Certification for Zero-Rating Step 1 of 3 33% This form should be completed by registered providers that have been issued with a levy notice and wish to certify that they are entitled to zero-rating after having due regard to: • the Financial Services Ombudsman Levy Scheme (Bailiwick of Guernsey) 2024 [‘the 2024 Guernsey Levy Scheme’] • the Financial Services Ombudsman Levy Scheme (Jersey) 2024 [‘the 2024 Jersey Levy Scheme’] • the Financial Services Ombudsman Fee Scheme (Bailiwick of Guernsey) 2024 [‘the 2024 Guernsey Fee Scheme’] • the Financial Services Ombudsman Fee Scheme (Jersey) 2024 [‘the 2024 Jersey Fee Scheme’] • 2024 Explanatory Notes For Financial Services Providers If you have any questions concerning the certification for zero-rating, please consult the explanatory note here. If you still require assistance, please contact CIFO with your question at billing@CI-FO.org. Registered providers that wish to apply for a zero-rating for the levy must complete and submit this certification form no later than the date specified in their levy notice. 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 2024 Guernsey Levy Scheme and the 2024 Jersey Levy Scheme. Please note that registered providers that certify as eligible for zero-rating must advise CIFO in the future if they 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. 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. Please complete a separate certification for each entity that has been sent a levy notice. Name of Entity* Levy invoice number* Name of person providing this certification* Job title* Contact phone number* Contact email address* For what reason(s) are you certifying that the above entity is entitled to zero-rating? (please the responses below that apply) 1.1(a) I certify that throughout this year the entity does not, and is sufficiently unlikely to, carry on relevant financial services business in or from within Jersey Yes 1.1(b) I certify that throughout this year the entity does not, and is sufficiently unlikely to, carry on relevant financial services business in or from within Guernsey Yes 1.2 Having considered the guidelines on sufficiently-close relationships, I certify that throughout this year the entity does not do business, or is sufficiently unlikely to do business, with eligible complainants Yes You must choose one of the exemption criteria above to be eligible for exemption. Please review your submission below: {all_fields}Submission Date NameThis field is for validation purposes and should be left unchanged.