Broker registration form - Suffolk Building Society Intermediaries

Intermediary Details

Title (Required)

First Name (Required)

Last Name (Required)

Company Name (Required)

Company Registration Number

Company Address (required)

Office Telephone (Required)

Mobile (Required)

Email (Required)

FCA Registration

Authorisation (Required) Directly authorisedAppointed representative

Firm FCA Number (Required)

Appointed representative FCA Number (Required)

Principal Company Name (Required)

Adverse credit

Have you had any adverse credit? (Required) YesNo

Please provide an explanation (Required)

Treating Customers Fairly

Please confirm that you actively apply all of the TCF outcomes and comply with all applicable aspects of MCOB at all times with your customers. (Required) YesNo

Consumer Duty

Please confirm that you actively comply with all applicable aspects of the Consumer Duty (it’s Consumer Principle, Rules and Outcomes around Products and Services, Price and Value, Consumer Understanding, and Consumer Support) at all times with your customers. (Required) YesNo

Intermediary Declaration

Please confirm that you actively apply all of the TCF and Consumer Duty outcomes, and comply with all applicable aspects of MCOB at all times with your customers. (Required) YesNo

Name (Required)

Date (Required)

Broker re-registration.