Individual Application Form

1. Contact Information

First Name

Surname

Contact details

Email Address

Phone Number

Advisor Referral: Name of the Advisor introducing you to Impact FS.

(Type N/A if joining Impact FS directly)

Work Permission in the UK:

British/EU National

Work Permit

Working Visa

Visa Expiry Date (if applicable)

Year/month

2. Personal Identification Details

Title (required)*

(e.g., Mr, Mrs, Ms)

Full Legal Name (required)*

Preferred Name

Date of Birth (required)*

Select Date ×

National Insurance Number*

Previous Name

(if applicable)

Date of Name Change

Select Date ×

Nationality (required)*

Passport Number*

(if no National Insurance number avaible)

Place of Birth (required)*

Address History: *

3-year history including addresses and dates

Address History:

3-year history including addresses and dates

3. Employment & Supervisory Roles

Current/Previous Company Roles (last 5 years):

Include company name, primary activity, date appointed, and current status.

Trainee Advisor Status:

Supervisor Role

No Yes

Trainee Registration Dates (if applicable)

Select Date ×

Authorization to Sell Mortgages & Protection Products

No Yes

Case Submission History:

Total mortgage and protection cases submitted and completed in the past 12/24 months.

4. Arrangement & Controlled Functions

Controlled Functions Arrangement:*

Mortgage

Protection & General Insurance

Pure Protection

General Insurance

5. Employment History (Last 5 Years)

Employment Details (up to 3 positions)

6. Fitness & Propriety

Criminal Proceedings:

Past and ongoing, cautions, and convictions.

Civil Proceedings:

Judgments, awards, and debt history.

Business Conduct:

Any disqualification or disciplinary actions.

Regulatory Matters:

Compliance with FCA/PRA and other regulatory bodies.

7. Financial Position

Income:

Partner’s income

Own income

Other income

Total income

Expenditure

Mortgage/rent, loan repayments, credit card expanses, household expanses, other obligations, and total expenditure.

Credit Commitments

History of arrears in the last 12 months.

Assets & Liabilities:

Assets:

Home, secondary properties, vehicles, bank balances, investments, etc.

Liabilities:

Outstanding mortgages, loans, credit card debts, personal guarantees.

8. Accountant Details (if self-employed within the last 5 years)

Name

Address

Phone

Email Address

9. Declarations & Signatures

Candidate’s Confirmation:

Agreeing to terms, accuracy of information, and understanding regulatory checks.

Declaration of Changes:

Commitment to update information as needed.

Consent to Data Processing:

For regulatory and marketing purposes.

Signature

Date

Select Date ×

10. Supporting Document Uploads

Individual Application Form:

1. Contact Information

Contact details

2. Personal Identification Details

3. Employment & Supervisory Roles

Trainee Advisor Status:

4. Arrangement & Controlled Functions

5. Employment History (Last 5 Years)

Employment Details (up to 3 positions)

6. Fitness & Propriety

7. Financial Position

Income:

Assets & Liabilities:

8. Accountant Details (if self-employed within the last 5 years)

9. Declarations & Signatures

Signature

10. Supporting Document Uploads

Required Documents:

Proof of Residency

ID

Bank Statements

Work Permit

DBS Certificate

CV

Credit Report

Exam Certificates

Tax Year Overview (HMRC) - Last Completed Tax Year

10. Supporting Document Uploads

Social Media Links:

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