|Add PSD agent form |
|Application under regulation 29 of The Payment Services Regulations 2009 |
|Firm name (i.e. name of PI) | (the firm) |
|Firm reference number (FRN) | |
|Address | |
Terms in this form
This form uses the following terms:
• ‘PSD’ refers to directive 2007/64/EC of the European Parliament and of the council of 13 November 2007 on payment services in the internal market amending Directives 97/7/EC, 2002/65/EC, 2005/60/EC and 2006/48/EC and repealing Directive 97/5/EC • ‘PI’ refers to Payment Institution • ‘EEA’ refers to European Economic Area
Please return the form by e-mail to ‘psd-agent@fsa.gov.uk’
Address: Regulatory Transactions & Systems Support The Financial Services Authority 25 The North Colonnade Canary Wharf London E14 5HS
Registered as a Limited Company in England and Wales No 1920623. Registered Office as above.
Notes
This form should be used to notify of a new agent of a Payment Institution. It is the responsibility of the payment institution to complete and submit this form on behalf of the agent.
Personal details Section A
|1 |Contact name at the PI (this is not necessarily the same person making | |
| |the declaration at the end of the form) | |
|2 |Contact's details: | |
| |a |position in the firm | |
| |b |daytime telephone number | |
| |c |email address | |
| |d |Individual reference number (IRN) | |
| | |[if applicable] | |
Agent details Section B
|1 |Agent name, or in the case of a sole trader, the individual’s name | |
|2 |If the agent is on the FSA Register, please provide its firm reference number (FRN) | |
|3 |Address (include country if not UK) | |
| | | |
| | | |
| | | Postcode/Zip: |
|4 |Trading
