Become a Member APPLICATION FOR MEMBERSHIP TO THE CYPRUS FIDUCIARY ASSOCIATION CYFA MEMBERSHIP FORM 1. Administrative Services Provider (ASP) detailsName: *Supervisory Authority: License/ Application No: *Address: Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryIncorporation date: Telephone: *Fax: Email: *Website: In case ASP is part of a Group of companies / Professional network:Name of Group/ Network: Countries represented: 2. Operational detailsNumber of staff: How many client entities (companies, trusts, etc.) do you manage? Cyprus Foreign Note 1: Management is included in its broadest sense and covers not only full management but also specific services only, such as directorship, corporate administration, etc. Note 2: The ratio of the number of client entities managed to the number of staff employed by the ASP should ensure the capability of the ASP to provide quality services to its clients.Name(s) and nationality of Director(s):Director(1): Nationality Director(2): Nationality Director(3): Nationality Name(s) and nationality of Principals (other than Directors):Principals(1) Nationality Principals(2) Nationality Principals(3) Nationality Name and contact details of 1-3 persons representing the Firm with the CYFA, being Directors or executives employed by the applicant (“Representatives”)Person(1): Contact Details: Person(2): Contact Details: Person(3): Contact Details: Details on the Compliance Officer, Lawyer, and Internal Audit functionCompliance Officer Name: In-house External Lawyer Name: In-house External Internal Auditor Name: In-house External Does the Firm have Professional Indemnity Insurance currently in force? YESNOIf yes, please specify Limit of coverage: Per Claim(€): In The Aggregate(€): Does the Firm or any Director or Officer have ‘Directors & Officers Liability Insurance’ currently in force? YESNOIf yes, please specify Limit of coverage: Per Claim(€): In The Aggregate(€): Note: Please submit copies of your abovementioned insurance covers. Motivation why Firm wishes to become member of the CYFA (optional). Any other considerations to be taken into account: *Declaration: By signing, the ASP agrees to adhere by the Membership Requirements and Code of Conduct of the CYFA. A registration fee of EUR500 is payable upon submission of the form and it is non-refundable. VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>: