Information form for fit & proper-assessment

• Board member

• Board alternate

• Director (elaborate)

• Owner

• Management responsible

• Personally liable partner

• General agent

• Responsible for the credit area

• Compliance responsible

• Risk manager

• AML manager

• Internal audit manager

• Member of the actual management

• Other key function (elaborate)

• Insurance intermediary

• Responsible for insurance intermediary

• Actuary

This form must be submitted individually for each application. Are you applying for several positions, you must enclose a statement on this under section N “other relevant information”.

• Enclose a copy of your passport, if you do not have a CPR/Danish civil reg. Number.

• If you have previously undergone a fit & proper-assessment in another EU/EEA country, you must provide proof of this, e.g. by presenting the relevant decision.

• CV

• If the application relates to a position as director or key function, the company must prepare a brief statement about your suitability for the position.

• If you have relationships with other companies or individuals which may give rise to conflicts of interest, you must enclose a statement on this.

• Certificate of criminal record.

• If you have been convicted or charged by a Danish or foreign court, you must enclose a statement on this.

• If you are registered as a bad payer or have arrears, you must enclose a statement on this.

• Further matters for the evaluation of the application must be enclosed in a statement of facts and relevant documentation.