ICIFA | The Institute of Certified Investment and Financial Analysts

Please select the following sections that apply to you. Ensure you submit more details for any entries that you select.

Have you been refused the right or restricted in your own right to carry business or profession for which you are registered or other authorization as required by law in any jurisdiction?

Have you been issued with a prohibition or faced disciplinary proceedings under any law or has been prohibited for operating in another jurisdiction by any regulatory authority?

Have you, in Kenya or elsewhere, been dismissed from any office or employment, or been subjected to disciplinary proceedings by your employer or barred from entry to any profession or occupation?

Has an adverse finding been made against you at any time preceding the date of this questionnaire in any civil or criminal proceedings by a court of law ( whether in the Republic of Kenya or elsewhere) in which you were found to have acted fraudulently, dishonesty, unprofessionally, dishonourably or in breach of a fiduciary duty?

Have you at any time preceding the date of this questionnaire been found guilty by any professional or financial services industry body (whether in the Republic of Kenya or elsewhere) of an act of dishonesty, negligence, incompetence or mismanagement?

Have you at any time preceding the date of this questionnaire ever been found to have contravened the provision of any law designed for the protection of members of the public against financial loss due to dishonesty or incompetence of, or malpractice by, persons engaged in transactions with marketable securities?

Has any entity with which you were associated as a director, shareholder or manager in any country made any compromise or arrangement with its creditors, been wound up or otherwise ceased business either while you were associated with it or within one year after you ceased to be associated with it?

Have you, or has any entity with which you are, or have been associated as a director, shareholder or manager, been the subject of an investigation, in any country, by a government department or agency, professional association or other regulatory body?

Are you presently, or do you, other than in a professional capacity, expect to be engaged in any litigation in any country?

Have you ever taken part in or been associated with any business practice that is fraudulent, prejudicial or which otherwise could be viewed to have discredited your methods of doing business?

Have you ever taken part or been associated with any other business practice as would, or have you otherwise conducted yourself in such a manner as to cast doubt on your competence and soundness of judgement?

Do you have any additional information, which should be brought to the attention of the Institute of Certified Investment and Financial Analysts which may have an impact on the evaluation by the Institute of your good character, integrity and professional conduct?If so give particulars
The omission of material facts may represent the provision of misleading information.

Confidentiality

The information given in response of this questionnaire shall be kept confidential by the Institute of Certified Investment and Financial Analysts in cases provided for by law.

Declaration

I am aware that it is an offence to knowingly or recklessly provide any information, which is false or misleading. I am also aware that omitting material information intentionally shall be construed to be an offence and may lead to termination of my registration.

I certify that the information given above is complete and accurate and to the best of my knowledge, and that there are no other facts relevant to this submission of which the ICIFA Council should be aware. I undertake to inform the Institute of any changes material to my continued membership as they arise.

Name *

Dated *

Fit and Proper Form

Member Details

Confidentiality

Declaration