Lansdown Insurance Brokers – Introducer Agreement

It is essential that all the information contained in this document is accurate. Please read it carefully and let us know immediately if there are any inaccuracies. Please retain a copy for your records.

Any questions please email – enquires@lansdowninsuance.com

Company Details

Introducer Name(Required)

Introducer Address(Required)

Street Address Address Line 2 City Postcode

Email(Required)

Website

Description of your Business Nature(Required)

Number of Employees(Required)

Main Contact Details

Name(Required)

First Last

Position(Required)

Email(Required)

Phone

Compliance

Are you authorised by the Financial Conduct Authority (FCA)?(Required)

Yes

If 'Yes' please provide FCA number(Required)

Type of Clients

Please provide an approximate split in the type of client you plan to introduce (%)(Required)

Private Clients – Consumers

Commercial Clients – Businesses

CAPTCHA

IMPORTANT

By receiving this document, you understand that as an Introducer to Lansdown Insurance Brokers, your involvement will be limited to passing our contact details to your own contacts, in order that they may contact us for quotations, mentioning your referral. As an introducer you are unable to recommend Lansdown Insurance Brokers to your clients, provide insurance advice or help them with their quotations/proposal forms.