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Up to May 31 2005Jun 1 2005 - Mar 22 2006

PFN SUP 3 Application for approval for a Cell of a Protected Cell Company — Insurance



Past version: effective from Jun 1 2005 - Mar 22 2006.
To view other versions open the versions tab on the right.

To view past versions of this module in PDF format, please visit the Archive.

Please download the Form in PDF format.

Purpose of this form

An Authorised FirmG wishing to apply for an additional CellG must submit this form.

Contents

This form consists of nine sections:

1. Authorised FirmG details
2. Ownership details
3. Insurance business
4. General
5. Additional information
6. Money LaunderingG declaration
7. Declaration and signature
8. Attachments

Notes for completing this form

  • Defined terms are identified throughout this form by the capitalisation of the initial letter of a word or phrase and are defined in the Glossary module (GLO) of the DFSAG RulebookG .


  • Sections 1, 2, 3, 4, 6 and 7 must be completed.


  • Please use section 5 if you wish to provide additional information that may clarify or support your answers in sections 1-4.


  • Questions must be fully answered and the use of abbreviations should be avoided.


  • Answers must be typed and the form must be signed by the Authorised Firm’s Senior Executive OfficerG .


  • Please ensure any supporting documentation is clearly labelled and securely attached.


  • When completed, submit this application form in line with SUP chapter 9. You may send applications by post or hand delivered and addressed to your usual supervisory contact.


The address for postal submission is:

DUBAI FINANCIAL SERVICES AUTHORITY
AUTHORISATION DEPARTMENT
LEVEL 13, THE GATE
PO BOX 75850
DUBAI, UAE


Derived from DFSA RM11/2004 (Made 16th September 2004). [VER1/09-04]
[Amended][VER4/06-05]