Confirmation of a proposed appointment to a senior position

This form should be completed to confirm to Lloyd's that an FSA Approved Persons application has been approved.

A confirmation page will appear upon successful completion of this form.

All fields are mandatory. Where a field does not apply please enter N/A.

Confirmation of a proposed appointment to a senior position
Name of underwriting agent
Name(s) of corporate members (if appointee will be a director of a corporate member)
Title
First name
Middle name / Initial
Last name
Job title
Date of FSA approval
FSA Individual Reference Number
Contact details of person completing the form
Name
Job title
Email address
Telephone
Last updated on 19 Jan 2010