What is this form used for

The certification identifies natural persons with significant ownership or control over an entity and supports KYC, AML, and regulatory reviews. Use it to document who benefits economically or controls the company.

Who should sign the document

An authorized officer or representative with authority to bind the entity must sign and date. Compliance teams may request proof of authority such as corporate resolutions or officer certificates.

Can the certification be e-signed

Yes, when the platform and recipient accept electronic signatures. Ensure the eSignature solution records intent, attribution, and retains a reproducible audit trail consistent with ESIGN and UETA requirements.

Is notarization ever required

Notarization depends on the recipient’s policy or applicable state law. If a notarized acknowledgment is requested, use a remote or in-person notary that complies with state requirements.

How do I correct an error after signing

Do not alter the signed copy. Complete a new certification with corrected details, have it signed, and provide an explanation referencing the replacement document to the recipient.

How long should we keep signed certifications

Retain while the account is active and for at least three years after closure; longer retention may apply for tax, SEC, or HIPAA requirements depending on industry and state rules.

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Legal
Beneficial Ownership Certification

Beneficial Ownership Certification

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

BENEFICIAL OWNERSHIP CERTIFICATION

This Beneficial Ownership Certification (the Certification) is made effective as of by and between Reporting Company: , a business entity formed under the laws of , with principal address (hereinafter the Reporting Company), and Authorized Representative: , Title: .

RECITALS

WHEREAS, the Reporting Company is required by applicable law and the policies of certain financial institutions to collect and certify information regarding individuals who are Beneficial Owners or who exercise substantial control over the Reporting Company; and

WHEREAS, the Reporting Company desires to provide a truthful and complete certification of its Beneficial Owners and to designate an Authorized Representative to attest to the accuracy of such information on its behalf; and

WHEREAS, capitalized terms used in this Certification have the meanings set forth herein.

NOW, THEREFORE, in consideration of the mutual covenants contained herein, the parties agree as follows:

1. DEFINITIONS

For purposes of this Certification:

(a) "Beneficial Owner" means each individual who, directly or indirectly, through any contract, arrangement, understanding, relationship or otherwise (i) exercises substantial control over the Reporting Company, or (ii) owns or controls, directly or indirectly, 25 percent or more of the ownership interests of the Reporting Company.

(b) "Substantial Control" includes, but is not limited to, an individual who: (i) is a senior officer; (ii) has authority to appoint or remove a majority of the board of directors; or (iii) otherwise exercises significant influence over important decisions affecting the company.

2. IDENTIFICATION OF BENEFICIAL OWNERS

The Reporting Company hereby certifies that the following individuals are Beneficial Owners or persons with substantial control as defined above. For each individual listed, the Reporting Company provides the legal name, date of birth, residential address, the nature of ownership or control, and the percentage of ownership (if applicable).

Beneficial Owner 1

Full Legal Name Date of Birth Residential Address Ownership Percentage (if applicable)

Nature of Interest (check all that apply) Direct owner of greater than 25% Indirect owner of greater than 25% Exhibits substantial control

Beneficial Owner 2

Full Legal Name Date of Birth Residential Address Ownership Percentage (if applicable)

Nature of Interest (check all that apply) Direct owner of greater than 25% Indirect owner of greater than 25% Exhibits substantial control

Beneficial Owner 3

Full Legal Name Date of Birth Residential Address Ownership Percentage (if applicable)

Nature of Interest (check all that apply) Direct owner of greater than 25% Indirect owner of greater than 25% Exhibits substantial control

Additional Beneficial Owners or Persons Exercising Substantial Control

3. EXCEPTIONS AND ALTERNATIVE STATEMENTS

If the Reporting Company asserts that no individual meets the definition of Beneficial Owner, indicate the applicable basis for this assertion by checking the appropriate box and providing the required details.

The Reporting Company is a publicly traded entity or a majority-owned subsidiary of a publicly traded entity (describe parent if applicable) The Reporting Company is a wholly-owned subsidiary (provide ultimate parent legal name) Other (describe)

4. REPRESENTATIONS AND WARRANTIES; ATTESTATION

The Authorized Representative, on behalf of the Reporting Company, hereby represents and warrants that the information contained in this Certification is true, complete and correct to the best of such representative's knowledge and belief. The Reporting Company acknowledges that the information supplied is subject to verification and agrees to update the information promptly if any material change occurs.

The Authorized Representative attests under penalty of law that the person executing this Certification is authorized to do so on behalf of the Reporting Company and that the information provided is accurate. The Authorized Representative further understands that knowingly providing false information to a financial institution or regulatory authority may result in civil or criminal penalties.

Name of Certifying Individual Title Contact Phone

5. NOTICES

Any notice required or permitted under this Certification shall be in writing and delivered to the other party at the address provided in the opening paragraph or to such other address as either party may designate by written notice to the other. Notices shall be effective upon receipt.

6. AMENDMENT; WAIVER

This Certification may be amended only by a written instrument executed by the Reporting Company and the Authorized Representative. No failure or delay by any party in exercising any right under this Certification shall operate as a waiver of that right.

7. GOVERNING LAW

This Certification shall be governed by and construed in accordance with the laws of the jurisdiction in which the Reporting Company is formed, without regard to conflict of law principles.

8. ENTIRE AGREEMENT; SEVERABILITY; COUNTERPARTS

This Certification constitutes the entire agreement between the parties with respect to the subject matter hereof. If any provision of this Certification is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect. This Certification may be executed in counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument.

Reporting Company:

By:

Date:

Authorized Representative:

By:

Date:

What the Beneficial Ownership Certification Is and when it’s used

A Beneficial Ownership Certification is a signed statement that identifies the natural persons who directly or indirectly own or control a legal entity. Financial institutions and other regulated parties collect it to satisfy customer due diligence, anti-money laundering, and Know Your Customer obligations. The certification typically lists owners with at least a set ownership or control threshold and affirms the accuracy of the disclosed information under penalty of law.

Why a clear Beneficial Ownership Certification matters

Accurate certification helps organizations meet regulatory customer due diligence obligations, reduce onboarding delays, and show a documented chain of ownership for audits. It establishes who can exercise economic benefit or control of the entity and supports risk-based monitoring and reporting.

Who typically completes or requests this certification

The certified statement should be signed by a person with authority to bind the entity; organizations often keep a copy with onboarding records and audit trails.

Banks and credit unions that require customer due diligence and sanctions screening.
Corporate officers or registered agents completing ownership disclosure for accounts or filings.
Compliance officers and legal teams verifying ownership during onboarding or audits.

Core elements to include in a professional certification

A complete certification provides identification of the reporting company, a list of beneficial owners with ownership or control percentages, a statement attesting to accuracy, signature and authority block, date, and any required notarization or verification steps.

Reporter

Legal entity name and taxpayer identification number to clearly link the certification to the subject entity and supporting records.

Owner list

Full legal names, dates of birth, addresses, and unique identifiers for each beneficial owner meeting the reporting threshold.

Ownership detail

Exact ownership percentage, indirect ownership description, or control basis so readers can determine who meets the ownership threshold.

Attestation

A clear statement that the information is true and complete, signed under penalty of law or regulatory sanction as required.

Signature

Printed name, title, signature, and date from an authorized officer or company representative who can bind the entity legally.

Verification

Notary acknowledgment or digital identity verification steps when required by the recipient or statute.

Required data points often requested

Entity name: Full legal name

Tax ID: EIN or TIN

Owner name: Full legal name

Owner ID: DOB and address

Ownership: Percentage or control

Signer info: Authority and date

Step-by-step: completing the certification

Follow these steps to prepare a clear, compliant certification and reduce processing delays.

01

Gather documents: Collect entity formation records and ownership schedules.
02

Identify owners: List all natural persons meeting ownership or control thresholds.
03

Complete fields: Enter entity, owner, and ownership details precisely.
04

Sign and verify: Have authorized signer execute and provide identity verification.

How to configure an online completion workflow

Set up fields and signer steps to match your internal approval and verification requirements before sending the form.

Field	Configuration
Signer order	Define sequential or parallel signing
Required fields	Mark entity and owner fields mandatory
Authenticator	Use email, SMS, or stronger ID
Audit trail	Enable timestamps and IP logging

Typical routing and submission flow

A standard process routes the certification from preparer to signer and then to the receiving compliance team with audit evidence.

Prepare: Populate form with entity and owner data
Verify: Attach identification or supporting documents
Sign: Authorized officer signs electronically or physically
Deliver: Send copy to compliance and retain record

Digital signing and eSubmission essentials

Ensure the chosen platform supports required compliance frameworks, secure storage (TLS/AES-256), and the ability to export signed records for long-term retention and audit requests.

File formats: PDF or DOCX
Authentication: Email, SMS, or stronger
Recordkeeping: Audit trail stored

Typical submission timing and response expectations

Timing depends on why the certification is requested: account opening, regulatory inquiry, transaction closing, or periodic reviews each have different expectations.

Account opening:

Provide certification at initial onboarding or within the onboarding window set by the institution.

Regulatory request:

Respond within the timeframe stated in the request or the regulator’s notice.

Periodic review:

Update during scheduled KYC refresh cycles or when ownership changes occur.

Ownership change:

Notify recipient promptly and supply an updated certification per their policy.

Verification follow-up:

Expect 3–10 business days for staff review; complex cases take longer.

Common preparation errors that cause delays

Incomplete owner details such as missing dates of birth or partial addresses requiring manual follow-up and proof requests.
Using informal names or initials instead of legal names, which prevents identity verification against government records.
Failing to show the signer’s authority or title, causing compliance teams to request corporate resolutions or officer certifications.
Submitting unsigned or incorrectly dated forms, which are routinely rejected or returned for correction.

Potential consequences of incorrect or false certifications

Regulatory fines: Monetary penalties or enforcement actions

Account closure: Business or banking relationships may be suspended

Reputational harm: Public disclosure or adverse media

Criminal liability: False statements may carry criminal penalties

Tax impact: Withholding or reporting errors

Contract risk: Agreements may be rescinded or voided

Real-world examples of common uses

These scenarios show how the certification functions in typical business and compliance workflows.

Bank onboarding

A new commercial client completes the certification listing two 25% owners and one controlling officer

The bank verifies IDs and flags one owner for enhanced screening
The signed record and audit trail are stored with onboarding files for future AML review and regulator proof.

Closing a transaction

A seller provides a certification to escrow confirming beneficial owners and control interests

Escrow requests notarization and copies of formation documents
The escrow agent relies on the certification to release funds and retains the executed copy for closing records.

eSignature vendor pricing and feature snapshot relevant to this certification

Select an eSignature provider that supports secure authentication, audit trails, and compliant storage. The table compares basic pricing and common features across vendors.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	7-day free trial	Yes	Yes	Yes	Yes
Bulk Send	Yes	Yes	Yes	Yes	No
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

Frequently asked questions about the certification

Answers to common questions about completion, signing, and retention to reduce confusion and prevent avoidable rejections.

Need help? Contact support

What is this form used for
The certification identifies natural persons with significant ownership or control over an entity and supports KYC, AML, and regulatory reviews. Use it to document who benefits economically or controls the company.
Who should sign the document
An authorized officer or representative with authority to bind the entity must sign and date. Compliance teams may request proof of authority such as corporate resolutions or officer certificates.
Can the certification be e-signed
Yes, when the platform and recipient accept electronic signatures. Ensure the eSignature solution records intent, attribution, and retains a reproducible audit trail consistent with ESIGN and UETA requirements.
Is notarization ever required
Notarization depends on the recipient’s policy or applicable state law. If a notarized acknowledgment is requested, use a remote or in-person notary that complies with state requirements.
How do I correct an error after signing
Do not alter the signed copy. Complete a new certification with corrected details, have it signed, and provide an explanation referencing the replacement document to the recipient.
How long should we keep signed certifications
Retain while the account is active and for at least three years after closure; longer retention may apply for tax, SEC, or HIPAA requirements depending on industry and state rules.

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