Probitas Pacific | Apply to Trade

Onboarding Application Form

Trade with Probitas Pacific

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Legal Entity Name**

AFSL Holder Legal Entity Name (If different from above)*

Australian Business Number*

Australian Financial Services Licence Number*

Corporate Authorised Representative Number (if relevant)

Authorised Representative Number (if relevant)

Principal Business Address*

Broker Cluster Group*

Primary Contact Details

First Name **

Surname **

Email Address*

Contact Number*

Name

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Probitas Syndicate 1492 is managed at Lloyd’s by Probitas Managing Agency Limited. Probitas Managing Agency Limited is registered in England and Wales (No. 12242600) at 88 Leadenhall Street, London, EC3A 3BP and is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority (Firm Reference Number 931446). Probitas 1492 (Pacific) Pty Ltd (ABN 82 663 993 244) is registered in Australia and is a Lloyd’s approved service company and coverholder of Probitas Managing Agency Limited. Probitas 1492 (Pacific) Pty Ltd is regulated in Australia by the Australian Securities and Investments Commission (Licence No: 545082). We may process your personal data. For information on how your personal data is used and the rights that you have please see the Privacy Notice. If you are providing personal data to us on behalf of another individual, you must provide this Privacy Notice to them. Please find our Terms of Trade here.