Intermediary Registration Form

Please use this form to register your Firm to submit mortgage business or amend details of your existing registration with the Vernon.

Firm Details

Name of Principal Contact *

Name of Firm *

Firm's FCA Number *

Registered address

House Name/No *

Postcode *

Address Line 1 *

Address Line 2

Town/City *

County

Country

Telephone Number *

Email Address *

Are you an Appointed Representative or Directly Authorised? *

Please select your network *

If other, please state

The FCA number of your Network *

Are you directly authorised?

Payment terms: Procuration fees will be paid to the Intermediary by BACS credit in the month following completion of the mortgage.

Sort Code *

Account Number *

Account Name *

Bank / Building Society Name *

Email address (for notification of payment) *

Do you use a mortgage club? *

If other, please state

The Intermediary’s Obligations

The intermediary warrants and represents that it:

is the agent of its Client and has the authority to act on behalf of its Client.
holds all relevant legal, regulatory, and other authorisations necessary for carrying out its business and for referring business to us.
conducts its business in accordance with the requirements of all relevant laws and regulations.

The intermediary agrees to inform us immediately in the event that:

it ceases to act on behalf of its Client.
its relevant permissions and authorisations to carry out its business are revoked or amended.
any personnel, employee, consultant, or partner in the Intermediary’s business are charged with any offence involving fraud or dishonesty or are investigated or disciplined by the FCA or where any of its authorisations, registrations, or permissions needed to conduct all or part of its business lawfully are not current or are believed to be in jeopardy.
an Adviser leaves or ceases to be authorised to advise.
it commits a material breach of any laws or regulations.

The intermediary undertakes to:

comply with the lending policy as notified by us.
act honestly and professionally in the interests of the client, including (but not limited to) ensuring that the mortgage is suitable for its clients where the intermediary gives advice.
give its best endeavours to provide information to us which is true and complete in all material respects. The Intermediary will advise us as soon as it is aware that such information is or becomes untrue or incomplete.
carry adequate insurance cover with a reputable insurer to cover all of its insurable liability under this agreement and for 6 years after the intermediary stops introducing business. The policy and premium receipts should be made available for inspection by us at any time.

Please confirm you have read and agree to the above *

I agree

Marketing Preferences

Would you like to receive occasional updates about Vernon Building Society intermediary products, services, and news?

By Phone *

Yes

No

By Email *

Yes

No

By Direct Mail *

Yes

No

You can unsubscribe at any time by emailing communications@thevernon.co.uk, calling 0161 429 6262, or writing to Marketing Communications, Vernon Building Society, 19 St Petersgate, Stockport, SK1 1HF. For information on how we use your data, see our Privacy Policy.

I confirm that I have read the above Privacy Policy document *

I confirm

Super Users

Once this registration form has been completed, all advisers at the firm will need to register individually on The Vernon's Broker Online service. The system allows up to two users within your firm to have ‘Super User’ status. Super Users are able to view the application data and progress of all registered users within your firm.

Please state the names of up to two individuals who require this facility.

Super User 1

Super User 2

Declaration

The firm holds current authorisation from the Financial Conduct Authority (FCA) for advising on and arranging mortgages or the firm is an Appointed Representative of an organisation authorised by the FCA for conducting such activities.

The firm agrees that in accordance with Money Laundering Regulations 2007, together with the guidance notes issued by the Joint Money Laundering Steering Group (JMLSG) that the firm will verify and record the identity of all mortgage applicants before passing the application to the Society and forwarding the required documentation.

The firm confirms that we will notify the Society immediately if: any of its permissions are withdrawn, it is under investigation for breach of the Financial Services and Markets Act 2000 or investigation by any other regulatory body.

The firm confirms that they have read and accepted the Society’s Intermediary Data Protection Agreement.

The firm declares that the information given in this document and in any separate documents is true and complete.

The completion of this form is approved by the Managing Director, or a suitably authorised individual within the firm, who is a named indiviudal on the Financial Services Register. Their details are:

Adviser's Name *

Position *

Principal's Individual Reference Number *

Date *

By submitting this registration form, I confirm that I have the authority of both the Firm and the Managing Director or other Senior Manager, who is a suitably authorised individual, named on the FCA Financial Services Register.

I, the Firm and its authorised persons agree to the declarations outlined above. *

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Intermediary Registration Form