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 partner, drector or controller (e a controller s a shareholder who controls 15% or more of the votng rghts) n the frm who s not a member of ACCA or another Desgnated Professonal Body (DPB). Further copes can be found on ACCA s webste (www.accaglobal.com/practsng) or requested from Authorsaton (tel: +44 (0)141 534 4175) but photocopes are acceptable. Please use BLOCK CAPITALS and black nk throughout and retan a photocopy of the completed form for future reference. 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 (http://www.accaglobal.com/prvacy), or contact prvacy@accaglobal.com PERSONAL INFORMATION Full name Ttle Date of brth Busness address wn County Postcode Tel Emal Fax Webste Is there an ACCA partner/drector at your busness address? Yes No If no complete page 3 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
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 Frm s/employer s name Busness Job ttle Responsbltes Dates From Frm s/employer s name Busness Job ttle Responsbltes Dates: From (contnue on separate sheet f necessary) 2
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 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 f 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 ACCA 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 7 (Complance Procedures), n respect of non-acca partners/drectors Sgned by each of the ACCA partners/drectors n the frm Full name Sgnature Date 3
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 ACCA, 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 1) 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 authorsaton by ACCA under the Investment Intermedares Act 1995. 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 9Exceptons) 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 Irsh Investment Busness Regulatons 2013 (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. Sgnature Date 4
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. Please return ths form to: Authorsaton, ACCA, 110 Queen Street, Glasgow G1 3BX, Unted Kngdom.