Business Partner Online Application, Step 1 of 4
Appointed Representatives:
If you are an Appointed Representative/member of a Network, you must apply via your normal network Principal contact for access to this Trading Centre first, not directly to Millennium. If in doubt telephone us on 0844 412 4153.
General Details About You
Main Contact Name
Main Contact Telephone
Company Compliance Officer Name (if different to above)
Your Trading name/Brand name
Full Registered Company Name (if Different from above)
Are you a member of BIBA
Yes
No
BIBA Membership Number
Company Registered Office and Registration No
Full Postal Address
Telephone Number
Facsimile Number
E-mail Address
Directors/ Principals and Approved Persons responsible for General Insurance
Name
Position
Qualifications /experience
IMD *)
1
2
3
IMD *) Responsible for Insurance Mediation under FSA
Background and Trading History
Have you or any Director/Partner/ Senior Manager listed ever been subject to an adverse finding, offence, conviction, or legal proceedings/ CCJ whether past or pending
Yes
No
Please provide full details, outcomes and dates
About your regulated business activities
Are you:
Mortgage broker
Introducer
Mortgage Packager
An IFA
An Estate
Letting Agent
Loan Company
General Insurance Broker
Other...
Please describe