the equity release council...6. associate firms – please complete this section 6.1 describe below...

www.equityreleasecouncil.com Application for Membership of the Equity Release Council 1

All firms generating revenue from activity associated with Lifetime Mortgages and Home Reversion Plans

should complete this section

New members: complete this form plus a copy of the Individual Declaration (Appendix A) in respect of each individual who is to be added to the membership.

Existing member firms: complete a copy of the Individual Declaration (Appendix

A) in respect of each additional individual who is to be added to the membership.

Please complete in block, black capitals

Person to contact regarding this application:

Email:

Telephone:

1. Which membership category are you applying for? Please tick

1.1 Adviser Firm

1.2 Provider Firm

1.3 Solicitor/licensed conveyancer Firm

1.4 Surveyor Firm

1.5 Associate Member

Please state

2. Company Details (to be completed by all firms)

Company Name:

Address:

Town:

Office Telephone:

Number of offices:

Postcode:

Website Address:

Your Companies House No:

2.1 Total number of equity release (ER) cases you handled in your last full

financial year

2.2 Total of ER cases as a % of total cases in last full financial year

2.3 Name of your professional indemnity insurance (PI) provider

(NB the underwriter not the broker) (Please supply copy of schedule)

2.4 Amount of PI cover you hold

2.5 Number of claims over the last 3 years regardless of whether they are in

connection with ER (provide details on an extra sheet if necessary)

The Equity Release Council Application for Membership of the Equity Release Council

http://www.equityreleasecouncil.com/


3. Provider and Adviser firms – please complete this section

3.1 Please provide your regulatory status by ticking the appropriate box

3.1.1 Directly Authorised 3.1.2 Appointed Representative 3.1.3 Restricted

3.2 Your FRN/PRA number

Note: If you advise on home reversion plans and lifetime mortgages as the Appointed Representative of a firm which is directly

authorised by the FCA, enter the name and FRN number of your Principal Please note Principal Firm must be a member.

3.3 Please list the permissions granted to you/your firm (NB: supply information at activity name level,

as outlined in the Financial Services Register)

3.4 Details of any FCA/PRA disciplinary action or specific action imposed by the FCA/PRA over the last 3 years

(provide details on an extra sheet if necessary)

3.5 Number of ER advisers qualified and active in the ER market at date

of application (if additional individuals subsequently become active as ER

advisers you must inform us)

3.6 Please list the names of the qualified ER advisers subject to this application. Each qualified adviser

giving advice on ER must complete and sign a copy of the declaration form which must be submitted with

this application

3.7 Please tick the advice/customer communication channels employed by your firm

F2F

Telephone based



4. Law firms (Solicitors or Licensed Conveyancers) – please complete this section

4.1 Please provide your SRA/CLC ID

4.2 Details of any SRA or CLC disciplinary action over the last 3 years (provide details on an extra

sheet if necessary)

4.3 Please list the names of qualified Solicitors/Chartered Legal Executives or Licensed Conveyancers

advising on ER subject to this application. Each qualified Solicitor/Chartered Legal Executive/Licensed

Conveyancer giving advice on ER must complete and sign a copy of the declaration form (Appendix A) which

must be submitted with this application

5. Surveyor firms – please complete this section

5.1 Please provide your RICS registration number

5.2 Details of any RICS disciplinary action over the last 3 years (provide details on an extra sheet if

necessary)

5.3 Please list the names of qualified RICS registered chartered surveyors dealing with ER subject to this

application. Each qualified surveyor involved with ER must complete and sign a copy of the declaration form

(Appendix A) which must be submitted it with this application



6. Associate firms – please complete this section

6.1 Describe below what your firm does and its activity in relation to equity release

6.2 Is your firm regulated* by/members of any specific professional body – please give details below

6.3 Details of any disciplinary action over the last 3 years (provide details on an extra sheet if

necessary)

6.4 Please list the names of the individuals qualified (if required) or otherwise who will be dealing with

ER subject to this application. Each individual involved with ER must complete and sign a copy of the

declaration form (Appendix A) and submit it with this application

7. Company declaration (all firms to complete)

7.1 Name/s and position/s of person/people authorised to apply for membership

Name Position

Signature of authorised person:



Company Name:

Company Membership Number (if known):

Have you any convictions for any offences other than those listed in Q1 above which are not spent, whether

or not in the UK (excluding traffic offences unless these resulted in a ban from driving or involved driving

without insurance)?

Individual Declaration

(to be completed by ALL individual applying members in association with a Firm membership)

Email: Telephone:

Note: if you answer yes to any of the questions on this declaration please give details on a separate sheet

Background check I – criminal convictions

1. Have you ever been convicted of any offence involving fraud, theft, false accounting against the administration of public justice (such as perjury, perverting the court of justice and intimidation of witnesses or jurors), serious tax offences or other act of dishonesty or any other offence, whether in the UK or not?

2. Are you the subject of any current criminal proceedings?

YES NO

YES NO

YES NO

4. Do you have any judgment debts (including CCJs) made under a court order still outstanding, whether in full or part?

YES NO

5. Are you now the subject of any bankruptcy proceedings, or proceedings for the sequestration of your estate?

YES NO

6. Have you entered into a deed of arrangement or an individual voluntary arrangement (or in Scotland a trust deed) or other agreement in favour of your creditors, or are you doing so?

YES NO

3. Do you have convictions for any offences (other than those listed in Q1 above), which are not spent, whether or

not received in the UK (excluding traffic offences, unless these resulted in a ban from driving or involved driving without insurance)?

Source Code

Correspondence address (if different from company address):

Your professional qualifications in respect of this application:

The Equity Release Council

Company/Principal Firm (if applicable):

Company/Principal ERC Membership Number:

Individual’s Name:

Email Telephone


14. FCA

a. Been refused, had revoked, restricted or terminated, any licence, authorisation, registration notification, membership or other permission granted by any such body?

b. Been criticised, censured, disciplined, suspended, expelled, fined or been the subject of any other disciplinary or intervention action by any such body?

c. Resigned whilst under investigation by, or been required to resign from, any such body?

d. Decided, after making an application for any licence, authorisation, registration, notification membership or other permission granted by any such body, not to proceed with it?

e. Been subject of any civil action which has resulted in a finding against you by a court?

The ERC logo is a registered UK service mark, number 2618988

to The Council and SHIP logos are registered UK service marks

with numbers 2525965, 2618988 and 3149279 respectively.

Please ensure, and tick, that you have enclosed the following information

All declarations completed

Additional info required, please provide details below

Declaration by individual

I of

undertake to comply with the Terms and Conditions of membership set out above:

Signature

Print Name

Please print name and position of person who has authorised this application

Please email the application to: [email protected]

Notes: Regulated* refers to: any self-regulatory organisation including IMRO, SFA, FIMBRA, AFBD, and TSA. Statutory bodies including FCA, PRA, SIB the society of Lloyd’s, registry of Friendly Societies commission, BoE, HM Treasury and any other recognised regulatory or designated professional bodies.


Data Protection Your privacy is important to ERC and we are committed to respect and protect your privacy and your personal information. Full details of

our Privacy Policy can be found on the Council’s website – www.equityreleasecouncil.com

The Council collect and use your personal data to enable us to:-

• To process, administer and renew your membership with ERC which will include posting details on our public register;

• Internal record keeping;

• To provide you with information which we think you may find useful including: relevant market, regulatory and industry

information;

• Promotional information from selected third parties such as conference organisers and training partners; and

• From time to time we may also use your information to contact you for market research purposes. This information may be used

to customise the website according to your interests.

As part of the application process we also collect information about criminal records and your professional conduct. Under data protection

law this is classed “special category” data (sensitive) and we require your consent to collect and use this data.

Declaration I agree to the Council collecting and using data on Criminal records and Professional Conduct.

Yes No
mailto:[email protected]://www.equityreleasecouncil.com/http://www.equityreleasecouncil.com/

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