CIFO Designated Contact Information Form Step 1 of 2 50% Financial services providers are asked to complete and submit this form to facilitate more timely and cost-effective communication with industry stakeholders. Please complete and submit one CIFO Contact Information Form for each corporate entity that is a financial services provider. *this information is requiredFinancial Service Provider Details:Name of financial service provider:* Website of financial service provider: Levy notice reference number (if known): Office postal address:* Address 1 Address 2 Town / Parish Country / Island Post Code Primary Contact Details:Primary contact (individual):* First Name Surname Business title of primary contact individual:* Telephone number of primary contact individual:* Telephone Number inc. Area Code Ext. if any Email of primary contact individual:* Alternate Contact DetailsAlternate contact (individual): First Name Surname Telephone number of alternate contact individual: Telephone Number inc. Area Code Ext. if any Business title of alternate contact individual: Email of alternate contact individual: Subscriptions:Email Subscription:Please indicate whether you wish to subscribe the above individuals to CIFO’s periodic newsletter and update bulletins to be sent by email to email address(es) provided above: Yes {all_fields}Submission Date: DD slash MM slash YYYY
