Templates › Forms › SEO page

Run: Beneficial Ownership Certification Form

A Beneficial Ownership Certification Form for collecting legal entity ownership, control person details, and certification in one place. Use it to support cu...

Fill this out, get a PDF emailed to you. No account required. Want to run it with your team and track results? Sign up free →

Form Purpose and Consent

I understand this form is used for beneficial ownership certification under 31 CFR 1010.230. (required)

Yes No N/A

I consent to the collection and use of the personal information provided in this form for customer due diligence and compliance review. (required)

Yes No N/A

Submission type (required)

Legal entity name (required)

Legal entity type (required)

If other, specify entity type (required)

Legal Entity Information

Tax identification number ending

Enter only the last 4 digits if your institution requires it. Do not enter a full tax ID unless specifically required by policy.

State or country of formation (required)

Business address (required)

Date of formation

Brief business purpose

Optional. Provide a short description if needed for compliance review.

Beneficial Owners

Does any individual own 25% or more of the legal entity? (required)

Individuals owning 25% or more

Beneficial owner details

No individual owns 25% or more

Yes No N/A

Control Person

Control person full name (required)

Title or role (required)

Date of birth

Residential address

Collect only if required by your institution's policy.

Identification type

Identification number ending

Enter only the last 4 characters if needed for verification. Do not enter full ID numbers unless required.

Certification and Review

Certifier name (required)

Certifier title or authority (required)

Certification statement (required)

I certify that the information provided is true, complete, and accurate to the best of my knowledge and that I am authorized to submit this certification on behalf of the legal entity.

Yes No N/A

Signature (required)

Date signed (required)

Compliance reviewer notes

Get your results

Enter your email — we'll send you a PDF of your filled-out template, plus the occasional MangoScoop newsletter (templates, workflow tips, product updates). Unsubscribe anytime — link is in every email.

Email (required)

Your name (optional)

Generated with MangoApps Templates — browse 250+ free

Ask AI Product Advisor

Hi! I'm the MangoApps Product Advisor. I can help you with:

Understanding our 40+ workplace apps
Finding the right solution for your needs
Answering questions about pricing and features
Pointing you to free tools you can try right now

What would you like to know?