsble for such actvtes wll also appear on the regster. Responsblty rests wth the sole practtoner or partner/drectors of the frm to ensure that ther frm s ncluded on the Fnancal Servces Regster before undertakng LTCI and/or other nsurance dstrbuton servces.)

2 Frms undertakng nsurance dstrbuton work Please answer the followng three questons f your frm requres regstraton to undertake nsurance dstrbuton. 1 In order to undertake nsurance dstrbuton a frm s requred to hold professonal ndemnty nsurance (PII) cover of the equvalent of 1,500,000 n the aggregate and 1,000,000 on each and every clam. Please confrm that you already have n place the approprate level of PII cover Yes No 2 Does anyone wthn ether the management structure of your frm or the staff drectly nvolved n nsurance dstrbuton* have a crmnal convcton for any serous offences relatng to fnancal actvtes or crmes aganst property? Yes No 3 Is anyone wthn ether the management structure of your frm or the staff drectly nvolved n nsurance dstrbuton* an undscharged bankrupt? Yes No Please provde detals on a separate sheet. * Staff means sub-contractors and consultants as well as employees. D Prevous authorsaton/regstraton My frm has prevously been granted/appled for exempt regulated actvtes regstraton or credt-related regulated actvtes regstraton from another Desgnated Professonal Body (DPB) or full nvestment busness authorsaton or credt-related regulated actvtes regstraton from the FCA* Yes No * You must tck Yes f your frm (or any of ts partners/drectors) has made any form of applcaton, ncludng any applcaton whch was rejected or wthdrawn, or whch s stll awatng consderaton. If YES, please ndcate whch ACCA ICAEW ICAS ICAI FCA Was the applcaton successful? Yes No If no, please state the reasons on a separate sheet and attach t to ths form. E Regulatory matters Has your frm (or any of ts partners/drectors/responsble ndvduals) ever been subject to any regulatory acton n respect of audt, nvestment busness, credt-related regulated actvtes or nsolvency by a regulatory body?** Yes No ** You must tck Yes f your frm (or any of ts partners/drectors/responsble ndvduals) has any pendng regulatory matter(s) under nvestgaton by a regulatory body. If YES, please provde detals on a separate sheet and attach t to ths form. Are you aware of any other regulatory matter(s) whch may mpact on your applcaton? Yes No If YES, please provde detals on a separate sheet and attach t to ths form. F Dscplnary matters Have you (or any of your frm s partners/drectors/responsble ndvduals) ever been subject to any dscplnary acton by a regulatory body?*** Yes No *** You must tck Yes f you (or any of your frm s partners/drectors/responsble ndvduals) have any pendng dscplnary matter(s) under nvestgaton by a regulatory body. If Yes, please provde detals on a separate sheet and attach t to ths form. G Composton of frm Please tck one box only My frm s controlled by practsng members of DPBs and contans ACCA partners/drectors My frm s controlled by practsng members of DPBs and contans no ACCA partners/drectors (the above contact partner/ drector must apply for drect admsson to ACCA membershp as ACCA can only regster frms for exempt regulated actvtes f at least one of the partners/drectors n the frm s an ACCA member. The relevant forms are avalable va ACCA s webste at or by contactng ACCA Connect on +44 (0) ) 2

3 CONDITIONS FOR EXEMPT REGULATED ACTIVITIES REGISTRATION In sgnng ths secton of the form I confrm that I have read and understood the condtons for exempt regulated actvtes regstraton, and that: Elgblty my frm s elgble for exempt regulated actvtes regstraton n accordance wth the Chartered Certfed Accountants Desgnated Professonal Body Regulatons 2001 (DPBRs) 3(1), 3(2) and 3(3), as applcable, as t s: a sole propretorshp and I hold an ACCA practsng certfcate vald for the UK; or a partnershp or ncorporated frm wth at least one partner or drector who s a member of ACCA and who holds an ACCA practsng certfcate vald for the UK; and all other partners or drectors are enttled to practse accountancy and are members of another DPB or, n the opnon of Admssons and Lcensng Commttee, hold an adequate qualfcaton; and the partners or drectors who are members of ACCA or of another DPB manage or control the frm; and each partner or drector who s a member of ACCA holds a practsng certfcate vald n the UK. Undertakngs each partner/drector/controller who s not a member of ACCA wll gve the undertakngs to Admssons and Lcensng Commttee n ether (a) or (b) below n accordance wth DPBR 3(2)(a)(), 3(2)(a)(), 3(3)(a)() and 3(3)(a)(), as applcable: a member of another Desgnated Professonal Body I confrm that I am a member of another DPB and undertake to agree to be bound by: the Chartered Certfed Accountants Global Practsng Regulatons 2003, Authorsaton Regulatons 2014 and Desgnated Professonal Body Regulatons 2001 (as amended from tme to tme) as f I was a member of ACCA; all bye-laws and regulatons of ACCA (and regulatons made pursuant to the bye-laws) concernng or relatng to the undertakng of exempt regulated actvtes as f I was a member of ACCA; the regulatons concernng lablty of ACCA n damages for ts acts and omssons; and v the dscplnary procedures of ACCA and penaltes whch may be mposed under such provsons nsofar as such penaltes could be applcable to a person who s not a member of ACCA. b other ndvduals elgble to practse accountancy and who, n the opnon of Admssons and Lcensng Commttee, holds an adequate qualfcaton I confrm that I am elgble to practse accountancy and undertake to agree to be bound by: the Chartered Certfed Accountants Global Practsng Regulatons 2003, Authorsaton Regulatons 2014 and Desgnated Professonal Body Regulatons 2001 (as amended from tme to tme) as f I was a member of ACCA; the Charter, all bye-laws and regulatons of ACCA (and regulatons made pursuant to the bye-laws) concernng or relatng to the undertakng of exempt regulated actvtes as f I was a member of ACCA; the regulatons concernng lablty of ACCA n damages for ts acts and omssons; and v the dscplnary procedures of ACCA and penaltes whch may be mposed under such provsons nsofar as such penaltes could be applcable to a person who s not a member of ACCA. (Each partner/drector or non-partner/drector responsble for undertakng exempt regulated actvtes who s not a member of ACCA must provde addtonal nformaton n a form specfed by, and to the satsfacton of, Admssons and Lcensng Commttee. One copy of the approprate form, PIB (UK), s attached to ths form.) Man busness the man busness of my frm s the provson of publc practce accountancy servces other than regulated actvtes n accordance wth DPBR 3(5)(a) and 3(5)(b); Tradng name of frm the name of the frm specfed on ths form s the name under whch exempt regulated actvtes are undertaken and that any change to the name of the frm wll be notfed 28 days n advance of the mplementaton of any change from the stated date of the change as requred under GPR 12(1)(a)() and GPR 12(1)(b); (If undertakng long-term care nsurance and/or other nsurance dstrbuton servces, ths name wll be provded to the Fnancal Conduct Authorty (FCA) n order for t to mantan a regster of frms elgble to undertake these servces.) Overseas branches and offces my frm wth a branch (or branches) or offce (or offces) outsde of the Unted Kngdom shall be elgble to undertake exempt regulated actvtes n the UK from ts UK branch (or branches) or offce (or offces) (subject to the requrements of other relevant regulatons); 3

4 Other authorsatons my frm does not hold nvestment busness authorsaton or credt-related regulated actvtes regstraton by FCA under the Fnancal Servces and Markets Act 2000; Approval and wthdrawal of regstraton, msconduct my frm accepts that ts applcaton for regstraton wll be dealt wth n accordance wth the provsons lad down n the Authorsaton Regulatons 2014 (ARs) and ARs 3, 4, 5 and 6 n partcular, and that ts regstraton may be subject to condtons, suspensons or wthdrawal as determned by ACCA n accordance wth the ARs and DPBRs. It further accepts that breaches of the DPBRs and undertakngs gven thereunder by partners/drectors, or other persons connected wth the frm may be treated as msconduct for the purpose of dscplnary proceedngs aganst the frm and/or any of ts partners/drectors; Prohbted actvtes my frm wll not carry out any prohbted actvtes as detaled n DPBR 4(2); Arrangements wth thrd partes my frm wll not enter nto arrangements wth thrd partes that contravene DPBR 5(3); Notfcaton, montorng and enforcement my frm acknowledges ts duty to notfy ACCA n wrtng of all matters specfed under GPR 12 and that such notfcaton must, n certan crcumstances, be gven 28 days n advance. My frm undertakes to notfy ACCA mmedately n the event of any nformaton prevously suppled to t n support of a regstraton ceasng to be true, accurate or complete, or n the event of any change n crcumstances, or the contnuaton of any regstraton granted. My frm wll provde such nformaton as necessary for ACCA to carry out ts dutes as a Desgnated Professonal Body under the Fnancal Servces and Markets Act 2000 ( the Act ) and wll co-operate wth ACCA n ts montorng and enforcement of ts regulatons as requred by GPR 14; Lablty my frm acknowledges that n the course of regsterng t to undertake exempt regulated actvtes, nether ACCA nor any of ts offcers or servants or agents nor any members of any commttee of Councl shall be lable n damages or otherwse for anythng done or omtted to be done n the dscharge or purported dscharge of any functon under the Act set out below unless the act or omsson s shown to have been n bad fath. The functons referred to above are the functons of ACCA so far as relatng to or matters arsng out of: a the bye-laws, regulatons and arrangements of ACCA so far as they relate to or are appled n respect of the undertakng of exempt regulated actvtes under the Act or any matters concernng the Act and/or to whch the requrements of the Act requres ACCA to comply; b any gudance ssued by ACCA n respect of any matter dealt wth by such rules as are mentoned n (a) above; c the oblgatons, powers and dutes to whch ACCA s subject by vrtue of the Act; d any orders or drectons gven by the Fnancal Conduct Authorty; Professonal ndemnty nsurance my frm accepts ts oblgaton to hold professonal ndemnty nsurance cover of 1,500,000 n the aggregate and 1,000,000 on an each and every clam bass n order to undertake nsurance dstrbuton work. (Provdng nformaton to an ntermedary or nsurance company after an ntroducton has been made a regulated actvty but wll be exempt from the ncreased professonal ndemnty nsurance requrement.) Credt-related regulated actvtes my frm shall comply wth the provsons of the Consumer Credt Act 1974 and the provsons of secondary legslaton made under that Act remanng n force, and shall ensure that ts offcers and employees (ncludng sub-contractors and consultants) comply wth all such legslaton. When carryng on a credt-related regulated actvty or an actvty connected to that regulated actvty, my frm wll comply wth the conduct provsons of the Consumer Credt sourcebook relevant to that actvty and the FCA s Prncples for Busnesses referred to n 1.1.4G of that sourcebook as f they were authorsed under the Act wth a permsson under Part 4A of the Act to carry on the relevant regulated actvty. Conduct my frm shall comply wth ACCA s Code of Ethcs and Conduct n the conduct of exempt regulated actvtes. Dsclosure of nformaton my frm shall supply ACCA wth all necessary nformaton to enable ACCA to comply wth ts oblgatons to the FCA and other bodes n ts capacty as a DPB. Ant-money launderng my frm wll comply wth the requrements of relevant ant-money launderng legslaton and regulaton, ncludng specfcally that: my practce has a nomnated offcer to take responsblty for complance there are procedures n place to gather and retan evdence of the dentfcaton of all clents prncpals and staff n my practce receve approprate tranng ongong complance montorng s carred out suspcons of money launderng are reported as requred by law. (Where reference s made to the GPRs, applcants regsterng to undertake exempt regulated actvtes should note that they must also comply wth the UK Annex to the GPRs.) Contact partner s/drector s sgnature 4

5 PROFESSIONAL INDEMNITY INSURANCE AND CONTINUITY OF PRACTICE Professonal ndemnty nsurance I detal below the name of my frm s nsurer and polcy number/i enclose a quotaton document as evdence that I have appled for a polcy and undertake to provde detals of my polcy number to ACCA once t has been confrmed.* Insurance company Polcy number * Delete as applcable Contnuty of practce My frm has made arrangements for contnuty of practce n the partnershp agreement or memorandum and artcles of assocaton OR wth the followng frm whch has exempt regulated actvtes regstraton or full nvestment busness authorsaton of frm Professonal body Town Country County 5

6 COMPOSITION OF FIRM Each partner/drector (ncludng contact partner/drector) must sgn below. In sgnng ths secton, each partner/drector expressly gves the undertakngs contaned n pages 2 4 and 11 of ths form. Contnue on a separate sheet f necessary. A ACCA partners/drectors Offce (e prncpal or ACCA membershp A, B, etc. as above) number B Non-ACCA partners/drectors* Offce Qualfcaton (f any) C Non-partners/drectors, e employees or consultants, undertakng ERA on behalf of the frm* Offce Qualfcaton (f any) (* Each person at B and C must complete a form PIB (UK). In the case of those at B, ths s rrespectve of whether or not they undertake ERA on behalf of the frm. 6

7 SHAREHOLDER DETAILS Ths secton s to be completed by ncorporated frms only e lmted companes and, where applcable, lmted lablty partnershps. A Share captal (not applcable to lmted lablty partnershps) Authorsed share captal shares of each. Shares ssued Not applcable to companes formed on or after 1 October If there s more than one share category, please provde full detals on a separate sheet. B Company regstraton number Country n whch regstered Date of latest Annual Return to Regstrar of Companes C Shareholders (lmted lablty partnershps should use ths secton to provde the votng rghts of partners) Drectors ACCA drectors who are shareholders (please contnue on a separate sheet f necessary) Non-ACCA drectors who are members of other DPBs who are shareholders (please contnue on a separate sheet f necessary) Drectors who are not members of ACCA or other DPBs who are shareholders (please contnue on a separate sheet f necessary) Controllers (Do not nclude persons already ncluded above. Please contnue on a separate sheet f necessary.) v Non-drectors who are ACCA members and controllers of 10% or more of votng rghts Membershp no. 7

8 Membershp no. v Non-drectors who are not members of ACCA but who are members of other DPBs who are controllers of 10% or more of votng rghts** v Non-drectors who are not members of ACCA or other DPBs who are controllers of 10% or more of votng rghts** (**Each non-acca controller must complete a form PIB (UK) rrespectve of whether or not they undertake ERA on behalf of the frm.) v Percentage of total votng rghts held by those named at C(), (), (v) and (v) % If ths total s less than 50%, ensure that you ndcate below (by annotatons n the margn) whch of the remanng shareholders are members of ACCA or another DPB. 8

9 v Other shareholders (please contnue on separate sheet f necessary) 9

10 CLOSE LINKS Please provde detals of the denttes of any other persons who have close lnks* wth the frm, together wth nformaton to enable ACCA to determne that those close lnks do not prevent the effectve exercse of ACCA s supervsory functons. * Close lnks has the meanng gven by artcle 13 pont 17 of Drectve 2009/138/EC, and comprses a stuaton n whch two or more persons are lnked by control or partcpaton, or a stuaton n whch two or more persons are permanently lnked to one and the same person by a control relatonshp. 1 Does your frm have close lnks?* Yes No If Yes, please provde the requred nformaton below about the close lnks and a structure chart whch shows the nature of the relatonshp between the frm and each close lnk. Natural persons Date of brth Contnue on a separate sheet f necessary Structure chart provded on a separate sheet Legal persons Is the entty regulated? Yes No Contnue on a separate sheet f necessary Structure chart provded on a separate sheet 2 Are you aware of any nformaton to suggest that any close lnk s lkely to prevent ACCA s effectve supervson of the frm? Yes No If Yes, please provde detals below Contnue on a separate sheet f necessary 10

11 CONFIRMATION If you (or any of your frm s partners, drectors or responsble ndvduals) have been subject to matters wthn the terms of Byelaw 8 and ACCA s Assessment and Investgatons Departments are aware of ths, you may sgn and submt ths form. If you are concerned that you (or any of your frm s partners, drectors or responsble ndvduals) may be subject to matters under Byelaw 8 of whch ACCA s Assessment and Investgatons Departments are not already aware, please notfy ACCA n wrtng to complantassessment@accaglobal.com or The Adelph, 1/11 John Adam Street, London WC2N 6AU. Followng ths notfcaton you may sgn and submt ths form. On behalf of my frm, I confrm that the nformaton n ths applcaton form s true, accurate and complete to the best of my knowledge and belef after makng all reasonable enqures. I understand that a false declaraton on ths form may lead to dscplnary acton beng taken aganst me and/or my frm and may nvaldate any decson relevant to ths applcaton. I confrm that I have read, and undertake to comply wth the condtons for the ssue of a frm s exempt regulated actvtes regstraton. I further confrm that I have not been subject to any crmnal, dscplnary, regulatory or any other matters wthn the terms of bye-law 8 (lablty to dscplnary acton) that may call nto doubt the valdty of my applcaton, whch I have not already brought to the attenton of ACCA s Assessment and Investgatons Departments. I understand that the UK Rehabltaton of Offenders Act 1974 does not apply to the accountancy professon, and that I am requred to dsclose any convctons and/or cautons that are not protected as defned by the Rehabltaton of Offenders Act 1974 (Exceptons) Order 1975 (as amended n 2013). I am aware of, and wll abde by, my contnung oblgaton to draw any such matters to ACCA s attenton. I also confrm that I have read the Chartered Certfed Accountants Global Practsng Regulatons 2003 and the Chartered Certfed Accountants Desgnated Professonal Body Regulatons 2001 and have taken partcular note of the notfcaton oblgatons. Contact partner s/drector s sgnature Date ENCLOSURES Attached forms Completed PIB (UK) for each partner/drector/controller who s not a member of ACCA and each employee/consultant undertakng ERA on behalf of the frm. CHECKLIST Before you send your applcaton to ACCA please check you have: Sgned the condtons for exempt regulated actvtes regstraton on page 4 Provded professonal ndemnty nsurance detals on page 5 Provded contnuty of practce detals on page 5 Completed the Close lnks secton on page 10 Sgned the confrmaton on page 11. Completed a PIB (UK) form for each partner, drector, employee or consultant who s not a member of ACCA. Please return ths form to: Authorsaton, ACCA, 110 Queen Street, Glasgow G1 3BX, Unted Kngdom. 11

12 BYE-LAW 8 LIABILITY TO DISCIPLINARY ACTION 8 a A member, relevant frm or regstered student shall, subject to bye-law 11, be lable to dscplnary acton f: v v v he or t, whether n the course of carryng out hs or ts professonal dutes or otherwse, has been gulty of msconduct; n connecton wth hs or ts professonal dutes, he or t has performed hs or ts work, or conducted hmself or tself, or conducted hs or ts practce, erroneously, nadequately, neffcently or ncompetently; he or t has commtted any breach of these bye-laws or of any regulatons made under them n respect of whch he or t s bound; n the case of a relevant frm, any person has n the course of the busness of that frm commtted any breach of these byelaws or of any regulatons made under them n respect of whch that person s bound; he s a specfed person n relaton to a relevant frm aganst whch a dscplnary order has been made and whch has become effectve or whch has been dscplned by another professonal body; he or t has been dscplned by another professonal body; v he or t has made an assgnment for the beneft of credtors, or has made an arrangement for the payment of a composton to credtors, or has had an nterm order made by the court n respect of hm, or s a specfed person n relaton to a relevant frm whch has made such an assgnment or composton or been wound up as an unregstered company, or entered nto a voluntary arrangement, admnstraton or lqudaton, n each case where applcable under the Insolvency Act 1986, or other smlar or analogous event has occurred n relaton to hm or t under applcable legslaton; v he or t has faled to satsfy a judgment debt wthout reasonable excuse for a perod of two months (the burden restng on hm or t to prove such a reasonable excuse on the balance of probabltes) whether or not the debt remans outstandng at the tme of the brngng of the dscplnary proceedngs hereunder; x x before a court of competent jursdcton n the Unted Kngdom or elsewhere, he or t has pleaded gulty to, been found gulty of, or has accepted a cauton n relaton to, any offence dscredtable to ACCA or to the accountancy professon; or before a court of competent jursdcton n the Unted Kngdom or elsewhere, n any cvl proceedngs n whch he or t has been a party or wtness, he or t has been found to have acted fraudulently or dshonestly. b c d e f g Each of the paragraphs n bye-law 8(a) shall be wthout prejudce to the generalty of any of the other paragraphs theren. For the purposes of bye-law 8(a), msconduct ncludes (but s not confned to) any act or omsson whch brngs, or s lkely to brng, dscredt to the ndvdual or relevant frm or to ACCA or to the accountancy professon. For the purposes of bye-law 8(a), n consderng the conduct alleged (whch may consst of one or more acts or omssons), regard may be had to the followng: whether an act or omsson, whch of tself may not amount to msconduct, has taken place on more than one occason, such that together the acts or omssons may amount to msconduct; whether the acts or omssons have amounted to or nvolved dshonesty on the part of the ndvdual or relevant frm n queston; the nature, extent or degree of a breach of any code of practce, ethcal or techncal, adopted by the Councl, and to any regulaton affectng members, relevant frms or regstered students lad down or approved by Councl. For the purposes of bye-law 8(a)(x), a copy of the certfcate or memorandum of convcton or cauton, and of any fnal judgment, rulng or determnaton gven n the crmnal proceedngs, shall be conclusve proof of the convcton or cauton, and of any facts and matters found, as the case may be. For the purposes of bye-law 8(a)(x): where the person n queston was a party to the proceedngs, a copy of a certfed judgment of the cvl proceedngs shall be conclusve proof of the facts and matters found; where the person n queston was a wtness n the proceedngs, a copy of a certfed judgment of the cvl proceedngs shall be prma face evdence of the facts and matters found. Subject to bye-law 8(f) above, any other fndng of fact n any cvl proceedngs before a court of competent jursdcton n the Unted Kngdom or elsewhere shall be admssble as prma face evdence n any dscplnary proceedngs. 12

13 PIB (UK) 2019 Applcaton for regstraton of a non-acca partner/drector/controller or a non-partner/drector responsble for Exempt Regulated Actvtes work n a frm seekng Exempt Regulated Actvtes regstraton One form must be completed by each non-acca partner/drector/controller and by each non-partner/drector e employee/consultant responsble for exempt regulated actvtes work, n a frm whch s seekng exempt regulated actvtes regstraton from ACCA. Further copes can be found on ACCA s webste ( but photocopes are acceptable. Please use BLOCK CAPITALS and black nk throughout. Please retan a photocopy of the completed form for future reference. Please return the form to: Authorsaton, ACCA, 110 Queen Street, Glasgow G1 3BX, Unted Kngdom. PERSONAL INFORMATION Full name Ttle Date of brth Busness address Town County Tel Emal Fax Webste Please provde an emal address where we can contact you about your applcaton Is there an ACCA partner/drector at your busness address? Yes No If no complete page 14 of ths form and ensure t s sgned by all the ACCA partners/drectors. EDUCATION Please state Professonal examnatons passed or membershp of professonal bodes, wth dates Degrees held, wth dates 13

14 EMPLOYMENT HISTORY Please lst below your employment hstory (ncludng, and commencng wth, your current post). If you held more than one poston wth the same employer, please lst these separately. Frm s/employer s name Busness Job ttle Responsbltes Dates: From To Frm s/employer s name Busness Job ttle Responsbltes Dates: From To Frm s/employer s name Busness Job ttle Responsbltes Dates: From To (contnue on separate sheet f necessary) 14

15 DISCIPLINARY MATTERS Please answer all of the followng questons and, where yes supply full detals on a separate sheet. Tck as applcable a Has a petton for bankruptcy or for sequestraton of your estate been presented aganst you at any tme n the prevous ten years? Yes No Are you aware that any such petton s pendng? Yes No b Have you at any tme n the prevous ten years had a recever apponted, faled to satsfy a debt adjudged due or a debt n respect of whch a decree has been passed aganst you, or come to a compromse or smlar arrangement wth your credtors? Yes No c Have you at any tme n the last ten years been subject to any dscplnary measures mposed on you by a regulatory and/or professonal body of whch you are, or were at the tme, a member or by any other regulatory and/or professonal body n Ireland/UK? Yes No d Have you been publcly crtcsed or dscplned n Ireland/UK or overseas n the last ten years by any organsaton or body recognsed or desgnated under the Irsh Investment Intermedares Act 1995 or the Fnancal Servces and Markets Act 2000 or by any other professonal body? Yes No e Have any legal proceedngs been successfully brought aganst you n relaton to your nvestment busness over the prevous three years? Yes No f In the same perod have you agreed, as a result of any such legal proceedngs, any out of court settlements? Yes No Are you nvolved n any such proceedngs at the tme of ths applcaton? Yes No Have you ever been convcted of an offence nvolvng fraud or other dshonesty or an offence under legslaton (whether or not of Ireland) relatng to other companes (ncludng nsder dealng), buldng socetes, ndustral and provdent socetes, credt unons, frendly socetes, nsurance, bankng or other fnancal servces, nsolvency, consumer credt or consumer protecton? Yes No UNDERTAKING BY THE PARTNERS/DIRECTORS We hereby undertake to appont beng an ACCA partner/drector n the frm and n full-tme practce n the UK holdng a practsng certfcate ssued by ACCA as the partner/drector responsble for ensurng adherence to DPBR 8 (Complance Procedures) n respect of non-acca partners/drectors Sgned by each of the ACCA partners/drectors n the frm Full name Date 15

16 CONFIRMATION If you have been subject to matters wthn the terms of bye-law 8 and ACCA s Assessment and Investgatons Departments are aware of ths, you may sgn and submt ths form. If you are concerned that you may be subject to matters under byelaw 8 of whch ACCA s Assessment and Investgatons Departments are not already aware, please notfy ACCA n wrtng to complantassessment@accaglobal.com or The Adelph, 1/11 John Adam Street, London WC2N 6AU. Followng ths notfcaton you may sgn and submt ths form. I (name of person detaled on page 12) declare that the whole of the nformaton contaned n ths form s true, accurate and complete to the best of my knowledge and belef. I acknowledge that any statement contaned heren whch s known by me to be false may nvaldate any decson by the Councl of ACCA or any of ts Commttees as to the elgblty of my frm for regstraton by ACCA to undertake exempt regulated actvtes. I further confrm that I have not been subject to any crmnal, dscplnary, regulatory or any other matters wthn the terms of bye-law 8 (lablty to dscplnary acton) that may call nto doubt the valdty of my applcaton, whch I have not already brought to the attenton of ACCA s Assessment and Investgatons Departments. I understand that the UK Rehabltaton of Offenders Act 1974 does not apply to the accountancy professon, and that I am requred to dsclose any convctons and/or cautons that are not protected as defned by the Rehabltaton of Offenders Act 1974 (Exceptons) Order 1975 (as amended n 2013). I am aware of, and wll abde by, my contnung oblgaton to draw any such matters to ACCA s attenton. I also confrm that I am not nelgble to practse accountancy and undertake and agree to be bound by: the Chartered Certfed Accountants Global Practsng Regulatons 2003, Authorsaton Regulatons 2014 and Desgnated Professonal Body Regulatons 2001 (as amended from tme to tme) as f I was a member of ACCA; the Charter, all bye-laws and regulatons of ACCA (and regulatons made pursuant to the bye-laws) as f I was a member of ACCA (nsofar as the same are approprate and applcable) other than those relatng to members rghts to attend and vote at meetngs of ACCA and oblgatons to pay subscrptons; the regulatons concernng lablty of ACCA n damages for ts acts and omssons; and v the dscplnary procedures of ACCA and penaltes whch may be mposed under such provsons nsofar as such penaltes could be applcable to a person who s not a member of ACCA. Date Please return ths form to: Authorsaton, ACCA, 110 Queen Street, Glasgow G1 3BX, Unted Kngdom. 16

17 BYE-LAW 8 LIABILITY TO DISCIPLINARY ACTION 8 a A member, relevant frm or regstered student shall, subject to bye-law 11, be lable to dscplnary acton f: v v v he or t, whether n the course of carryng out hs or ts professonal dutes or otherwse, has been gulty of msconduct; n connecton wth hs or ts professonal dutes, he or t has performed hs or ts work, or conducted hmself or tself, or conducted hs or ts practce, erroneously, nadequately, neffcently or ncompetently; he or t has commtted any breach of these bye-laws or of any regulatons made under them n respect of whch he or t s bound; n the case of a relevant frm, any person has n the course of the busness of that frm commtted any breach of these byelaws or of any regulatons made under them n respect of whch that person s bound; he s a specfed person n relaton to a relevant frm aganst whch a dscplnary order has been made and whch has become effectve or whch has been dscplned by another professonal body; he or t has been dscplned by another professonal body; v he or t has made an assgnment for the beneft of credtors, or has made an arrangement for the payment of a composton to credtors, or has had an nterm order made by the court n respect of hm, or s a specfed person n relaton to a relevant frm whch has made such an assgnment or composton or been wound up as an unregstered company, or entered nto a voluntary arrangement, admnstraton or lqudaton, n each case where applcable under the Insolvency Act 1986, or other smlar or analogous event has occurred n relaton to hm or t under applcable legslaton; v he or t has faled to satsfy a judgment debt wthout reasonable excuse for a perod of two months (the burden restng on hm or t to prove such a reasonable excuse on the balance of probabltes) whether or not the debt remans outstandng at the tme of the brngng of the dscplnary proceedngs hereunder; x x before a court of competent jursdcton n the Unted Kngdom or elsewhere, he or t has pleaded gulty to, been found gulty of, or has accepted a cauton n relaton to, any offence dscredtable to ACCA or to the accountancy professon; or before a court of competent jursdcton n the Unted Kngdom or elsewhere, n any cvl proceedngs n whch he or t has been a party or wtness, he or t has been found to have acted fraudulently or dshonestly. b c d e f g Each of the paragraphs n bye-law 8(a) shall be wthout prejudce to the generalty of any of the other paragraphs theren. For the purposes of bye-law 8(a), msconduct ncludes (but s not confned to) any act or omsson whch brngs, or s lkely to brng, dscredt to the ndvdual or relevant frm or to ACCA or to the accountancy professon. For the purposes of bye-law 8(a), n consderng the conduct alleged (whch may consst of one or more acts or omssons), regard may be had to the followng: whether an act or omsson, whch of tself may not amount to msconduct, has taken place on more than one occason, such that together the acts or omssons may amount to msconduct; whether the acts or omssons have amounted to or nvolved dshonesty on the part of the ndvdual or relevant frm n queston; the nature, extent or degree of a breach of any code of practce, ethcal or techncal, adopted by the Councl, and to any regulaton affectng members, relevant frms or regstered students lad down or approved by Councl. For the purposes of bye-law 8(a)(x), a copy of the certfcate or memorandum of convcton or cauton, and of any fnal judgment, rulng or determnaton gven n the crmnal proceedngs, shall be conclusve proof of the convcton or cauton, and of any facts and matters found, as the case may be. For the purposes of bye-law 8(a)(x): where the person n queston was a party to the proceedngs, a copy of a certfed judgment of the cvl proceedngs shall be conclusve proof of the facts and matters found; where the person n queston was a wtness n the proceedngs, a copy of a certfed judgment of the cvl proceedngs shall be prma face evdence of the facts and matters found. Subject to bye-law 8(f) above, any other fndng of fact n any cvl proceedngs before a court of competent jursdcton n the Unted Kngdom or elsewhere shall be admssble as prma face evdence n any dscplnary proceedngs.