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Êtes-vous un courtier agréé? O N
Role (check all that apply) Manager personal Lines Manager commercial lines Producer Customer Service Representative Branch Manager Accounting contact PD contact other
Year of birth== sélectionnez == 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010
Please indicate if you are 40 years of age and under and would like to become part of our Young Broker Network. If so, please enter your birthday O N
Date de naissance(mois) jan fév mar avr mai juin juil août sep oct nov déc ,
Name of Insurance Company sponsoring your license
How many general insurance companies does your firm contractually represent?(Exclude life insurance companies & facility carrier). Please list these companies.
Is the only business of the firm that of an insurance broker? O N If no, please explain
Does your firm hold a trust account? O N
Details of your Errors & Omission Insurance:
Carrier Policy Number Effective Date
Please indicate percentage, if any, of brokerage shares which are owned by a financial institution (includes insurance company)
Have you or any employee of your firm ever had an insurance license suspended or revoked? O N If yes, please provide details
Provide a brief history of your Brokerage
"The undersigned confirms to the IBANB that, with respect to any information provided, the undersigned has obtained the appropriate consent of the applicable individual to release that individual's information to IBANB." Yes - I, the undersigned, confirm all information to be true and accurate.
Consentez-vous à recevoir des communications par courriel de notre part? O N
I HEREBY CERTIFY that the applicant insurance brokerage is owned by a "Financial Institution" (includes Insurance Company) as defined by IBANB Bylaws 1.1 revised April 2009 1.1 "Financial institution" (a) a bank; (b) a body corporate to which the Trust and Loans Companies Act (Canada), as amended from time to time applies; (c) an association to which the Co-operative Credit Associations Act (Canada), as amended from time to time applies; (d) an insurance company or fraternal benefits society to which the Insurance Companies Act (Canada), as amended from time to time applies; (e) a trust, loan or insurance corporation incorporated by or under an Act of the legislature of a Province; (f) a co-operative credit society incorporated and regulated by or under an Act of the legislature of a Province; and (g) a credit union under the Credit Unions Act, Loi sur les Caisssies Polulaires or similar legislation. Read More O N
1.1 "Financial institution"
(a) a bank;
(b) a body corporate to which the Trust and Loans Companies Act (Canada), as amended from time to time applies;
(c) an association to which the Co-operative Credit Associations Act (Canada), as amended from time to time applies;
(d) an insurance company or fraternal benefits society to which the Insurance Companies Act (Canada), as amended from time to time applies;
(e) a trust, loan or insurance corporation incorporated by or under an Act of the legislature of a Province;
(f) a co-operative credit society incorporated and regulated by or under an Act of the legislature of a Province; and
(g) a credit union under the Credit Unions Act, Loi sur les Caisssies Polulaires or similar legislation.
I HEREBY CERTIFY that the applicant insurance brokerage is "controlled" by a Financial Institution (includes Insurance Company) as defined by IBANB Bylaws 1.2 revised April 2009
1.2 (1) Control of Brokerage – A Brokerage is “controlled” by a financial institution if the Brokerage is:
(a) a corporation in which the financial institution, its subsidiaries or affiliates holds the controlling shares for the election of directors of the corporation;
(b) a general partnership, there are one or more partners consisting of a financial institution, its subsidiaries or affiliates;
(c) a limited partnership, there is a limited or general partner consisting of a financial institution, its subsidiaries or affiliates, or
(d) an individual, the individual is an employee or agent of a financial institution or its affiliates.
1.2 (2) Notwithstanding subsection (1), a Brokerage which appears to be controlled by a financial institution shall not be deemed to be controlled by a financial institution if the Brokerage can establish, to the satisfaction of the Board acting in its sole discretion, that it is independent and free of any controlling interest. Any such determination by the Board shall be binding upon the Brokerage.
I CONFIRM the applicant insurance brokerage/broker is applying for membership as a == sélectionnez == voting non-voting member in accordance to Bylaw Part 2 Article 2.1 Membership Categories.
2.1 Membership Categories – Membership in the Association is voluntary. The categories of membership in the Association are as follows:
1. Member – A Brokerage, whether a corporation, partnership or an individual, including their Subsidiaries, carrying on business in New Brunswick and which satisfy the criteria contained in the Membership Application Form, being Appendix A to these by-laws, may become a member of the Association. A Brokerage is entitled to only one membership for the Brokerage and its Subsidiaries, which membership will be in the name of the Brokerage, regardless of how many corporations, partnerships, individuals, employees or offices are represented by the Brokerage and its Subsidiaries.
2. Associate Member – The following qualify as Associate members:
(a) Persons who qualify for the designation of C.A.I.B., C.P.I.B. or C.C.I.B. and hold a valid “other than life” brokers license to transact general insurance under the Insurance Act of New Brunswick as an employee of a brokerage which is not a member and who satisfy the criteria contained in the Association’s Membership Application Form, being Appendix B to these by-laws;
(b) In the discretion of the Board, any other person, business or Brokerage not able to meet the qualifications of an Associate member under paragraph (a) or do not come within the definition of Brokerage, but satisfy the criteria contained in the Associate membership Application Form being Appendix A to these by-laws.
NOTE: Associate Members have no voting rights and are prohibited from using the Broker Identity Program logos and slogans of the Insurance Brokers Association of New Brunswick and the Insurance Brokers Association of Canada.
3. Life Member – The Board may, in their sole discretion, grant Life Membership to a broker who has been active as an insurance broker for at least 25 years as a member of the Association or has rendered outstanding service to the Association. The Board may, in their sole discretion, revoke any such membership at any time. No membership fees are payable by life Members and they have no voting rights.
4. Honourary Member – The Board may, in their sole discretion, grant Honourary Membership to Past Presidents of the Association who are not engaged in the insurance business. The Board may, in their sole discretion, revoke any such membership at any time. No membership fees are payable by Honourary Members and they have no voting rights.
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