Unisure Intermediary Application

COUNTERPARTY DETAILS

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REGULATORY STATUS

PROFESSIONAL INDEMNITY INSURANCE

We are required to obtain details and evidence of your Professional Indemnity / Errors and Omissions Insurance Policy.

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GENERAL BUSINESS CONDUCT

ACCOUNT PROFILE

BANK ACCOUNT INFORMATION

For settlement of commissions, brokerage and/or introducer fees (as appropriate to your status and the TOBA / Introducer Agreement provided by us).

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DECLARATION

We confirm that to the best of our knowledge and belief the information contained in this questionnaire and attachments are correct.