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Intermediaries
Wednesday Financial Services — Introducer Registration
Please complete the details below. Required fields are marked.
Date *
Company Name *
Address *
Post Code *
Company Registration Number *
FCA Number *
Data Protection Reg (ICO) *
Website
Business Areas
Mortgages
Insurance
Secured Loans
Bridging
Commercial
Pensions & Investments
Lead Provider
Products to Access *
Secured Loans
Mortgages
Unsecured Loans
Commercial Loans
Bridging Loans
Client Agreement Process
We will only accept clients who have agreed to the referral and are expecting contact. Do you have a process to ensure this?
yes
no
Primary Contact
Full Name *
Position *
Email *
Mobile Number *
Landline Number
Declarations
Have you been subject of an enquiry/investigation by a regulatory or self-regulatory body? *
yes
no
Are you currently, or have you ever been, involved in any legal proceedings (civil/criminal)? *
yes
no
Have you/your companies ever had a licence revoked or been disciplined/investigated? *
yes
no
Ever been bankrupt, had arrangements with creditors, or assets confiscated? *
yes
no
Refused entry to a profession, dismissed, or restricted from trade/business? *
yes
no
Any associated company gone into liquidation/ceased trading with debts/insolvency? *
yes
no
Found liable for fraud/misconduct or investigated under company law? *
yes
no
If YES to any of 17–23, please explain
Banking Details
Bank Name *
Account Name *
Commission Email *
Account Number *
Sort Code
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