Join TripleA
First Name
Last Name
Preferred Name
Gender
Male
Female
Business Search
Search for your company name here
Other Trading Names
Email
One unique email address is required for each member
Password
8 or more characters, both letters and numbers
Password Confirmation
Please re-enter your password for verification.
Personal Details
Date Of Birth
Physical Address
Website
If your company has a website, please enter the URL here
LinkedIn URL
Mobile
Landline
Permission To Promote
No
Yes
We have a members directory on our website (our most visited page) which helps promote you and the services you offer clients. Tick this box if you want to be promoted on our members directory.
Financial Services Industry Details
Adviser Type
Financial Adviser (employee)
Financial Adviser (contractor)
Nominated Representative
Other
Year Started in Industry
2024
2023
2022
2021
2020
2019
2018
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2016
2015
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2012
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1942
1941
1940
Adviser FSP No.
If you have an FSPR number this field must be completed.
FAP Licence Number
Note: This is NOT your company FSP number, but rather the number indicated on the letter you received from the FMA when you registered your licence.
FAP Licence Holder Name
License Type
Full Licence
Transitional Licence
Other
Licence Type Note
If your License Type is 'Other', please explain here.
Company FSP Number
Dispute Resolution
N/A
Insurance and Savings Ombudsman (IFSO)
Financial Dispute Resolution (FDR)
Financial Services Complaints Ltd (FSCL)
Other
Your current Disputes Resolution service
References
Please provide two Industry related references - one personal and one Provider you work with. Provide name, job title, their relationship to you, and a contact number or email address for each reference.
% Fire & General
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Please indicate approximately what percentage of your turnover do you expect to come from Fire & General.
Fire & General cont.
Increase
Stay the same
Decrease
In the next two years, do you expect this percentage to ...
% Mortgage
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Please indicate approximately what percentage of your turnover do you expect to come from Mortgage broking.
Mortgage cont.
Increase
Stay the same
Decrease
In the next two years, do you expect this percentage to ...
What CRM (customer relationship management) software do you use?
What software compliance tools do you use?
What software analysis tools do you use?
Which Product providers do you use?
Interested in locum service
Yes
No
Maybe
Are you interested in using a locum service provided by the TripleA?
Willing to be a locum
Yes
No
Maybe
Are you willing to be a TripleA approved locum?
Declarations
I have read and accept
the TripleA Code of Conduct.
No
Yes
Have you ever been bankrupt, declared or not?
No
Yes
Have you ever been the Owner, Manager or Director of a business that has been insolvent?
No
Yes
Have you been an Officer of a company wound up by the courts?
No
Yes
Have you been convicted of any criminal offence, other than minor traffic violations?
No
Yes
Have you ever been refused an agency or agreement with any Company or Organisation?
No
Yes
Have you ever been refused professional indemnity (PI) insurance, or had a PI claim lodged and upheld against you?
No
Yes
Have you ever been disciplined, dismissed or had a complaint lodged and upheld by a professional body, employer or disputes resolution service on ethical, legal or any other grounds?
No
Yes
Are you aware of any matters that may impact upon the Association's consideration of your application not covered above?
No
Yes
Details
If yes to any of the above please provide details.
Services
Select the financial services you provide to your customers
Personal Insurance
Business Insurance
Investment Advice
Kiwisaver
Direct investments
Financial & retirement planning
Pensions
Budgeting, debt & cash management
Mortgages
Home equity release
Tax advice
DIMS
Professional Indemnity Scheme
Applying for PI?
No
Yes
Are you intending to apply to join the TripleA's PI scheme?
Work History
Just bullet point the main organisations, role, length or service and years you worked for each organisation.
PI Coverage History
If you have had PI cover previously just briefly bullet point which roles this related to and if possible who provided your PI cover at the time.
PI Claims History
Please provide a summary of any historic PI claims or notifications made against you in previous roles.
I have read and accept the
PI Scheme Conditions
.
No
Yes
I can confirm I have no criminal history, current client complaints, pending claims, bankruptcy history or other issues with the FMA or other disputes process, either in New Zealand or overseas, that might have a bearing on this application.
No
Yes
Where necessary I authorise TripleA to conduct credit, police or companies office checks in addition to the check outlined above. TripleA will notify me of any associated costs.
No
Yes
I understand that TripleA reserves the right, at its sole discretion, to decline PI coverage for any reason. No PI cover exists until this application is approved in writing
and
the relevant PI scheme premium is paid to the TripleA Advisers Association
No
Yes
Details
If No to any of the above please provide details or reasons why you are unable to agree to this declaration.
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