Nomination Form for the Member-Board of Directors ofFPSB India

Financial Planning Standards Board India

702, 7th Floor, Leela Business Park, Andheri Kurla Road, Andheri East, Mumbai-400059

Phone: +91 22 61712424; Fax: +91 22 61712444

Email: ; Website:

BIOGRAPHICAL DATA FORM AND QUESTIONNAIRE

Please complete this Data Form in as much details as possible, including providing home address and phone numbers. If you need more space to respond, please attach a separate sheet using the corresponding numbers for each section. (NOTE: The form must be completed on a computer or typed.)
Return all completed documents no later thanFebruary 3, 2017, 1800hrsto
The Chief Executive Officer (CEO)
Financial Planning Standards Board India
702, 7th Floor, Leela Business Park
Andheri Kurla Road, Andheri East
Mumbai 400 059
For any further information please contact Mr.Mohamed Iqbal
Tel : +912261712404, +919322886871
Email:
Title:
/ Full Name:
Major Responsibilities:
/ Business/Organization Name/Address:
Date Appointed to Current Post: / Business Phone:
Cell phone:
Fax:
E-mail:
Business Title: / DIN:
Previous Employment/Positions Held:
/ Home Address:
Date of Birth: / Home Phone:
1. Educational Degrees Received:
Degree(s):
/ Date(s): / Educational Institution(s):
2. Professional Designations Received:
Designation(s): / Date(s): / Awarding Organization(s):
3. Licenses Received:
License(s):
/ Date(s): / Awarding Organization(s):
4. List Relevant professional association/industry/community service and position held:
Service/Position(s):
/ Date(s): / Reference(s):

—Continued on next page—

Clearly describe areas of particular national or international leadership or prominence in your background.
Please state briefly your general qualifications that will allow you to contribute to the Vision & Mission of FPSB India.
Kindly disclose any potential/deemed Conflict of Interest in your professional / personal capacity, that could emerge if nominated as the Member – Board of Directors of FPSB India?
Please state briefly your specific qualifications to serve on FPSB India.
Have you served as a member of the Board of any establishment before? If yes, kindly give details, and kindly specify your area of expertise / contribution.
Have you been associated with FPSB India as a Volunteer, viz. Board Member, Committee Member etc of FPSB India? If yes kindly indicate your contribution and other details of participation.
How does your Company/Firm promote CFPCM Certification? Kindly give details.
5. Media Experience and Published Works
Please list current and/or past media experience and books/magazine articles/papers authored.
6. Disclosure of Complaints / Litigation Current and Past
Are you/your organization, have ever been, under notice for any complaints by clients or any regulatory / government agency which have led or may lead to legal or disciplinary action or is there any outstanding / pending litigation (anytime during the last three years) against you/your organization?
Complaints:
Currently  Have been  No 
If you are currently under notice or you have been in the past, please briefly explain:
Litigation :
If there is any outstanding/pending litigation, please briefly explain:
7. Are you a CFPCM Certificant?(Please Specify)
8. (a) Are you in a Management position, where in Financial Planners form part of your team? If Yes, kindly indicate how many?
If No, kindly answer part (b) below: 
YES ( ) NO ( )
(b) Which of the following is a service you are able to offer your clients directly without referring them on to a third party specialist? (Please place ( ) in the appropriate boxes)
General / Life insurance advice( ) Real Estate Advice( )
Investment Planning ( ) Superannuation /Retirement Advice( )
Taxation planning and advice, including trusts ( ) Wills and estate planning advice( )
Others ( )
C. What percentage of your working week is engaged in providing Financial Planning advice to clients or managing the team for the same? (Please Place ()appropriate box)
0-19%( ) 20-50%( ) 51-75%( ) 76-100% ( )
D. What percentage of your client base fits the following description?
1. Retired persons ______
2. Retrenched persons ______
3. Young savers ______
4. Windfall recipients ______
5. High net worth individuals______
6. Superannuation funds ______
7. Other (e.g. wills) ______
E. Charges to clients for services. ( Please () all that apply to you)
Fee for service ( ) Commissions ( ) Other/s______

BIOGRAPHICAL DATA FORM AND QUESTIONNAIRE (Continued)

Q.1 / Why do you want to be Member-Board of Directors?
Q.2 / How do you intend to balance serving as Member-Board of Directors with your existing professional obligations?
Q.3 / What traits, skills or experience do you posses that would allow you to be successful in the capacity as Member-Board of Directors?
Q.4 / How will you measure success in the Member-Board of Directors?
Q.5 / Have you, in the past / currently served / serving as a Member-Board of Directors of the company, and/or any of its subsidiaries? If yes, kindly share your experiences and initiatives undertaken to meet the objects of the company i.e CFP Certification etc?
Q.6 / What major challenges face by FPSB India in the near term, and how would you like to address them?
Q.7 / What major challenges face by FPSB India in the long term, and how would you like to address them?
Q.8 / How do you think that the Financial Planning will help in professionalization of financial services in India?
(Please answer within 50 -60 words, kindly attach any additional sheet/s, if required)
Q.9 / Kindly state and disclose all your associations/ other Directorships, positions (of influence) etc, that may affect your position as Member-Board of Directors of the company by virtue of the initiatives by the Company and/or in terms of any Conflict of Interest?
Q.10 / What new initiatives should FPSB India Consider?
Q.11 / What current initiatives should be modified or discontinued by FPSB India?
Q.12 / What is the greatest strength(s) of the CFPCM Certification program (in India)?
Q.13 / What is the greatest weakness (es) of the CFPCM Certification program (in India)?
Q.14 / What is your Vision for the future of the CFPCM Certification marks (in India)?
Q.15 / How do you think CFPCM Certification mark can be well established (in India)?

# Nominated by: Signature

(#Charter Member)

[Nominator]

# Recommended by: Signature

(#Charter Member/ Board Member)

[Recommender]

Signature

(Candidate)

Designation:

Date:

Address:

Kindly read section 8.4 of the Articles of Association of FPSB India. Please see the guidelines as below for your quick perusal as well:

Guidelines

The person who would be nominated as a Board Member by the Nomination Committee will be considered in his own individual personal capacity and not as a representative of Charter Member. Hence his tenure shall not be function of his association with the Charter Member organization by whom he/she would be nominated.

He/She will be required to be nominated by a Charter Member, where he is not currently employed, and will also need to be recommended by another Charter Member, where he is not currently employed, or a Board Member.

The person/organization who is nominating any candidate should not stand for election himself/nominate and/or any other candidate as well. However if the person/organization who/which is recommending, and wants to stand for election himself/herself/ and/or wants to recommend any other candidate, then he/she and/or the candidate being nominated/represented should not be nominated or recommended by the same candidate (or his organization), to whom he/it has already recommended.

A person/Charter Member can nominate or recommend any candidate as per clause above, only once.

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