Application Form & FSMA Certficates for Individual Investors

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Angels 5k membership
application form

As an individual investor, you have satisfy certain legal requirements in order to become a member of Angels 5K. The Financial Services and Markets Act 2000 (“FSMA”) and the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005 (as amended) (“FSMAO”) require individuals seeking to make angel investments in SMEs to provide evidence that they are a “certified high net worth individual” or “self-certified sophisticated investor” or a “certified sophisticated investor”. In the latter case, you are certified by an FSMA authorised person. If you are either a certified high net worth individual or a certified sophisticated investor, then you are exempt from the provisions of the FSMA. For more on this, visit the Financial Conduct Authority website.

To satisfy the requirements of the FSMA you must sign a certificate using the wording in one of the following two documents. There are links to PDF versions after each document. Alternatively you can provide a certificate not more than three years old from an FSMA authorised person. Please send your certificate by post to The Secretary, Angels 5K, Southgate Chambers, 37-39 Southgate Street, Winchester SO23 9EH:

Certified High Net Worth Individual

I confirm that I am a certified high net worth individual for the purposes of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005.

I understand that this means:- (a) I can receive financial promotions that may not have been approved by a person authorised by the Financial Services Authority; (b) the content of such financial promotions may not conform to rules issued by the Financial Services Authority; (c) by signing this statement I may lose significant rights; (d) I may have no right to complain to either of the following: (i) the Financial Services Authority; or (ii) the Financial Ombudsman Scheme; and (e) I may have no right to seek compensation from the Financial Services Compensation Scheme.

I am a certified high net worth individual because at least one of the following applies:-

(a) I had, during the financial year immediately preceding the date below, an annual income to the value of £100,000 or more; or (b) I held, throughout the financial year immediately preceding the date below, net assets to the value of £250,000 or more.

“net assets” for these purposes do not include:- (i) the property which is my primary residence or any loan secured on that residence; (ii) any rights of mine under a qualifying contract of insurance within the meaning of the Financial Services and Markets Act 2000 (Regulated Activities) Order 2001; or (iii) any benefits (in the form of pensions or otherwise) which are payable on the termination of my service or on my death or retirement and to which I am (or my dependants are), or may be, entitled.

I accept that I can lose my property and other assets from making investment decisions based on financial promotions.

I am aware that it is open to me to seek advice from someone who specialises in advising on investments.

Signed

Date

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Or

Statement for Self-Certified Sophisticated Investor

I confirm that I am a self-certified sophisticated investor for the purposes of the Financial Services and Markets Act (Financial Promotion) Order 2005.

I understand that this means: (a) I can receive financial promotions that may not have been approved by a person authorised by the Financial Services Authority; (b) the content of such financial promotions may not conform to rules issued by the Financial Services Authority; (c) by signing this statement I may lose significant rights; (d) I may have no right to complain to either of the following:- (i) the Financial Services Authority; or (ii) the Financial Ombudsman Scheme; and (e) I may have no right to seek compensation from the Financial Services Compensation Scheme.

I am a self-certified sophisticated investor because at least one of the following applies:-

(a) I am a member of a network or syndicate of business angels and have been so for at least the last six months prior to the date below; (b) I have made more than one investment in an unlisted company in the two years prior to the date below; (c) I am working, or have worked in the two years prior to the date below, in a professional capacity in the private equity sector, or in the provision of finance for small and medium enterprises; (d) I am currently, or have been in the two years prior to the date below, a director of a company with an annual turnover of at least £1 million.

I accept that I can lose my property and other assets from making investment decisions based on financial promotions.

I am aware that it is open to me to seek advice from someone who specialises in advising on investments.

Signed

Date

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