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Welcome to our online application form to join Financial Dispute Resolution Service.

Please note that you must complete your FSPR registration first in order to provide us with your FSP number.

Once you have completed your application, our membership team will be in touch to discuss your membership, advise on any membership fees and to provide confirmation of membership, which will enable you to complete your FSPR obligations. Click here for information on membership fees, annual renewal fees and complaint fees.

At any point if you would like some assistance, simply phone us on 0508 337 337  or email  enquiries@fdrs.org.nz

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Membership Information

Are you transferring form another financial Dispute Resolution Scheme? *

YesNo

If yes, please provide the name of the other Dispute Resolution Scheme *

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What is your FSP Number? *

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Please also select the date you are paid to so that we can calculate the correct level of annual fee *

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What is the FSP Number registered as? *

IndividualFAP Entity (Provides DRS Cover)FAP Entity (No DRS Cover)Entity who is not a FAP

Your Contact Information

Your name: *

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Your contact email address: *

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Your contact phone number: *

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Registered business Name: *

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Registered business address: *

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Trading as:Please use the add more option below if more than one

FAP Contact Information

FAP name:

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Contact person name:

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Contact email address:

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Contact phone number:

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Financial Services Information

Please select the financial services you provide from the following :

(Tick all that apply)

Creditor under a credit contract *

YesNo

What is the total book value? *If you selected Creditor under a credit contract please provide this

Which contract type/s? *

Consumer credit contractNon-consumer credit contract

Client money or property service *

YesNo

Services: *

Custodial service – retail serviceCustodial service – wholesale serviceNon-custodial service – retail serviceNon-custodial service – wholesale service

You may select more than one

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Wholesale and/or generic financial advice service *

YesNo

Wholesale and/or generic financial advice service provider type/s: *

Financial Advice Provider – licensee – full license Financial Advice Provider – licensed – Authorised Body under full license Financial Advice Provider – wholesale service Financial Advice Provider – relying on exemption from licensing

You may select more than one

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Financial Adviser *

YesNo

Financial Advisor Provider type/s: *

Financial Advice Provider – licensee – full licenseFinancial Advice Provider – licensed – Authorised Body under full licenseFinancial Advice Provider – wholesale serviceFinancial Advice Provider – relying on exemption from licensing

You may select more than one

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Trading financial products or foreign exchange on behalf of other persons *

YesNo

Which market type/s? *

Trading on licensed marketsOther than trading on licensed markets

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Please select the licence type/s you provide the above selected services under:

Offeror under an FMC offerProvider of prescribed intermediary services – licensedNon-bank deposit takerManager of a registered scheme - licensedDerivatives issuer – licensedDIMS Provider - licensedInvestment manager under an FMC OfferIssuer under an FMC OfferCustodian of a registered scheme or DIMsFinancial Advice Provider – licensee – traditional licenseFinancial Advice Provider – licensed – Authorised Body under transitional licenseSupervisor under an FMC OfferSupervisor under an FMC OfferIndependent trustee of a restricted scheme – licensedChanging foreign currencyGiving financial guaranteesIssues and managing means of paymentKeeping, investing, administering, or managing money, securities or investment portfolios on behalf of other personsOperating a money or value transfer serviceProviding forward foreign exchange contracts.

You may select more than one

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Membership Contact Information

General contact information

Who do we contact regarding general FDRS related information?

Name of contact: *

Email: *

Phone: *

Postal Address:

Website address:

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Complaint contact information

Who do we contact if we receive a complaint about you?

Details as above

Name: *

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Email: *

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Phone:

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Invoicing contact information

Who do we charge complaint fees to?

Same as general contact information

Same as complaint contact information

Name: *

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Email: *

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Phone:

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Who do we charge membership fees to?

Same as general contact information

Same as complaint contact information

Name *

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Email: *

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Phone:

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Additional Financial Advisers Information

Are you registering any additional financial advisers or nominated representatives? *

YesNo

For the DRS Membership we require that you complete the Advisor and/or Nominated Representatives Schedule.

Once completed and submitted, please return to this form, to continue filling out your details.

Please click here to complete the schedule.

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Confirmation and Acknowledgement

I/We confirm that the information provided is correct and can be relied upon by Fair Way to set up my/our membership of the Financial Dispute Resolution Service (FDRS) scheme *

I/We agree to update Fair Way of any changes to licensing conditions/details as soon as practicable after they change *

I/We confirm and acknowledge acceptance of the FDRS Scheme Rules and the FDRS Terms and Conditions, as amended from time to time *

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