High Net Worth Form


STATEMENT FOR CERTIFIED HIGH NET WORTH INDIVIDUAL

I declare that I am a certified high net worth individual for the purposes of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2001.

I understand that this means:

  • I can receive financial promotions that may not have been approved by a person authorised by the Financial Services Authority;
  • the content of such financial promotions may not conform to rules issued by the Financial Services Authority;
  • by signing this statement I may lose significant rights;
  • I may have no right to complain to either of the following: the Financial Services Authority; or the Financial Ombudsman Scheme;
  • I may have no right to seek compensation from the Financial Services Compensation Scheme.

I am a certified high net worth individual because at least one of the following applies:

  • I had, during the financial year immediately preceding the date below, an annual income to the value of £100,000 or more;
  • I held, throughout the financial year immediately preceding the date below, net assets to the value of £250,000 or more. Net assets for these purposes do not include: the property which is my primary residence or any loan secured on that residence; any rights of mine under a qualifying contract of insurance within the meaning of the Financial Services and Markets Act 2000 (Regulated Activities) Order 2001; or any benefits (in the form of pensions or otherwise) which are payable on the termination of my service or on my death or retirement and to which I am (or my dependants are), or may be, entitled.

I accept that I can lose my property and other assets from making investment decisions based on financial promotions.

I am aware that it is open to me to seek advice from someone who specialises in advising on investments.

Leave this empty:

Signature Certificate
Document name: High Net Worth Form
Unique Document ID: fff7a7134b1ea845206a04d896dbb1a2a7da2716
Timestamp Audit
December 16, 2017 9:44 am BSTHigh Net Worth Form Uploaded by Ray Hipple - general@westportinvest.co.uk IP 2a00:23c3:3b:1101:659e:7b56:9c2a:3012