APPOINTED REPRESENTATIVE AGREEMENT

[Option: TIED AGENCY AGREEMENT]

This Appointed Representative Agreement is dated as of the _____ day of ________20____

PARTIES

[FULL COMPANY NAME] incorporated and registered in England and Wales with company number [NUMBER] whose registered office is at [REGISTERED OFFICE ADDRESS] (“Principal”); and

[APPOINTED REPRESENTATIVE COMPANY NAME] incorporated and registered in [JURISDICTION] with company number __________________whose registered office is at ________________________________ (“Appointed Representative”)

BACKGROUND

The Principal is authorised and regulated by the FCA [Option: reference to applicable provisions of the ESMA] (with FCA reference number [NUMBER]) to carry on the following regulated activities: [RELEVANT ACTIVITIES__________________________________].

The Principal wishes to appoint the Appointed Representative as its appointed representative for the purposes of section 39 of FSMA under the terms of this agreement and the Appointed Representative wishes to accept the appointment.

AGREED TERMS

DEFINITIONS AND INTERPRETATION

The following definitions and rules of interpretation apply in this agreement.

Definitions:

“Applicable Laws and Regulations”: all laws, rules and regulations applicable from time to time to either party in relation to this agreement.