SUP 10A Annex 4 Form A: Application to perform controlled functions under the approved person regime

This annex consists only of one or more forms. Note that there are separate forms for Solvency II firms, large and small non-directive insurers, incoming EEA firms and other firms. Swiss general insurers must use the forms for large non-directive insurers not the form for Solvency II firms.3 It also includes the scope of responsibilities form which must be included as an attachment to Form A in certain cases.1 Form A: Notes for completion (March 2016)

Long Form A for Solvency II firms (excluding incoming EEA firms and large non-directive insurers)2:

Long Form A - Solvency II firms only2

Short Form A for Solvency II firms (excluding incoming EEA firms and large non-directive insurers)2:

Short Form A: UK and Overseas Firms (not incoming EEA) (March 2016)

Short Form A: Incoming EEA firms (March 2016)

Long Form A for large non-directive insurers:2

Long Form A - large non-directive insurers2

Short Form A for large non-directive insurers:2

Short Form A - large non-directive insurers

Long Form A for small non-directive insurers:2

Long Form A - small non-directive insurers

Short Form A for small non-directive insurers:2

Short Form A - small non-directive insurers2

Scope of responsibilities form for Solvency II firms2:

Solvency II Firms: Scope of responsibilities2

Scope of responsibilities form for large non-directive insurers:2

Scope of responsibilities form - large non-directive insurers2

Scope of responsibilities form for small non-directive insurers:2

Scope of responsibilities form - small non-directive insurers2

Long Form A - UK and Overseas Firms (not Incoming EEA)

Long Form A - Incoming EEA only

Long Form A - UK Firms (Relevant Authorised Persons only)

Long Form A: UK firms (March 2016)

Long Form A for firms which are not Solvency II firms (including large non-directive insurers) or small non-directive insurers2

(and are not incoming EEA firms or2

Relevant Authorised persons)1

Short Form A for firms which are not Solvency II firms (including large non-directive insurers) or small non-directive insurers2 (and are not incoming EEA firms or2

Relevant Authorised persons)1

Long Form A for incoming EEA firms2

Short Form A for incoming EEA firms2