AFN AUT–IND3 Application to Withdraw Authorised Individual Status

Set out here are the preliminary notes relating to the form, click here click here to download the specific AFN form above, press "Read only" and then enter details where the form permits you to.

Purpose of this form

This form must be submitted by an Authorised Firm applying to withdraw an Authorised Individual's authorised status. In some cases the DFSA may require additional information in order to complete the processing of this application. If this is necessary, the DFSA will contact the person identified in section 1 of this form.

If the Authorised Individual will cease to perform one or more Licensed Functions but remain an Authorised Individual, Form AUT–IND2 (Application to Extend or Vary Authorised Individual Status) should be submitted instead of this form.

Representative Offices

If this form is being completed to withdraw a Principle Representative of a Representative Office please tick here.

You will not be required to answer questions 1.1 and 2.1.

The declaration in section 3 will need to be signed by a Director at the head office.


Section Title
1 General information
2 Licensed Functions
3 Declarations

Notes for completing this form

•  Defined terms are identified throughout this application form by the capitalisation of the initial letter of a word or phrase and are defined in the Glossary module (GLO) of the DFSA'sRulebook.
•  Unless otherwise specified, applicant refers to the individual for whom Authorised Individual status is being withdrawn.
•  Unless otherwise specified, Authorised Firm refers to the firm on whose behalf the application to withdraw Authorised Individual Status is being submitted.
•  Prior to completion of this form, Authorised Firms should read the relevant sections of the GEN Module of the DFSARulebook applying to Authorised Individuals.
•  All sections of the form must be completed.
•  Questions must be answered fully and the use of abbreviations or acronyms should be avoided or defined.
•  Do not leave any questions blank. If a question is not applicable this should be indicated in the response section. Failure to answer questions or provide full responses will delay the progress of the application.
•  Answers must be typed, in electronic format, and the form must be signed by a Director/Partner of the Authorised Firm.