Certification form for new Guernsey and Jersey registered providers who have received an ‘Invitation to Consider Eligibility for the Levy’ Step 1 of 3 33% This form should be completed by recipients of an 'Invitation to Consider Eligibility for the Levy' letter, to identify those recently registered providers that are liable to pay CIFO levies and those that could not generate eligible complaints and therefore should be zero-rated. This should be completed no later than the date stated in the letter. The obligation to pay the levy is a legal requirement so it is important that the consideration of eligibility and the zero-rating certification is carried out by a staff member with the appropriate level of responsibility. If zero-ratings are claimed incorrectly, registered providers will be liable to pay the levy retrospectively as specified in the levy schemes. Please note that registered providers that certify as eligible for zero-rating must advise CIFO if they later become no longer eligible for zero-rating. Registered providers should consider the guidelines on sufficiently-close relationships to decide whether the provider does business exclusively with those who could not be, or are sufficiently unlikely to be, eligible complainants. If you require assistance, please contact CIFO with your question at billing@CI-FO.org. How to Complete the Certification Once you have completed the form you will have an opportunity to review the document before certifying and submitting. You may wish to save or print a copy for your own records. Name of Entity* Name of person providing this certification* Job title* Contact phone number*Contact Email Address* Please complete either statement 1 or 2 as appropriate for this entity.1. I certify that the entity listed is liable for the levy as it could give rise to eligible complaints Yes 2. For what reason(s) are you certifying that the above entity is entitled to zero-rating (please tick all the responses that apply)2(a) I certify that the entity listed does not carry on relevant financial services business in or from within Jersey or the Bailiwick of Guernsey or is sufficiently unlikely to do so Yes 2(b) Having considered the guidelines on sufficiently close relationships, I certify that the entity listed does not do, or is sufficiently unlikely to do, this business with eligible complainants Yes Please review your submission below:Submission Date PhoneThis field is for validation purposes and should be left unchanged.
