Section 126 certificate form

Section 1 – About this form

Societies registered under the Co-operative and Community Benefit Societies Act
2014 (including credit unions) should use this form following a transfer of
engagements (under sections 110 or 112) or dissolution (under sections 119 or
123) to certify that al property vested in the society has been duly conveyed or
transferred to those persons entitled to it.

We will provide confirmation that we have cancelled the registration of the

society once we have received this form.

Please note that this form, including any details provided on the form, will
be made available to the public through the Mutuals Public Register
https://mutuals.fca.org.uk.

Section 2 – About this application

Society name

Register number

Section 3 – Cancellation details

Do you certify that all property vested in the society has been duly conveyed or
transferred by the society to the persons entitled?

Yes ☐

FCA  Mutuals Section 126 certificate  Release 4  February 2019 Page 1 of 2

Section 4 – Declaration

The secretary of the society, or the liquidator, must complete this section.

Name

My signature below confirms that the information in this form is accurate

to the best of my knowledge
Signature

Position

Date

Section 5 – Submitting this form

Please submit a signed, scanned version of your application by email to:

mutual.societies@fca.org.uk

Or please submit by post to:

Mutual Societies
Financial Conduct Authority
12 Endeavour Square
London
E20 1JN

This form is available on the Mutuals Society Portal:

https://societyportal.fca.org.uk

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Registered as a Limited Company in England and Wales No. 1920623. Registered office as above.