Specialist Financial Services

simply complete the registration form below or download a copy and fax it to us on: 0871 900 3904 and we will also send you a copy of our latest introducer pack.

registration form

Title
Your Name *
Company *
Your Position
Business Type
Full Address *
..
..
Postcode *

Office tel. No. *
Fax No.
E-mail (1) *
Website

Mobile tel. No.
Other tel. No.
E-mail (2)
DX Address

Are you regulated by the FSA to offer advice on Mortgages?

yes no

Are you regulated by the FSA to offer advice on General Insurance?

yes no

If FSA registered, what is the name of your compliance officer?

FSA, Registration No.
Data Protection Registration No.
Consumer Credit Licence No.
Expiry Date of Consumer Credit Licence
Your sources of new business?

Other 2nd mortgage & commercial mortgage agencies held?
Which name should commission cheques be made payable to?

DECLARATION & SIGNATURE(S) -
I/We confirm that the answers given in this application are true and complete and may be relied upon on the
basis of any contract between us.  I/We know of no other information that if disclosed would affect the granting 
to me/us of agency facilities.  I/We agree references may be obtained where required and I/we agree that
the information given in this application may be used to obtain credit searches against all individuals or
companies named herein.

I/We agree you may submit this information to any lender you place business with who may also take
references and/or make credit reference searches.  I/We agree that you may in the normal course of your
business pass this information to any national or local government agency or department, or 
any other relevant trade body.  I/We agree that you may keep this information for as long as you deem
necessary.  I/We agree to notify you should there be any material change in the circumstances as set out
in this application.


I/We hereby agree to the following: -

1.  
I/We agree to work within the confines of the Consumer Credit Act 1974, in the business of 
Consumer Credit, Consumer Hire or Consumer Brokerage, and if I/we hold a Consumer 
Credit Licence, to remain properly licensed under the Act for all requisite purposes and 
under any other relevant legislation.

2.
I/We undertake to pay all costs incurred by me/us in the generation, submission or funding 
of loans, and I/we agree not to charge any fees whatsoever to the customer that are not 
part of the lenders' offer of finance.

3.
I/We understand that you will pay commission for all funded loans from the Agent at the 
agreed commission structure. In the event that a lender claws back commission, such 
clawback will be passed on to me/us and shall become immediately repayable. I/We 
understand that you may at any time set off any amounts owed by me against any amount 
payable to me.

4.
I/We agree to you sending marketing material to any customer that I/we introduce to you, 
solely with the intention of arranging further advances or new loans, and I/we understand 
that commission on these advances will be payable to me/us at 50% of the normal 
commission rate due.

5.
This agreement is between me/us and Specialist Financial Services and any sister or 
parent or subsidiary company or other company within the group of companies of which 
Specialist Financial Services is a member.  As such I/We agree not to re-solicit any 
borrower either directly or indirectly that has received a loan within 6 months of the loan 
completion.

6.
I/We agree to you sending us information that you believe will be of interest to me/us by 
post, facsimile, SMS text and/or e-mail. If you do not want us to do this tick the box below 
or alternatively advise us in writing which of these methods you do not want us to use.

7.
I/We confirm that a breach of any of the conditions contained within this agreement will 
result in the forfeiture of commission due to me/us, and the termination of my/our agency 
with you, at the absolute discretion of the Director(s) of the parent company of Specialist Financial Services.

Digital signature: * by checking this box you confirm that you are bound by the above terms and conditions of this registration form.
by checking this box you confirm that you do not want us to send you information that we believe will be of interest to you by post, facsimile, SMS text and/or e-mail.

register with us

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