Delegated Authority Qualification Questionnaire

Thank you for completing the Delegated Authority Qualification Questionnaire

Your details will now be passed to a member of the Commercial Delegated Authority Development Team who will aim to be in touch within 48 hours.

 

There's been an error - please try again.

Delegated Authority Qualification Questionnaire

Please fill out the below form with as much information as possible. Nothing in this form shall be legally binding on either party and nothing herein shall obligate Aviva or you to proceed with any transaction or provision of services contemplated between us. Each party reserves the right, in its sole discretion, to terminate any discussions contemplated by this form.

Contact information

Qualification questions

Please enter the date in the format dd/mm/yyyy

Next steps

By submitting this form, you agree that the information provided is to the best of your knowledge complete and accurate. You agree to promptly notify us if there is a material change to any of the information you provided. Once you have submitted this form, your details will be passed to a member of the Commercial Delegated Authority Development Team who will use reasonable endeavours to be in touch within 48 hours.

Privacy Policy

The personal data collected on this form will be used in accordance with our Intermediary Privacy Policy to assist you with your Delegated Authority enquiry. If you would like more information about how Aviva use your personal data and your associated rights you can access the Aviva Intermediary Privacy Policy using the link below.

Aviva uses your personal data as set out in our Privacy Policy. We use Google’s reCAPTCHA technology to protect our websites from spam and abuse. The Google Privacy Policy and Terms of Service apply to reCAPTCHA.