Set up a New Agency

Please complete the details below and submit to us. We will contact you shortly to progress your Agency Application.

Contact Details


Registration Details and Directors

(under present ownership)

Please give details of the directors/partners/proprietors of the company:

Compliance Details

Are any directors or partners engaged in other business?/
Are you registered with the FCA?/
Registration Number:
Have the FCA raised any queries on your accounts?/
Have any company or underwriter ever cancelled your agency or imposed business restrictions or variations that company's standard agency terms?/
Are you part of a broker network?/
Please specify the name of the broker network:
Are you able to hold client money?/

Have you or any director, principal, partner or senior employee:

Been involved in liquidation/bankruptcy proceeding (on you/his/their own account, or in the account of any firm or company with which you/he/they were at the time connected as a Director, Principal or Partner) or had any judgement awarded against you/him/them?/
Ever traded under another title or titles?/
Been dismissed from any office of employment or any representative position?/
Currently any involvement in civil litigation either in your/his/their own account or on the account of any firm or company with which you/he/they has/have been connected as a Director, Principal or Partner/
Knowledge of any allegations of negligence against you/him/them or any firm or company with which you/he/they has/have been connected as a Director, Principal or Partner during the last ten years/
Had any order made against you/him/them under the Companies Act or the Insolvency Acts?/
Had any High Court or County Court Judgements made against you/him/them and if so, so any remain unsatisfied?/
Been convicted of any criminal offence (excluding driving offences) not treated as a spent conviction under the Rehabilitation of Offenders Act 1974?/

If you have answered yes to any of the questions above please add notes below:


Your Details


I/We apply for an agency with P J Hayman & Company Ltd. and declare that the information given above is correct and that nothing has been withheld which might influence the acceptance of this application.

I/We agree that:

  • A client's account will be maintained for premiums payable to the Company and such premiums are held in trust for the Company.
  • I/We will advise the Company of any alterations in the above information.

Submit Application

P J Hayman & Company Limited. Registered in England No 2534965. Registered Office: Stansted House, Rowlands Castle, Hampshire PO9 6DX. P J Hayman & Company Limited is authorised and regulated by the Financial Conduct Authority. Our FS register number is 497103. You can check this by visiting or calling 0800 111 6768 or 0300 500 8082.