Credit Union Application Pack - Form



Application for approval of use of words ‘Credit Union’ in name

Under Section 3 of the Credit Unions Act 1979

Full name of applicant firm for which approval is sought

|      |

approval of use of words “Cre

Union” in name

Under Section 3 of the Credit Unions Act 1979

|1 |Details of applicant firm |

1.1 Address

|Address |      |

| | |

| | |

| | |

|Postcode |      |

|Phone number (including STD code) |      |

|Email address |      |

1.2 Tick whichever of the following applies:

Pre-registration study group

Association / grouping of Credit Unions

Credit Union Development Agency

Specialist supplier of services to credit unions

Friends of xyz Credit Union(You must also complete Annex 1

1.3 Give more details about the applicant’s activities

|      |

| |

| |

| |

1.4 Give reasons to support this application for approval (if appropriate please supply supporting documentary information)

|      |

| |

| |

| |

Signature

Signed on behalf of the applicant

| Name |      |

|Position |      |

|Signature | |

|Date |dd/mm/yy |

| |Annex 1 |

| |Supplementary application for ‘Friends of xyz Credit Union’ groups to be completed by the supporting credit union. |

2.1 Name and address of Credit Union

|Name |      | |

|Address |      |

| | |

| | |

| | |

|Postcode |      |

2.2 Firms reference number

|      |

2.3 Contact details

|Name |      | |

|Phone number |      | |

Declaration

This is to confirm that the credit union is content for

|      [applicant’s name] |

to make an application to the FCA for the approval of the use of the above name under section 3 of the Credit Unions Act 1979.

Signed on behalf of the credit union (the person signing this return should be an ‘Approved Person’ of the credit union).

| Name |      |

|Position |      |

|Signature | |

|Date |dd/mm/yy |

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Important information you should read before completing this form

Please keep a copy of your form for future reference.

Please be aware that any personal details you give on the form will be placed on the credit union’s public file.

It is important that you provide accurate and complete information and disclose all rele[?]"€„Þà P R T h j l v x | ~ € – ˜ ¤ ¦ ¸ ¼ Ö å×Ì×Á±¥œ¥”?…”w”?fTBTBTBTB"haÎ5?B*CJ OJQJaJ phÿÿÿ"hÜ,G5?B*CJ Ovant information. If you do not, it may increase the time taken to assess your application.

Terms in this form

In this form we use the following terms:

• 'we', ‘us’ or 'our' refers to the appropriate regulator;

• ‘the FCA’ refers to the Financial Conduct Authority;

• ‘the PRA’ refers to the Prudential Regulation Authority;

• 'the applicant firm' refers to the firm applying for registration and authorisation; and

• 'you' refers the person(s) signing the form on behalf of the applicant firm.

Filling in the form

1 If you are using your computer to complete the form:

• use the TAB key to move from Question to Question and press SHIFT TAB to move back to the previous Question; and

• print out all completed form and arrange for it to be signed.

2 If you are filling in the form by hand:

• use black ink;

• write clearly; and

• sign the declaration in the 'declaration' Section.

3 If you

• leave a Question blank; or

• do not sign the declaration; or

• do not attach the required supporting information without telling us why

we will have to treat the application as incomplete. This will increase the time taken to assess your application.

4 If there is not enough space on the forms, you may need to use separate sheets of paper. Clearly mark each separate sheet of paper with the relevant Question number.

5 Post this form to us at:

The Financial Conduct Authority

25 The North Colonnade

LONDON

E14 5HS

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