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Your Details
Your deal origination business details
(if applicable)
(if applicable)
Business structure and ownership

Please let us know the full name, position, personal address and % shareholding of all company directors, partners and sole traders

Please enter the details of the office account which payments such as commissions should be paid into

Compliance and regulation

Have you or your company or any principal in your company (e.g. director, partner or principal) ever been:

Subject to a bankruptcy or insolvency order either in Europe or the UK or elsewhere.?

Subject to any investigation or disciplinary action taken by the FCA or other regulatory body in Europe or the UK or elsewhere.?

Subject to any litigation within the last five years (include any pending proceedings).?

Subject of an investigation into allegations of misconduct or malpractice in connection with any business activity.?

Investigated for or accused of corrupt conduct or bribery.?

Accused by any government agency or convicted of bribery or fraud in the past five years (include pending proceedings).?

Disqualified by a court from acting as a director of a company or from acting in a management capacity or conducting the affairs of any company, partnership or unincorporated association?

Anti-bribery arrangements

Does your company:

Have a code of conduct/ethics and an anti-bribery and corruption policy in place which covers controls relating to gifts and entertainment, expenses and political/charitable donations.?

Prohibit facilitation payments, including to public officials.?

Requires its employees to undergo anti-bribery and corruption training.?

Data protection consent

How will Integer Wealth Global use your information?

Integer Wealth Global is committed to processing your information in accordance with the Data Protection Act 1998. We may use your information to make business decisions, carry out enquiries, detect and prevent fraud, and to ensure that we comply with legal and regulatory requirements.

We reserve the right to conduct monitoring of your firm or request documentation which will support a compliant and regulatory culture during your relationship with Integer Wealth Global.


In order to support a compliant and regulatory culture during my relationship with Integer Wealth Global and to assess my firm’s application, I consent to Integer Wealth Global:

1. Using different data made available by creditreference agencies, which may be taken from publicly held information such as electoral roll and court judgments as well as non-public information relating to my credit history and data provided by fraud prevention agencies; and

2. Using a combination of the data referred to above to verify my identity; make business decisions; carry out enquiries; detect and prevent fraud; and to ensure that Integer Wealth Global complies with its legal and regulatory requirements.

I/we confirm as Partner(s)/Director(s) that you may carry out all necessary appropriate credit checks in processing this application which may involve registration against my/our names at licensed credit reference agencies (CRA’s). In addition, if you have made this application on behalf of yourself and any other person(s), by doing so you confirmed to us that you had their authority to disclose their personal information to us, and to give consent on their behalf to all of the uses of their Personal Data.

I/We confirm that the above data is accurate, current and complete to the best of my/our knowledge.

I/We confirm thatI/we will notify Integer Wealth Global immediately if there are any material changesto the information provided above.

I/We understand that Integer Wealth Global reserves the right to decline this application or choose to defer the application pending additional information.

Please ensure this form is signed by an authorised person(s) of the business