Licensed Dealer Financial Planners Addendum
Attaching to and forming part of the proposal for Professional Indemnity Insurance.
Please answer all questions fully. If there is insufficient space in the form, please supply the details in a separate signed and dated attachment on your letterhead. 1. a. What is the AFSL number under which you operate? b. Are you a Licensed Dealer ? c. Are you an Authorised Representative? If Yes, please complete the Authorised Representative addendum. d. Do you hold a current Professional Indemnity policy? e. Do you require cover for all your EXTERNAL authorised representatives? If Yes, please complete attached list of all representatives to be covered. 2. Please provide details of the top 5 investment products that produce the highest per investment income as a % (including commissions, fees) to you in the past 12 months. Type of Income TOTAL Do you disclose Rate of Investment Name of Investment Earned commission the commission Return on (i.e. Product from this rate for this to client on this Investment Equity, Product product product? Product Property) $ % Yes No % $ $ $ $ 3. a. Do any of the institutions in Question 2 above have a proprietary/financial interest in your business? If Yes, please provide details. b. Do you have a financial or proprietary interest in any of these institutions or products? If Yes, please provide details Yes No % % % % Yes Yes Yes Yes No No No No % % % % Yes Yes Yes Yes No No No No
Yes
No
AXIS Specialty Australia (AXIS), a branch of AXIS Specialty Europe Limited, ARBN 131 203 122, is authorised and supervised by the Australian Prudential Regulation Authority as a general insurer. AXIS Specialty Europe Limited is authorised and regulated by the Irish Financial Services Regulatory Authority. 1 of 5 FP Lic Dealers Adden Jan 2009
4. Please indicate the percentage breakdown of your gross income (both fees and commissions) between the following activities. a. b. c. d. e. f. Financial Planning/ Portfolio Management Life Insurance acting as AFS Licensed Holder Life Insurance acting as AFS Authorised Representatives General Insurance Agency/Broking (please note this will be excluded) Mortgage Originating/Mortgage Broking (please complete Mortgage Brokers Addendum) Superannuation Administration i.e. the overall administration of a self managed or regulated super fund (please complete Question 8 ) g. Accounting (please complete Accountants Addendum) h. Other (Please provide details) Total % % % % % % % % 100%
5. Please advise the percentage of client’s investments according to the following breakdown. a. b. c. d. e. f. g. h. i. j. k. l. m. n. Australian equities on a Direct basis Australian equities via a Managed Fund Foreign equities via a Managed Fund Foreign equities on a Direct basis Property trusts via a Managed Fund Property trusts on a Direct basis Fixed interest securities and/or cash Hedge Funds Margin Lending via a Managed Fund Margin Lending on a Direct Equity basis Derivatives Managed Investment Schemes (exempted by ASIC) Managed Investment Schemes (other than above) Other (please provide full details) % % % % % % % % % % % % % % 100 %
Total
6. Australian Equities on a Direct Basis a. In relation to Australian Equities on a direct basis, do you obtain external advice regarding the investment in shares? If No, please attach your guidelines for ensuring the investment is suitable to your client. b. Do you ensure the investments are spread across more than five industries?
Yes
No
Yes
No
AXIS Specialty Australia (AXIS), a branch of AXIS Specialty Europe Limited, ARBN 131 203 122, is authorised and supervised by the Australian Prudential Regulation Authority as a general insurer. AXIS Specialty Europe Limited is authorised and regulated by the Irish Financial Services Regulatory Authority. 2 of 5 FP Lic Dealers Adden Jan 2009
7. Margin Lending Activities a. What is the maximum percentage of any one of your client’s overall portfolio that you recommend they place via a margin lending facility? b. (i) Do you provide taxation advice to the client on the implications of margin lending? (ii) If No, do you refer them to a Certified Practicing Accountant? c. Please list below the Margin Lending facilities utilised by you: % Yes Yes No No
8. Superannuation Administration a. Are you involved in establishing/setting up superannuation funds? b. Are you involved in preparing any documentation in respect to the establishment of superannuation funds? (i.e. trust deeds) c. Are you performing superannuation administration work? d. Are you acting in the capacity as a trustee of a superannuation fund? 9. Property Trust a. Are you financially connected to, or have any ownership in, any Property Yes No Trust you recommend to clients? b. Do you ensure all of the investment reports from Independent Research Houses provide a current (last 12 months) “investment grade” classification Yes No to the specific investment? c. Do any of the investment reports on the Property Trust have a grading below A? Yes No If Yes, please advise ALL the names of such Property Trusts rated below A. d. What is the highest rate of return received on Property Trust investments? e. Do you provide any disclaimers to your clients in relation to investing in Yes No Property Trusts? Please attach a list of the top ten Property Trusts you recommend to your clients Yes Yes Yes Yes No No No No
10. Unlisted/Unrated Debentures/ Promissory Notes a. Do you provide any advice involving Unlisted/ Unrated Yes Debentures/Promissory Notes? If Yes, please answer questions b and c. b. What percentage of your total fees/income is derived from activities involving Unlisted Debentures and promissory notes? c. Who are the Issuers of the unlisted/ unrated debentures and promissory notes? No
%
11. Portfolio Management a. (i) Are you involved in client portfolio management on a discretionary basis? (ii) If Yes, please advise percentage of income undertaken on this basis. b. Do you have a written agreement with each client? Yes No %
AXIS Specialty Australia (AXIS), a branch of AXIS Specialty Europe Limited, ARBN 131 203 122, is authorised and supervised by the Australian Prudential Regulation Authority as a general insurer. AXIS Specialty Europe Limited is authorised and regulated by the Irish Financial Services Regulatory Authority. 3 of 5 FP Lic Dealers Adden Jan 2009
12. Approved Product List a. Do you allow Authorised Representative to advise clients on any investment products not on the Licensed Dealers Approved Product List? If Yes, please provide list of such investment products. Yes No
13. Risk Appraisals/ Disclaimers a. Do you conduct a risk appraisal / needs analysis for all financial planning / portfolio management clients and present a written plan for their agreement and have copies of the signed agreement on file? b. Do you provide all your clients with a copy of a Statement of Advice? c. Do you provide all your clients with a copy of a Product Disclosure Statement for ALL investment products recommended? d. Do you provide any disclaimers on your documentation in relation to high risk investment? (please provide a sample copy) f. Are Independent Research House reports obtained in relation to Property Trusts you recommend to clients? Yes Yes Yes Yes Yes No No No No No
14. Audit Details a. Please advise the date when your organisation last audited all your authorised representatives. b. Did any recommendations/ suggestions come out of the audit conducted? If Yes, please attach a copy of the outcome. c. Have you ensured the authorised representatives have implemented the recommendations/suggestions from the audit? / Yes Yes / No No
15. Training & Education Development a. b. Please advise the date when the last training session was provide to your authorised representatives by your organisation? Please advise the date when was the last training session was conducted by any external training organisation to your organisation? / / / /
16. Para Planner a. Do you have a para planner on staff? If No, who completes the plans? Yes No
Name of Business or Practice:
Signature of Principal or Director:
Name of signatory:
Date:
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AXIS Specialty Australia (AXIS), a branch of AXIS Specialty Europe Limited, ARBN 131 203 122, is authorised and supervised by the Australian Prudential Regulation Authority as a general insurer. AXIS Specialty Europe Limited is authorised and regulated by the Irish Financial Services Regulatory Authority. 4 of 5 FP Lic Dealers Adden Jan 2009
AUTHORISED REPRESENTATIVES TO BE INCLUDED UNDER POLICY
Please provide details of ALL EXTERNAL authorised representatives (AR) that are required to be covered by this application. Name of Individual Date Does the AR Authorised Corporate Name Qualifications Commenced have a claims Representative as AR history / / Yes No / / / / / / / / / / / / / / / / / / / / / / / / / / / ** If there are any claims please provide FULL DETAILS / / / / / / / / / / / / / / / / / / / / / / / / / / / Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No No No No No No No No No No No No No No No No No No No No No No No No No No No
Name of Business or Practice:
Signature of Principal or Director:
Name of signatory:
Date:
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AXIS Specialty Australia (AXIS), a branch of AXIS Specialty Europe Limited, ARBN 131 203 122, is authorised and supervised by the Australian Prudential Regulation Authority as a general insurer. AXIS Specialty Europe Limited is authorised and regulated by the Irish Financial Services Regulatory Authority. 5 of 5 FP Lic Dealers Adden Jan 2009