| Please provide below as a percentage of where your business will be derived from | |
| Introducers | 0 |
| Client Retention | 0 |
| Client Referrals | 10 |
| Purchase of Leads | 90 |
| Other | 0 |
| If other, please provide details of source | |
| Introducers – if you have provided a percentage above for introducers, please provide the following: | |
| Name of Firm/individual | |
| Will they be referring protection business | |
| Will they be advertising your services | |
| Please provide details of ALL companies where you have been a director, company secretary or shareholder.
If the company has dissolved, please provide full details including the reason for dissolution and if there was any debt as a result of this. If N/A, please state. | Between September 2010 and March 2011 I was in a self employed partnership in a small catering business, we ceased trading as profits were not sufficient to continue. There were no outstanding debts and we had overpaid tax so received a rebate on submission on the tax returns. |
| Please provide details of any other business interests (if N/A, please state) | None |
| Please indicate how much income you expect to generate over the first 12 months (after becoming an Appointed Representative), that is derived from non-regulated, non-financial services activities. | |