Personal Questionnaire

PRIVATE AND CONFIDENTIAL

    General Information

    Please provide two references below

     

    Services of Interest

    Please tick the boxes representing the services that you may be interested in.

    Portfolio ManagementCapital ManagementAdvisoryCapital Builder (Regular Plans)Unit Linked ManagementTheme PortfoliosPrivate Bank AccountsOther ServicesLife and BenefitsHealthcareSales SupportInvestment ProposalPortfolio AnalysisDirect Access to Portfolio ManagersAssistance in Client MeetingsClient SeminarsSupport SystemsBusiness Processing via Elgin agenciesZeus On-line valuation SystemE-mail AddressMarketingBrochures / WebsiteBusiness CardsFact Finds etc.

    Supporting Documentation Requirements

    Certificate of Incorporation/RegistrationRecent (up to 12 months) certificate of good standingCertificate of registered officeCertificate of Directors and SecretaryCertificate of shareholdersIndividuals and/or Company DirectorsCertified copy of passportCertified copy of proof of address less than 6 months old (utility bill, tax bill, bank statement)Police clear criminal record certificate

    We can receive the above mentioned documents by email except for the ones that specify “Certified”.

    Important Note: If you are interested in becoming a registered Insurance Advisor in Cyprus, please provide us with your current qualifications and we will submit to the Commissioner of Insurance for approval.

    Corporations Advisor Branch

    Definitions:

    Elgin AMC is a trade name of Numisma Capital Ltd, which is regulated by CySEC (license number 122/10) and licensed under MiFID (Markets in Financial Instruments Directive 2004/39/EC) to provide investment services. It has passporting rights to offer its services to all 28 EU countries. As an associate, you can be an “introducer” to Elgin AMC in any of the 28 EU countries, but may not provide investment advice.

    Note: You may also consider being a branch of the company in any EU country, in which case you would be able to offer investment advice (this would of course be subject to your qualifications). Please contact us if you would like to explore this route.

    Elgin Insurance Agents, Sub-Agents and Advisors is regulated by the Cyprus Insurance Companies Control Service (license number 21FOS) and is licensed as an insurance intermediary. It has passporting rights to various EU countries including the UK, Spain, Sweden and the Czech Republic.

    Elgin Group LLC is a Swiss-based portfolio management company and regulated by VQF and BOVV (license number 12814). VQF is the biggest SRO in Switzerland and is officially recognised by FINMA. Elgin Group LLC also has agencies with various insurance companies.

    Declaration

    Have you or your company ever been convicted of any offenses other than minor motoring offenses in any country?Are you or your company the subject of any criminal or civil proceedings in any country?Have any legal proceedings been bought against you or your company in any country regarding financial services?Have you at any time been refused or had revoked any membership to any professional body or association?Have you or your company ever been declared bankrupt or are subject to bankruptcy proceedings in any country?Have you or your company ever been investigated by any agency regarding advice given in conjunction with financial services?Have you or your company ever been disqualified from any country for actions regarding financial advice?

    Please read carefully

    This declaration is to be signed by the individual applying for terms of business.

    I declare that the information supplied by me in this questionnaire is complete and correct to the best of my knowledge.

    I authorise Elgin Administration Ltd to approach the aforementioned referees to obtain any information regarding my character and reputation.

    I authorise Elgin Administration Ltd to share this information with its affiliated companies.