Agent Application Process Operational Branches recruitment and registration of Agents licence 2009
CONTENTS Personal data 3 Annex 1. Fitness and Propriety 8 Documentation Evaluation 12 DECEMBER 2013 PAGE/2
ACCOUNT OPENING PROCEDURE Applicant to complete all sections as indicated All Applicants must pass a fit and proper test as part of our criteria for acceptance(based on FSA rules). The information given on this form will be used in determining the application. All questions must be completed before the application can be considered. If a question does not apply, please write not applicable or none as appropriate. Please write clearly in black ink and use capital letters PERSONAL DATA (FILLS IN AN INDIVIDUAL): Surname: Date of birth: Citizenship: Name: Place of birth: Address (registration): Address (place of residence): Identification document: document type: number: name of the issuing authority: Post address: Telephone and fax numbers: E-mail addresses: Web-site: Spoken languages: series: date of issue: Working hours: APPLICATION FOR RETAIL AGENT SERVICES Company Name: Trading names if different : Registered number (Companies House): License number: If the agent is on the FSA Register please provide the firm s reference number (FRN): (date of initial registration): (renewal date): Registered Address: Post address: Business Address: DECEMBER 2013 PAGE/3
Telephone number: Fax number: Email address: Website address (if available): Office working hours: Spoken languages: Authorized capital of the organization: Legal status (Private limited company, public limited company, partnership, LLP, sole trader etc.): List of payment services that will be provided e.g.: Services enabling cash to be placed on a payment account and all of the operations required for operating a payment account Services enabling cash withdrawals from a payment account and all of the operations required for operating a payment account The execution of the following types of payment transaction - direct debits, including one-off direct debits; payment transactions through a payment card or a similar device; credit transfers, including standing orders The execution of the following types of payment transaction where the funds are covered by a credit line for the payment userdirect debits, including one-off direct debits; payment transactions executed through a payment card or a similar device; credit transfers, including standing orders Issuing payment instruments or acquiring payment transactions Money remittance The execution of payment transactions where the consent of the payer to execute the payment transaction is given by means of any telecommunication, digital or IT device and the payment is made to the telecommunication, IT system or network operator acting only as an intermediary between the payment user and the supplier of the goods or services. Will you be providing services in another EEA States(s)? yes no If yes please list each EEA State you will be providing services in: If you are to provide payment services in another EEA state please confirm whether you will have an establishment or will provide cross-border services: Names of all directors: Names of all beneficial owners (i.e. those owning more than 25% of the company/partnership etc.): Name of individuals authorised to represent the company: DECEMBER 2013 PAGE/4
Who and how long is part of the management of the organization? Personal structure of the managing board, including the personal composition of the shareholder(s) - legal entity: Management structure: Please provide details of nature, scale and complexity of your business: What are the main business areas of the organization (core activities)? Other activities undertaken by the organization: Turnover of the business (not just profit level). The average monthly turnover of the organization,including expected: When the last time the audit (or tax audit) was carried out? Who and based on what documents is authorized to sign documents on behalf of the organization? Number of Employees Is the organization a member of any association or union? yes no How long has business been operational? Who are the main partners (contractors) of the organization (specify from 1 to 3 partners who signed long-term contract or signs new contracts on regular base)? What is the estimated volume of transactions (in sterling)? What is the average number of transactions? What is the prime source of customer funds? Monthly Annual Monthly Annual What is the typical purpose of transactions? Are there any transactions which are processed which are out of the ordinary or otherwise different from the typical transaction profile? yes no Main alternative ways of sending money: electronic money wire transfers bank cards cash in pocket other: DECEMBER 2013 PAGE/5
Please provide a description of the internal control mechanisms that will be used by you to comply with money laundering legislation: Features of the market Which companies are the major competitors in the market? Who is the leader in the remittance market? Which tariffs are using competitors (if possible please provide comparison table)? When sending money transfers (USD, EUR, etc.) When receiving incoming transfers (USD, EUR, etc.) Which currencies competition operates? If you have the information, specify the approximate volume of transfers is currently sending the competition. Where such information can be found (the data of the central bank, the Ministry of Statistics, etc.): What rates do you think will be the optimal? List the main countries to where (from where) would go the greatest flow of transfers: Diasporas of which countries are present in the country (if possible, identify the specific name, web-site): Whether a massive advertising campaign needed yes no If you want to open an office, specify: estimated cost of the rent: employee salary : other non-recurring and monthly expenses): Does the organization have intention to maintain a long term relationship with Mayzus Financial Services? The intention of the organization to collaborate with Mayzus Financial Services: DECEMBER 2013 PAGE/6
Revenues of the organization are generated: What MoneyPolo services are representing primary interest to you? How these services can help your business? MoneyPolo services will be for you a source of Please complete the following table for the propriety, director(s)/partner(s) and persons responsible for management of the agent. Please ensure each of the persons listed below completes Annex 1. Annex 1 sets out the questions the FSA expects us to ask each of the individuals listed below to assess their fitness and propriety. This is not an exhaustive list and you should disclose any issues that could affect your fitness and propriety. Full name of individuals-include previous name(s), if applicable and date(s) of name change(s) and any names commonly known by. National insurance number (NI) or passport number if NI is not available. Date of birth dd/mm/yy Completed Annex 1? Anything to disclose in relation to Annex 1.* * If yes please set out details of the disclosure on page 13, clearly identifying the individual it relates to DOCUMENTS TO BE PROVIDED To substantiate the information of the application form above it is required that the signer provides the following: 1. Company Registration Document 2. Extract from appropriate company register 3. Certificate of Incorporation (certified by lawyer/accountant) 4. Copy of memorandum and articles (certified by lawyer/accountant) 5. Letter on company letterhead confirming who is authorised to represent the company (must be signed by at least two directors) 6. Certified copy of ID/proof of address for owners and the person(s) authorised to represent the company 7. Copy of current AML manual (including confirmation of MLRO/Nominated Officer) If available: 8. Copy of Payment Service registration DECEMBER 2013 PAGE/7
ANNEX 1 Fitness and propriety Please complete Annex 1 for each person responsible for payment services at the institution or agent premise: 1.01 a Has the candidate ever been convicted of any offence (whether spent or not and whether or not in the United Kingdom):... Involving fraud, theft, false accounting, offences against the administration of public justice (such as perjury, perverting the course of justice and intimidation of witnesses or jurors), serious tax offences or other dishonesty; or... Relating to companies, building societies, industrial and provident societies, credit unions, friendly societies, insurance, banking or other financial services, insolvency, consumer credit or consumer protection, money laundering, market manipulations or insider dealing? b c Is the candidate the subject of any current criminal proceedings? Has the candidate ever been given a caution in relation to any criminal offence? 1.02 Has the candidate any convictions for any offences (whether spent or not and whether or not in the United Kingdom) other than those in 1.01 above (excluding traffic offences that did not result in a ban from driving or did not involve driving without insurance)? 1.03 a Has the candidate, ever had a County Court Judgment ( CCJ ) or other judgment debt, whether satisfied or not and whether discharged or not (whether or not in the United Kingdom)? Has the candidate had: More than 2 CCJs or Judgment debts?... More than 1,000 in total of CCJs or Judgment debts? b Is the candidate aware of: Any proceedings that have begun, or anybody s intention to begin proceedings against the candidate or a CCJ or other judgment debt?... More than one set of proceedings, or anybody s intention to begin more than one set of proceedings that may lead to a CCJ or other judgment debt?... Anybody s intention to claim more than 1,000 of CCJs or judgment debts in total from the candidate? DECEMBER 2013 PAGE/8
1.04 Does the candidate have any current judgment debts (including CCJs) made under a court order still outstanding, whether in full or in part? 1.05 Has the candidate ever failed to satisfy any such judgment debts within one year of the making of the order? 1.06 a Is the candidate, or has the candidate ever been, the subject of any bankruptcy proceedings, or proceedings for the sequestration of the candidates estate? b Has the candidate ever entered or is in the process of entering into an agreement in favour of the candidate s creditors, for example a deed of arrangement or an individual voluntary arrangement (or in Scotland a trust deed)? 1.07 Does the candidate have any outstanding financial obligations arising from regulated activities, which the candidate has carried on in the past (whether or not in the United Kingdom or overseas)? (In the case of advisors, this will include any outstanding liabilities arising from commissions paid for the sale of packaged products that have lapsed) 1.08 Has the candidate ever been found guilty of carrying on any unauthorised regulated activities or been investigated for the possible carrying on of unauthorised regulated activities? 1.09 Is the candidate, or has the candidate ever been, the subject of an investigation into allegations of misconduct or malpractice in connection with any business activity? 1.1 Has the candidate ever, (whether or not in the United Kingdom) - a b c d Been refused entry to, or been dismissed, suspended or requested to resign from, any profession, vocation, office or employment, or from any fiduciary office or position of trust whether or not remunerated? Been refused, restricted in, or had suspended, the right to carry on any trade, business or profession for which specific licence, authorisation, registration, membership or other permission is required? Been disqualified from acting as a director of a company or from acting in a management capacity or conducting the affairs of any company, partnership or unincorporated association? Been the subject of a disqualification direction under section 59 of the Financial Services Act 1986 or a prohibition order, under section 56 of the Financial Services and Markets Act 2000, or received a warning notice that such a direction or order be made? DECEMBER 2013 PAGE/9
1.11 In relation to activities regulated by the FSA or any other regulatory body (see note section 5), has: The candidate Any company, partnership or unincorporated association of which the candidate is or has been a controller, director, senior manager, partner or company secretary, during the candidate s association with the entity associated with it, ever a b c d e Been refused, had revoked, restricted or terminated, any licence, authorisation, registration, notification, membership or other permission granted by any such body? Be criticised, censured, disciplined, suspended, expelled, fined, or been the subject of any other disciplinary or intervention action by any such body? Resigned whilst under investigation by, or been required to resign from, any such body? 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? Been the subject of any civil action which has resulted in a finding against the candidate or it by a Court? 1.12 Has any company, partnership, or unincorporated association of which the candidate is or has been a controller, director, senior manager, partner, or company secretary, in the United Kingdom or elsewhere, at any time during the candidate s involvement or within one year of such an involvement - a b c d Been put into liquidation, wound up, ceased trading, had a receiver or administrator appointed or entered into any voluntary arrangement with its creditors? Been adjudged by a court liable for any fraud, misfeasance, wrongful trading or other misconduct? Been investigated or been involved in an investigation by an inspector appointed under companies or any other legislation, or required to produce documents to the Secretary of State, or any other authority, under any such legislation? Been convicted of any criminal offence, censured, disciplined or publicly criticised, by any inquiry, by the Takeover Panel or any governmental or statutory authority or any other regulatory body (other than as already indicated under 5.11(b) above)? 1.13 Is the candidate aware of any business interests, employment obligations, or any other situations which may conflict with the performance of the controlled functions for which approval is now sought? DECEMBER 2013 PAGE/10
DATA PROTECTION MoneyPolo (Mayzus Financial Services Limited) is a data controller registered with the Information Commissioner s Office. For the purposes of complying with the Data Protection Act 1998, the personal information in this form will be used by us and passed on to the FSA to enable it to discharge its statutory functions under the Payment Services Regulations 2009 and other relevant legislation. DECLARATION I declare that: to the best of my knowledge all the information I have given in this application is correct I understand that Mayzus Financial Services Limited must be informed of any material changes to the information I have provided within 30 days of the change I agree that Mayzus Financial Services Limited may make such enquiries as it thinks fit to consider my application as an Agent MayzusFinancial Services Limited will use various references to validate and verify the information and your answers given, not limited to credit checks or criminal checks and authorise Mayzus Financial Services Limited to conduct these checks as necessary I have read and I understand the declaration above. Signed Dated AUDIT REPORT: A full review of the business operational processes, records and reports relating to payment services activity specific to local regulations. Date Manager Location Status DECEMBER 2013 PAGE/11
DOCUMENTATION EVALUATION Folder Type Content Remarks Business Information Compliance and FSA Agents Company Incorporation Business Tax Ref Business Payee Ref Bank Account Numbers and Contacts and Mandates Staff Log Operational Licences AML COBs SAR Reporting Registration Index list For each entity KYC and Confirmation of entry to MLR and FSA for ACE To be reviewed by Mayzus Financial Services on inspection prior to activation of service To be reviewed by Mayzus Financial Services on inspection prior to activation of service Where applicable reviewed by Mayzus Financial Services on inspection prior to activation of service SAR Reports Training Material SAR Index SAR internal SAR external Training Log Training Material Test for each employee To be reviewed by Mayzus Financial Services on inspection prior to activation of service To be reviewed by Mayzus Financial Services on inspection prior to activation of service DECEMBER 2013 PAGE/12
If you have anything to disclose in relation to Annex 1 please set out details of the disclosure on this page, clearly identifying the individual it relates to DECEMBER 2013 PAGE/13