Register as an Insurance Agent with Commercial Express

It’s easy to register with us; we’ll get in contact and see how we can help.

**Please provide as much detail as possible to enable a smooth registration process. Mandatory fields are indicated by *.**

First Name *

Surname *

Job Title *

Trading or Business Name *

No/Name

Trading Address Line 1 *

Trading Address Line 2

City

Postcode *

Telephone Number *

Website Address

Email Address *

Accounts Email Address *

Registered Business Name *

No/Name

Registered Address Line 1*

Registered Address Line 2

City

Postcode *

Have you previously held a Commercial Express Agency?

Why are you looking to set up a Commercial Express agency?

What are your core trading products?

Please indicate the size of your organisation:

How long has the business been trading for?

Have any Directors of the business, or any company in which they have held a senior position, been involved in liquidation, receivership, bankruptcy, dissolution, a high court writ, voluntary wind up orders, or is any similar procedure pending? *

Have any Directors of the business been convicted of any criminal offences, other than Motoring offences? *

Have any Directors of the business had provision of bond or fidelity guarantee in the past declined, terminated or restricted? *

Have any Directors of the business had an insurance agency or insurance agency application declined, terminated or restricted? *

Regulatory Information

FCA Number *

Do you have FCA permission to hold client money? *

Registration number for the Information Commissioners Office (ICO) *

ICO Registration Expiry Date: *

Companies House Registration Number

Are financial crime procedures in place covering Anti-Bribery & Corruption, Anti-Money Laundering & Sanctions, and have staff been fully trained on the
procedures? *

Please provide details: *

Are sanctions checks carried out? *

Please provide details of the frequency of sanction checks and the processes followed *

Is a complaints procedure in place? *

If yes, how are customers notified of this?

Are data protection and Information Security policies in place and have staff been fully trained? *

Please provide details: *

Are business continuity / disaster recovery plans in place? *

Date last tested:

Are there any outstanding actions from the last test? *

Please provide details: *

Please provide details of your professional indemnity insurance.

Name of Insured *

Policy Number *

Renewal Date *

Limit of Indemnity *

A copy of your PI Certificate will be required *

Please Note:-
Unless specifically agreed with us, appointed representatives are not permitted to access our online platform, nor do we allow wholesaling of Commercial Express products.

I Agree *

If your application is successful, we will need to keep your business up to date with any changes to our Insurers, products, services or training materials. Details of any changes will be sent by email to the registered contacts we have for your business.

I Agree *

Please confirm that to the best of your knowledge all questions have been answered truthfully.

I Agree *

We’d also like to keep you up to date with details of our latest news, corporate events and competitions. Please tell us which marketing updates you would like to receive and how by selecting the options below: *

Commercial Express news (EMAIL) Commercial Express news (POST) Corporate events Competitions NONE of the above

Please ensure you have ticked the box below before submitting.