Intermediary Panel Application

To join our registered intermediary panel, and start doing business with us, please submit your details to us using the form below.

Intermediary Details

Title*

First Name*

Surname*

Business Name*

Company Registration Number

Business Address*

Correspondence Address

Office Telephone*

Mobile

Preferred Contact Number*

Email*

FCA Registration

Authorisation* Directly authorised Appointed representative

Firm FCA Number*

Appointed representative FCA Number*

Principal Company Name*

FCA Registration Number

Date Registered

Network Name

Network FCA Number

Network/Club

We have partnerships with numerous networks and clubs. Many are national agreements, while others enable access only to intermediaries in our heartland area. Please check by calling us on 0330 123 1073 or click here. If we can accept business from you, your client can be based anywhere in England and Wales

If you will be submitting an application via a mortgage club, please list the clubs used

Do you have an AIP/Application to submit in the next 2 days?* Yes No

Working Together

We’re passionate about our customer service – we want to work closely with you by offering you and your clients the best possible service from the start of our relationship. We will therefore call you within 14 days of receipt of your application to join our panel, to find out a little about you and your business and share relevant information about our proposition so that you get the most from our relationship.

In the meantime, so that we can ensure you have the information and support you need from day one, please could you confirm the following:

Your typical business mix (i.e purchase/remortgage, BTL, shared ownership, self build, expat etc)*

Typical client profile (i.e LTV, age, employed/self employed, impaired credit, capital raising etc)*

What do you need from us? (i.e access to sales team, online portal, regular updates by phone or email)*

What sourcing systems do you use?*

Supporting Documents

To progress your application please tick to confirm you will supply copies of the following documents:

Professional Indemnity Insurance certificate

Current bank details as applicable on signed letter headed paper (for procuration fee payment)

Full details if you answer yes to any of the following statements:

Have you been subject to disciplinary action by the firm, FCA or any supervisory body Have you been convicted of a criminal offence Have you had a CCJ registered against you Have you entered into an arrangement with creditors Have you been the subject of a receiving order Have you been the director of a company subject to winding up procedures

Please return supporting documents including full details of any of the above statements you have indicated (if applicable) to bdt@ibs.co.uk, by fax to 01473 278600 or by post to Ipswich Building Society, PO Box 547, Ipswich IP3 9WZ.

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.* Yes No

Terms of Business

By joining our panel you agree to accept our general terms of business for intermediaries, as follows. The Society reserves the right to remove you from its intermediary panel if you do not adhere to the general terms. We reserve the right to request further information as needed:

It is your responsibility to ensure that:

You always have your customer’s authority to act on their behalf, and their permission to pass information to the Society
Your customer is fully aware, that when the Society searches their credit file to assess either an AIP or Application, a record of that search will be left (i.e. it will leave a hard footprint on the customers records)
You have all the appropriate, current authorisations from the Financial Conduct Authority (FCA) to submit applications
You will hold the relevant permissions with the FCA to conduct Consumer Credit Activities and Professional Indemnity Insurance cover at all times

The Society can carry out ongoing reviews when required to assess your membership of the panel and we reserve the right to terminate your membership at any time.

Please confirm you have read and accepted the Terms of Business* Yes No

Intermediary Declaration

I confirm that in accordance with current Anti Money Laundering Regulations, I will have undertaken appropriate ‘Know Your Customer’ checks including the verification of identity and recording the details of all mortgage applicants before passing applications to Ipswich Building Society
I confirm that any information Ipswich Building Society holds about me and how I use their website may be used for monitoring and management information purposes. This may be shared with the management team within my own organisation
I indemnify Ipswich Building Society in respect of any liability, losses, damages or costs it may incur arising from a breach of my warranties and/or obligations, imposed by these terms of business, or by reason of any misrepresentation or negligent, or fraudulent act or default by me
I agree to Ipswich Building Society making checks as they deem necessary prior to appointing me to their intermediary panel, and at any future time, including credit checks, business searches and ongoing business reviews.

Name*

Date*

Thank you

We will reply to your application very shortly

Intermediary Panel Application

Intermediary Details

FCA Registration

Network/Club

Working Together

Supporting Documents

Treating Customers Fairly

Terms of Business

It is your responsibility to ensure that:

Intermediary Declaration

Thank you

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