Individual Membership Application
This form is to be completed by every financial adviser and every director of the Financial Advice Provider (FAP) business that intends on joining KAN.
Personal Details
Which best describes your relationship with the FAP Business that is a member or prospective member of KAN?
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I am a financial adviser on behalf of the FAP Business.
I am a financial adviser AND a director of the FAP Business.
I am a non-advising director of the FAP Business.
Your name
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First Name
Middle Name
Last Name
Preferred name (If applicable)
Email address
*
example@example.com
Mobile phone number
*
Date of Birth
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Day
-
Month
Year
Are you a NZ Citizen?
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Yes
No
Home address
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Street Address
Street Address Line 2
City
Postal / Zip Code
Your FSPR number
e.g. FSP999999. If you are in the process of applying for your FSP number, type "00000"
Dispute Resolution Scheme you belong to:
If you are new to industry and have yet to apply for DRS, put "TBC"
Legal company name of the business you will provide regulated financial advice on behalf of
*
This will be the name of the business/FAP name that appears on the companies register and FSPR. e.g. not KAN, your branded business. If you are moving off an AB licence, put the future business/FAP name here
Are you a member of any industry bodies? (please specify):
For example FANZ
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Advice Types & Education
Which types of regulated financial advice will you provide to clients?
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Financial Advice on Mortgage Products / Consumer Credit Contracts
Financial Advice on Personal & Business Risk Insurance Advice
Switching funds within a Managed Investment Scheme (including KiwiSaver)
Financial Planning
Other
Which NZCFS Level 5 Education qualifications have you already completed relevant to your role as a Financial Adviser
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Core Module
Residential Property Lending Strand
Life, Health & Disability Strand
Investment Strand
Financial Advice Strand
Other
If you have not completed all of your required study, please outline your plan for when you expect to have it completed (if applicable):
As a member of KAN you will need to be working toward completing your CORE module, plus all applicable strands based on the types of regulated financial advice you provide. Please outline when you plan on completing your outstanding education, and with which provider.
Mortgage and Residential Lending
Number of years practical lending experience
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Institutions where this lending experience was gained (which bank etc.)
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Please enter company, role, and date. If you have worked at a bank and you are applying for new accreditions (not a transfer), it can take between 4-12 weeks for the banks to process your application
Do you have any existing accreditations?
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Yes
No
Which lenders do you currently hold accreditations with?
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ANZ
ASB
Westpac
BNZ
AIA/Sovereign Home Loans
Avanti Finance
ASAP Finance
Bank Of China
Basecorp
Bluestone
Co-operative Bank
Cressida Capital
DBR
First Mortgage Trust
Funding Partners
Heartland Bank
HSBC
Kiwibank
Liberty
NZ Home Loans
Pepper Money
Plus Finance
Resimac
SBS
Southern Cross Partners
TSB
China Construction Bank (CCB)
ICBC
Unity
BizCap
Other
Of the lenders you are not currently accredited with, are there any you would like us to help you become accredited with during your onboarding? Please select any that apply.
ANZ
ASB
Westpac
BNZ
ASAP Finance
Avanti Finance
Bank Of China
Basecorp
Co-operative Bank
Cressida Capital
DBR
First Mortgage Trust
Funding Partners
Heartland Bank
Pepper Money
Plus Finance
Prospa
Resimac
SBS
Southern Cross Partners
Liberty
China Construction Bank (CCB)
ICBC
Bluestone
TSB
Kiwibank
Unity
BizCap
Why do you not hold accreditations with all of the big four lenders (ANZ, ASB, BNZ, Westpac)?
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KAN members need to be accredited with the main four lenders as a minimum i.e. ANZ, ASB, BNZ, and Westpac, or have a good reason as to why they are not accredited. If you currently do not have an accreditation with any these providers, please can you tell us why? Have you approached one of these lenders before and been declined, or had your accreditation revoked? We will find this out during our due diligence process, but it is going to be easier for us to get this information up front.
Personal and Business Risk Insurance
Are you after a Master or a Sub Agency
Master Agency
Sub Agency
Number of years experience advising on personal and business risks
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Institutions where insurance experience was gained
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company, role, and date
Current insurance agencies/sub agencies held
Accuro
AIA/Sovereign
AMP Life
Asteron Life
Chubb
Fidelity Life
NIB NZ
OnePath Life
Partners Life
Southern Cross
Other
Investment and KiwiSaver Advice (Managed Funds)
Number of years experience advising on managed investment funds and KiwiSaver schemes
*
Institutions where this experience was gained
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company, role, and date
Current KiwiSaver and managed fund agencies/sub agencies
Amanah
AMP
ANZ Bank
Aon New Zealand
ASB Group Investments
Booster Investment Management
CRAIGS Investment Partners Select
Fisher Funds Management
Generate Investment Management
JUNO
Mercer KiwiSaver
Milford
New Zealand Funds Management
OneAnswer
Select Wealth Management
Koura
Other
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Documents Required
Please upload a copy of your passport
*
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ID does not need to be verified by a JP but must be a current copy
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Please upload a name-change document (if applicable)
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If your name does not match the name on your passport, please upload a marriage certificate or general name change confirmation document. This is required to evidence your correct legal name if it is not the same as the name listed on your passport.
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Please attach a copy of your New Zealand residency status
*
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Please upload a bank statement as proof of residential address
*
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Must contain your name and address and be no more than 3 months old
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Please upload a copy of your current Professional Indemnity Insurance Certificate (if applicable)
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If you are new to the industry and are in the process of obtaining PI, upload a blank document. Please note, as a member of KAN we require you to hold $2,000,000 per financial adviser as a minimum. Please ensure you increase your cover if it is less than this amount. If PI Cover is in the name of a company, the insurance company must provide a list of the Advisers/ Brokers covered under the policy.
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Please upload evidence of meeting your Level 5 education standards (if completed)
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E.g. NZQA unit standards or certificate of completion from Strategi
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Transferring Mortgage Adviser
Please upload a completed copy of the Transferring Adviser Accreditation form for both the main lenders and non-bank lenders
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Please upload a completed copy of the Clawback Commission Agreement
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Please upload an up to date copy of your CV
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If you do not have a recent CV, we also accept copies of your LinkedIn Experience section or a written list of your work history
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New to Industry Mortgage Adviser Required Documents
Please upload a verified copy of your passport
*
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The copy of your passport should be verified by a trusted referee, e.g. JP, lawyer, accountant.
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Please attach a copy of your New Zealand residency status
*
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Please upload a name-change document (if applicable)
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If your name does not match the name on your passport, please upload a marriage certificate or general name change confirmation document. This is required to evidence your correct legal name if it is not the same as the name listed on your passport.
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Please upload verified bank statement as proof of your residential address
*
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Must contain your name and address and be no more than 3 months old. It should be verified by a trusted referee, e.g. JP, lawyer, accountant.
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Please upload a completed copy of the New Adviser Accreditation form for both the main lenders and the non-bank lenders
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Please upload a completed copy of BNZ and/or Westpac's Mortgage Adviser Test (if you have over 6 months of practical lending experience)
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Please upload an up to date copy of your CV
*
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Please upload a copy of your business plan and mentorship program
*
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This is required if you are a new adviser being accredited for the first time.
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Fit & Proper Adviser Declaration
Fit & Proper Declaration
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Yes
No
Have you ever had an industry or business licence either refused, suspended, withdrawn, cancelled or subject to a banning order in New Zealand or overseas?
Except to the extent that any conviction is affected by the Criminal Records (Clean Slate) Act 2004, have you ever been convicted of an offence involving a criminal charge, or is any such charge pending?
Have you ever been a director of a company that has gone into voluntary liquidation or to a receiver, provisional liquidator, liquidator, scheme manager or an official manager has been appointed while you were a director or within six months that you ceased being a director?
Are you an undischarged bankrupt (in New Zealand or overseas) or have you been declared bankrupt?
Have you ever been refused membership of a statutory, professional or other body in no respect of your professional capacity in New Zealand or overseas?
Have you ever been subject to public disciplinary proceedings or expelled by a statutory body in respect of your professional capacity in New Zealand or overseas?
Have you ever been dismissed as an employee of a financial institution?
Have you any past of pending claims made against your Professional Indemnity Insurance under which you operate in relation to advice you have tendered?
Have you ever been refused Professional Indemnity Insurance?
Have you ever had a complaint upheld by, or have any current unresolved complaints lodged with an approved disputes resolution scheme?
Have you ever been denied membership or had your membership cancelled by a professional association?
Have you ever been denied accreditation or had your accreditation cancelled by a financial institution?
Have you ever been known by another name (maiden name or pseudonym)?
Are you, or any associated person in your business/company, including directors and employees involved in any way in property development or real estate sales?
Are you, or any associated person in your business/company, including directors and employees also acting as an accountant or solicitor?
If you have answered yes to any of the above questions, please provide further details about your answer below:
Please specify the disclosure statement by referring to it in your response
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Privacy Waiver & Authority to Collect Information
I/We acknowledge and authorise that:
Personal information provided to Kiwi Adviser Network Ltd (KAN) and its related or associated companies—whether contained in this application or obtained otherwise—may be collected, held, used, and disclosed for the following purposes:
To assess and make decisions on my/our application to join KAN as a Financial Advice Provider (FAP) or Financial Adviser (FA);
To conduct due diligence, including obtaining information from:
Licensed product providers, insurers, and investment platforms;
Previous or current aggregators, dealer groups, and compliance partners;
The Financial Markets Authority (FMA) and other regulators;
Current and/or former employers;
To verify details relating to conduct, complaints, compliance or disciplinary matters, production or performance history, and other information relevant to assessing my/our fitness and propriety;
To administer any agreements, products, or services I/we engage in with KAN;
To provide my/our contact details to third parties as necessary to process my/our application and support service delivery during the course of my/our agreement.
I/We authorise:
KAN to obtain at any time from any person any information (including credit or criminal checks) relevant to this application and for that person to release such information to KAN;
KAN to retain this information at its head office (23 Aviemore Drive, Highland Park) and/or any regional offices.
I/We understand:
This waiver is provided under the Privacy Act 2020;
Information will be used solely for the purposes of onboarding and managing the relationship with KAN;
I/We have the right to request access to, and correction of, personal information held by KAN;
This authority remains valid for the duration of the application and any resulting engagement, unless revoked by written notice.
I/We declare that:
All information given in this application is true and wish to apply for an Adviser Agreement with KAN Ltd
I/We the undersigned have read and understood this Privacy Act Waiver and Declaration.
Signature
*
Applicant signature
Date
*
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Day
-
Month
Year
Date
Type name in full
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First Name
Middle Name
Last Name
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