Appendix 17 - FSM Dealer Application Completing this application This form must be completed for an application for designation as an FSM Dealer. Please read and follow all instructions. If you need assistance with your application, please contact NZX Participant Compliance on or +64 4 498 2279. All information provided to NZX in relation to this application will be kept confidential, except to the extent that disclosure of any or all of the information provided is necessary for the exercise of NZX’s regulatory functions, or as required by law. NZX reserves the right to decline an application even if it meets the prescribed minimum criteria. Completed application forms (together with any supporting information) should be emailed to or uploaded to the NZX Participant reporting platform. Checklist Please ensure that the following documentation and information has been provided: Application form has been completed and the undertaking signed by the Applicant Undertaking has been signed by the Market Participant’s Managing Principal Evidence of the Applicant’s qualifications and professional memberships Applicant’s CV outlining employment history and experience Details of any adverse or potentially adverse matters in relation to the Applicant which have been brought to the attention of any relevant regulatory authorities during the last 6 years Any relevant information in relation to this application Applicant Details
Appendix 17 - FSM Dealer Application Completing this application This form must be completed for an application for designation as an FSM Dealer. Please read and follow all instructions. If you need assistance with your application, please contact NZX Participant Compliance on or +64 4 498 2279. All information provided to NZX in relation to this application will be kept confidential, except to the extent that disclosure of any or all of the information provided is necessary for the exercise of NZX’s regulatory functions, or as required by law. NZX reserves the right to decline an application even if it meets the prescribed minimum criteria. Completed application forms (together with any supporting information) should be emailed to or uploaded to the NZX Participant reporting platform. Checklist Please ensure that the following documentation and information has been provided: Application form has been completed and the undertaking signed by the Applicant Undertaking has been signed by the Market Participant’s Managing Principal Evidence of the Applicant’s qualifications and professional memberships Applicant’s CV outlining employment history and experience Details of any adverse or potentially adverse matters in relation to the Applicant which have been brought to the attention of any relevant regulatory authorities during the last 6 years Any relevant information in relation to this application Applicant Details
Appendix_17_-_FSM_Dealer_Application.docx