Senior Management Regime Statement of Responsibilities | Personal and Firm Identification Details | Effective Date and Relevant SMFs | Template for FCA Applications and Authorised Firms

This form applies to UK relevant authorised persons. It does not apply to incoming EEA relevant authorised persons, third country relevant authorised persons, or appointed representatives of any relevant authorised person.

A statement provided under section 60(2A) of the Act (Applications for approval), including a statement revised under section 62A of the Act (Changes in responsibilities of senior managers).

For candidates for approval, this form must be submitted as an attachment to a Form A application or a Form E application

For significant changes to an existing statement of responsibilities, this form must be submitted as an attachment to a Form J notification or a Form I application or variation.

FCA Handbook Reference: SUP 10C, SYSC 4.5, SYSC 4.7

PRA Rulebook Reference: Senior Managers Regime – Applications and Notifications

1 November 2018

Name of individual                    ___________________________________________________________________
(to be completed by firm)

Name of firm                               ___________________________________________________________________
(to be completed by firm)

1 Personal identification details 

1.1 Individual Reference Number (IRN)                  ___________________________________

1.2 Title (e.g. Mr, Mrs, Ms, etc)                                  ___________________________________

1.3 Surname                                                                ___________________________________

1.4  ALL forenames                                                   ___________________________________

1.5  Date of birth                                                         ___________________________________

1.6  National Insurance number                                ___________________________________

2 Firm identification details 

2.1 Name of firm

2.2 Firm Reference Number (FRN)

2.3

a. Who should the FCA/PRA contact at the firm in relation to this statement of responsibilities?   ______________________

b. Position                                                                                                                                                            ______________________

c. Telephone                                                                                                                                                        ______________________

d. Fax                                                                                                                                                                    ______________________

e. Email                                                                                                                                                                ______________________

I have supplied further information related to this page in Section 4        Yes  ___   No ____

3 Senior Management Functions

A statement of responsibilities should be drafted to clearly show the responsibilities that the candidate or senior manager is to perform as part of their controlled function and how they fit in with the firm’s overall governance and management arrangements. A statement of responsibilities should also be consistent with the firm’s management responsibilities map.

A statement of responsibilities should be drafted in such a way as to be practical and useable by regulators. The FCA and the PRA consider that this would be achieved by succinct, clear descriptions of each responsibility which avoid unnecessary detail. Firms have the opportunity to provide details of each responsibility allocated to an individual using the free text boxes in this form, however, the PRA and FCA would not usually expect the description of each responsibility to exceed 300 words.

A statement of responsibilities must be a self-contained document. There should be one statement  per senior manager per firm. Where an individual performs a senior management function on behalf  of more than one firm within a group, one statement of responsibilities is required for each firm. Any supplementary information may be provided in section 4 (or if submitting electronically, in a single attachment). A statement of responsibilities must not cross refer to other documents, attachments or links.

A statement of responsibilities should include responsibilities held in relation to FCA controlled functions that are included in a PRA controlled function under SUP 10C.9 (Minimising overlap with the PRA approved persons regime).

(SUP 10C.11)

If the appropriate regulator considers that the statement of responsibilities is not sufficiently clear to  be practical and usable, it could be challenged as part of a candidate’s application for approval, or in ongoing supervision.

Details of the individual’s responsibilities should be set out in sections 3.2 to 3.4, as appropriate:

• Section 3.2 covers prescribed responsibilities required by regulators to be allocated to one or more senior
• Section 3.3 covers having overall responsibility for each of the business areas, activities, and management functions of the
• Section 3.4 covers anything else, not otherwise included, for which a candidate or senior manager is to be responsible as part of their FCA and/or PRA senior management function(s)

3.1   Effective date and relevant Senior Management Functions

3.1.1 Please state the effective date of this statement of responsibilities:

Please note that where this is a revised statement of responsibilities, i.e. since the granting of the application, there has been a significant change in the aspects of the firm’s affairs which the individual is responsible for managing in performing the function (for example, a change in allocation of responsibilities within the firm, or the senior manager is applying for a new or additional senior management function), then this statement of responsibilities supersedes any previous versions.

3.1.2 List all senior management functions which the approved person is to perform and the effective date the person commenced or will commence the performance of the

This statement of responsibilities is considered to automatically include the existing legal and regulatory obligations where they exist for these roles and functions. For example, certain specific responsibilities of a director are set out in company law. Such responsibilities do not need to be recorded in this statement, but any additional responsibilities should be recorded in the sections below.

3.1.3 Please indicate those FCA functions that are included in a PRA controlled function under SUP

10C.9 (Minimising overlap with the PRA approved persons regime).

3.1   Prescribed Responsibilities

This section deals with those responsibilities to be allocated to one or more senior managers. The allocation of responsibilities under a statement of responsibilities should not reduce or alter the scope of any applicable prescribed requirements.

If the responsibilities that the candidate or senior manager is to carry out as described  in  the statement of responsibilities go beyond those set out in this section, those additional responsibilities should not reduce or alter the scope of the prescribed requirements set out in this section.

(FCA SUP 10C.11/PRA: Allocation of Responsibilities)

3.2.1 Please indicate below which of the responsibilities listed are/will be allocated to this individual, if any.

Note: the form includes references to provisions in the FCA Handbook which are also set out in the PRA Rulebook, sometimes in slightly different wording. Where this is the case, the underlying provisions should be interpreted as equivalent in substance unless indicated otherwise. Any differences are purely presentational.

If the individual has not been allocated a prescribed responsibility, please go to section 3.3

3.2.2 If necessary, please provide additional information about each prescribed responsibility, including:

• A breakdown of the different components and tasks which the responsibility encompasses; and
• If applicable, details of any sharing arrangements including, if known, the name(s), IRN(s) and/or job title(s) of the individual(s) you are sharing this prescribed responsibility The responsibility should be recorded in the same way in the statements of responsibilities for each individual.

Additional information must be relevant, succinct and not dilute or undermine the prescribed responsibility.

I have supplied further information related to this page in Section 4                   YES __    NO ___

This section deals with having overall responsibility for any of the business areas, activities, or management functions of the firm.

By overall responsibility we mean the ultimate responsibility (under the governing body) for managing or supervising that function, and primary and direct responsibility for briefing and reporting to the governing body about that function and putting matters for decision about that function to the governing body of the firm.

(SYSC 4.7)

3.3.1 If the individual has overall responsibility for any or part of the business areas, activities, or management functions of a firm, please provide details of each in the table

Where responsibilities are shared (for example, a responsibility may be shared as part of a  job share or where departing and incoming senior managers work together temporarily as part of a handover), please provide details of any sharing arrangements including, if known, the name(s), IRN(s) and/or job title(s) of the individual(s) you are sharing this responsibility with. The responsibility should be recorded in the same way in the statements of responsibilities for each individual.

If the individual does not have overall responsibility for a business area, activity or management function of the firm, please go to section 3.4

A firm may wish to refer to SYSC 4 Annex 1G (replicated in Annex A of this form) to help it make sure it has not failed to allocate overall responsibility for a particular activity of the firm. Please note that the FCA does not require firms to organise themselves by the functions in SYSC 4 Annex 1G, and that the Annex is not comprehensive. It is important that a firm does not fail to allocate overall responsibility for business areas, activities and management functions, in line with SYSC 4.7.8R.

I have supplied further information related to this page in Section 4                   YES __    NO ___

3.4 Other Responsibilities

3.4.1 Please set out below anything else, not otherwise included in this statement, for which a candidate or senior manager is to be responsible as part of  their FCA and/or PRA controlled function(s) role. For example, responsibilities outside the normal course of business such as those linked to high profile projects of initiatives.

Where responsibilities are shared (for example, a responsibility may be shared as part of a job share or where departing and incoming senior managers work together temporarily as part of a handover), please provide details of any sharing arrangements including, if known, the name(s), IRN(s) and/or job title(s) of the individual(s) you are sharing this responsibility with. The responsibility should be recorded in the same way in the statements of responsibilities for each individual.

I have supplied further information related to this page in Section 4                   YES __    NO ___

4 Supplementary Information

4.1 Is there any other information the individual or the firm considers to be relevant?          YES ___      NO ____

If yes, please provide details below or on a separate sheet of paper and clearly identify the section and question to which the additional information relates.

SYSC 4                                 The main business activities and functions of a relevant authorised person
Annex 1G

The above question(s) should be completed whether submission of this form is online or in one of the other ways set out in SUP
15.7 or in ‘Senior Managers Regime – Applications and Notifications’ in the PRA Rulebook