Intermediary Application – Unisure Solutions

EU Intermediary Application

Please refer to the Data Protection Policy for details of how Unisure Solutions collects, holds and processes Personal Data.

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INTERMEDIARY PROFILE

Full registered name of Intermediary

Trading name if different

Was the entity ever registered under a different name?

Type of corporation (e.g. Limited Company, Sole Trader, etc)

Date incorporated

Registration Number

Country of Incorporation

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Legal Information

Cookie Policy

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Unisure Solutions Fried E.U (“Unisure Solutions”)
Owner Hermann Fried
Commercial register in Vienna, Austria FN 518802w

Unisure Solutions Fried is a registered insurance broker under the laws of Austria and registered under 32231632 in the GISA Trade Register. Unisure Solutions is licensed to passport its services to all EEA countries exclusively via Intermediaries authorised by Unisure Solutions.

The sale in all EEA countries is exclusively made via Intermediaries authorised by Unisure Solutions.

Unisure Solutions Fried E.U (“Unisure Solutions”)
Owner Hermann Fried
Commercial register in Vienna, Austria FN 518802w

The sale in all EEA countries is exclusively made via Intermediaries authorised by Unisure Solutions.

EU Intermediary Application

INTERMEDIARY PROFILE

Registered Address

Correspondence Address

Intermediary Principal Contact 1

Intermediary Principal Contact 2

Intermediary Administration Contact

Full name of each Director (or equivalent)

Full name of each Shareholder / Beneficial Owner representing at least 25% of voting equity (please ensure that each Ultimate Beneficial Owner is identified):

SUPERVISORY AUTHORITY DETAILS

PROFESSIONAL INDEMNITY COVER

DOCUMENTS TO BE UPLOADED

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