If you have been contacted by or dealt with an unauthorised mortgage or insurance firm or broker it would be of assistance to the FSA if you would provide some information on your dealings with that firm or individual.  

Please note that once submitted, we will only contact you again if we require any further information from you and the FSA may not be able to advise you of any steps we take concerning your enquiry.

If you have been contacted by more than one firm in this way, we would be grateful if you could complete a separate form for each organisation which has contacted you.

* Denotes required field

 
Section 1: Your details
1. Your name
2. Your address
3. Your daytime telephone number
Section 2: Unauthorised firms details
4. Name of the firm *
5. Address of the firm
6. Firms telephone number
7. Firms website address
8. How were you initially contacted Telephone

Letter

Email

Other (please specify)
9. When were you contacted
Section 3: Details of the transaction
10. What was the firm offering to do? *
11. Did you go through with the transaction? Yes No
12. Were you charged a commission or fee? Yes No
12a. If no, why not
12b. If yes what was the type of product was it? E.g. a residential or first charge mortgage or PPI or car insurance?

12c. If yes, which provider was the mortgage or the insurance taken out with?

13. Have you received any documents from the company?

Yes No
13a. If yes, we would be grateful if you could use the attachment option to send us more information, for example, if you have saved or scanned in any letters or documents that relate to your query. Attachments must be under 4MB in size and in one of the following file formats: .txt .rtf .doc .pdf .jpg .gif .png .tif

Yes No

Email attachment
This link will open an email for you attach your documents. Once you have sent the email please continue to submit this form.