Declaration (Annual Attestation for Directors & Senior Managers)

The purpose of this document is to complete your annual fit and proper attestation as a director or senior manager of Maurice Trapp Group & Mortgage Lab.It is split into three sections.Training and Professional Development.Individual DeclarationRegulatory DeclarationPlease select yes or no for each question. If any answer is Yes, you must provide full details. You must answer each question in relation to both New Zealand and/or other jurisdictions.
Your Name

First NameLast Name
Training & Professional Development Questions
Are you currently a member of a professional body?

YesNo
Have you completed training and/or professional development in the past 12 months directly relevant to your role with MTG/MLab?

YesNo
Have you maintained compliance with MTG’s prescribed learning modules?

YesNo
Type a question
Regulatory Questions
Have you ever been charged with or convicted of (in New Zealand or overseas) a criminal offence relating to dishonesty, fraud, or misleading or deceptive conduct?

YesNo
Have you ever been convicted (in New Zealand or overseas) of any offence for which you were sentenced to, were liable to be sentenced to, a term of imprisonment (even if you were not imprisoned)?

YesNo
Have you ever been convicted (in New Zealand or overseas) of any offence for which you were sentenced to, were liable to be sentenced to, a term of imprisonment (even if you were not imprisoned)?

YesNo
Have you ever been charged with or convicted of an offence, or subject to a proceeding in New Zealand under any financial markets legislation, as defined in the Financial Markets Authority Act 2011?

YesNo
Have you ever been charged with or convicted of an offence, or subject to a proceeding in another jurisdiction under any financial markets legislation equivalent to that referred to in the question above?

YesNo
Have you ever been the subject of any civil proceedings (in New Zealand or overseas) for conduct relating to dishonesty, fraud, or misleading or deceptive conduct?

YesNo
Have you ever been the subject of any proceedings or action taken by a regulatory authority in New Zealand, or overseas?

YesNo
In the last 15 years have you been (in New Zealand or overseas) a trustee, director/partner of, or held any position of senior management in, any company or other incorporated/unincorporated entity which, while you were connected to that entity was placed into liquidation, administration, receivership or statutory management (or any overseas equivalent status), or entered into any compromise agreement, moratorium or other restructuring to avoid liquidation, administration or receivership (or any overseas equivalent)?

YesNo
Have you ever been banned (in New Zealand or overseas) from providing financial services, or, acting as director of a company or other incorporated body, or, being involved in the management of any class of incorporated or unincorporated entity?

YesNo
Have you ever been dismissed, asked to resign, or subject to disciplinary proceedings resulting from, or in respect of, a position of trust, fiduciary appointment or similar (in New Zealand or overseas)?

YesNo
Have you ever been refused registration, other entry into, or restricted from the right to carry on in, any profession or occupation under the law of the country, or under the membership rules of any professional body at any time (in New Zealand or overseas)?

YesNo
In the last 15 years have you been made bankrupt, entered into a compromise agreement with creditors or been placed into statutory management (in New Zealand or overseas)?

YesNo
Are you subject to any pending proceedings or actions (in New Zealand or overseas) that mean you would have to answer YES to any of the above questions if an adverse finding is reached?

YesNo
Details
A PEP is a person, an immediate family member of that person, or someone who has close business ties to that person, who is or has been (in the last 12 months) in a prominent public function in an overseas country. For example, a head of state, senior politician, or an official with a public profile.
To the best of my knowledge, I am not a Politically Exposed Person as per the definition above.

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Training & Professional Development Questions

Regulatory Questions