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Politically Exposed Person Declaration

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Politically Exposed Person Declaration

This Politically Exposed Person Declaration (the "Declaration") is made on by: Declarant Name: (the "Declarant") and Institution Name: (the "Institution").

Recitals

WHEREAS, the Institution is required to identify and assess customers, beneficial owners and related persons for enhanced due diligence when a person is, or is related to, a Politically Exposed Person; and

WHEREAS, the Declarant is providing information to the Institution to enable the Institution to comply with applicable anti-corruption, anti-money laundering and counter-terrorist financing obligations and policies; and

WHEREAS, the parties wish to record the Declarant's status, relevant familial and associate relationships, sources of funds, and undertakings relating to notification and consent to processing of personal data.

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

1. Definitions

For the purposes of this Declaration, "Politically Exposed Person" or "PEP" means an individual who is or has been entrusted with prominent public functions, including heads of state or government, senior politicians, senior government, judicial or military officials, senior executives of state-owned corporations and senior officials of political parties, together with family members and close associates where the relationship creates increased risk for financial crime. The Institution's classification of PEP shall be determinative for the Institution's compliance measures.

2. Declarant Status

The Declarant hereby confirms the following (check as applicable):

I am a Politically Exposed Person (PEP).

I am a close family member of a PEP.

I am a close associate of a PEP.

3. PEP Category and Office Details

If any PEP-related box is checked above, indicate the category and details of the public function(s) held:

Category (check all that apply):

Head of state or head of government
Senior elected politician
Senior government, administrative or judicial official
Senior military official
Senior official of a state-owned enterprise
Senior official of a political party

Period in office: From To

4. Family Members and Close Associates

Provide full details (name, relationship, date of birth, nationality) of any family members or close associates who are relevant to this Declaration:

5. Source of Wealth and Funds

Describe the origin of the Declarant's wealth and the source of funds to be used in transactions with the Institution. Provide details sufficient for verification:

6. Representations and Warranties

The Declarant represents and warrants to the Institution that all information provided in this Declaration is true, complete and accurate as at the date of execution. The Declarant acknowledges that any material omission, misstatement or failure to update this information may constitute a breach of contract and may give rise to regulatory reporting obligations and termination of services.

7. Consent to Processing and Due Diligence

The Declarant expressly consents to the Institution collecting, storing, using and disclosing personal and sensitive personal information, including but not limited to identification documents, public position details, financial information and third-party verification reports, to the extent necessary for the Institution's compliance with applicable laws and its internal risk policies. The Declarant acknowledges that such processing may include sharing information with affiliates, correspondent entities and competent authorities where required by law.

8. Notification Obligation

The Declarant undertakes to notify the Institution in writing within days of any material change to the facts or circumstances set out in this Declaration, including new public offices, changes in family or associate relationships, or material changes to sources of wealth.

9. Indemnity

The Declarant agrees to indemnify and hold harmless the Institution, its officers, employees and agents from and against any and all liabilities, losses, damages, costs and expenses (including reasonable legal fees) arising from any false, misleading or incomplete statement or omission in this Declaration or from the Declarant's failure to comply with the notification obligations herein.

10. Confidentiality

Information provided by the Declarant will be treated as confidential by the Institution except to the extent disclosure is required by law, regulation or supervisory authority, or is necessary to fulfil the Institution's legal obligations. The Institution shall use reasonable measures to protect the confidentiality of the Declarant's information.

11. Governing Law

This Declaration shall be governed by and construed in accordance with the laws of without regard to conflict of laws principles.

12. Entire Agreement; Severability; Amendments; Waiver; Notices

Entire Agreement: This Declaration constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior understandings, agreements and representations.

Severability: If any provision of this Declaration is held to be invalid or unenforceable, the remaining provisions shall remain in full force and effect.

Amendments and Waiver: No amendment or waiver of any provision of this Declaration shall be effective unless in writing and signed by both parties. Failure or delay by either party in enforcing any right shall not operate as a waiver of that right.

Notices: Notices under this Declaration shall be in writing and delivered to the addresses provided by the parties. For the Declarant:

Certification

The Declarant certifies that the information provided in this Declaration is true and complete to the best of the Declarant's knowledge and belief, and acknowledges that the Institution may rely upon this Declaration in undertaking its client acceptance and ongoing monitoring obligations.

Executed as a deed on the date first set forth above.

Declarant - Print Name:

By:

Date:

Institution - Print Name:

By:

Date:

Enter text✕

What a Politically Exposed Person Declaration Is and When It’s Used

A Politically Exposed Person Declaration is a compliance statement completed by an individual to disclose whether they, a close family member, or a close associate hold a prominent public function. Financial institutions, legal firms, real estate professionals, and other regulated entities use the declaration as part of customer due diligence and enhanced risk screening under anti–money laundering (AML) and know-your-customer (KYC) policies. The form captures identity details, the nature of the public office, dates in office, related persons, and source-of-funds information to support risk-based decisions and suspicious activity monitoring.

Why a PEP Declaration Matters for Compliance and Risk Management

Collecting a Politically Exposed Person Declaration helps organizations identify higher-risk relationships, document enhanced due diligence steps, and satisfy AML program requirements while protecting against financial crime exposure.

Why a PEP Declaration Matters for Compliance and Risk Management

Who Typically Completes or Requires a PEP Declaration

The form is commonly used by organizations performing regulated onboarding, internal compliance checks, or transaction-level screening.

  • Commercial banks and credit unions performing KYC and transaction monitoring for new accounts or high-value transfers.
  • Broker-dealers, investment advisers, and private wealth teams assessing AML risk for new clients and beneficial owners.
  • Real estate brokers, title companies, and escrow agents screening buyers and counterparties in significant property transactions.

Use this declaration whenever screening for public-office connections or when a customer’s risk profile changes materially.

Core Elements of a Professional PEP Declaration

A complete declaration organizes identity, role details, related persons, financial relevance, attestations, and signature sections so reviewers can quickly confirm status and record sufficient evidence for the compliance file.

Header

Document title, unique form ID, and version or effective date for auditability and version control.

Declarant Identity

Full legal name, date of birth, government ID number, and contact information to match against customer records and screening sources.

PEP Role Details

Office title, jurisdiction, employer, start/end dates, and whether the role is current or former for accurate risk classification.

Related Persons

Fields to list spouses, immediate family, and known close associates who may create indirect risk exposure.

Source of Funds

Brief description of income or funds relevant to the transaction to demonstrate legitimate provenance for AML purposes.

Attestation & Signature

Signed declaration with date, printed name, and method of signature (wet or e-sign) plus optional notary details if required.

Step-by-Step: Completing a PEP Declaration

Follow these core steps to complete and submit the declaration correctly.

  • 01
    Gather IDs: Collect government ID and supporting documents before starting.
  • 02
    Complete Fields: Fill identity, office, and related-person fields accurately.
  • 03
    Review for Changes: Confirm accuracy and update any prior entries before signing.
  • 04
    Sign and Submit: Apply signature, date, and submit through the designated compliance channel.

Typical eSubmission Workflow for a PEP Declaration

Digital workflows streamline collection and verification while maintaining auditable records suitable for internal controls and regulators.

  • Upload Template: Load the PEP form into your document system or e-sign platform.
  • Assign Signer: Send the form to the declarant through a secured signing link or email invite.
  • Authenticate Signer: Verify identity with email code, SMS OTP, or stronger authentication as policy requires.
  • Capture Audit Trail: Store timestamp, IP, and signer actions with the signed document for compliance.

Recommended Digital Workflow Settings

Configure workflow controls to match your AML/KYC policies and evidence retention rules.

Field Configuration
Authentication Email + SMS OTP for moderate risk; KBA or ID verification for high risk
Required Fields Make identity, role, and related-person fields mandatory
Conditional Logic Show additional questions when 'Yes' to PEP status is selected
Retention Hook Auto-archive signed records to secure storage with access logging

Platform Considerations for Secure eSubmission

Choose a platform that supports audit trails, strong encryption, and the authentication methods your policy requires.

  • Integrations: Salesforce, NetSuite, Google Workspace
  • Security: AES-256 at rest; TLS 1.2/1.3 in transit
  • Auth Options: Email, SMS, KBA, ID verification

Key Security and Compliance Data Points

Encryption: TLS 1.2/1.3; AES-256
Certifications: SOC 2 Type II; ISO 27001
HIPAA: BAA required for PHI
Audit Trail: IP, timestamp, action log
Access Controls: Role-based permissions
Retention: Configurable export and archive

Principal Risks and Penalties for Incomplete or Incorrect Declarations

Regulatory Fines: Civil penalties and AML enforcement actions
SAR Exposure: Increased SAR filings and scrutiny
Operational Delay: Account holds or transaction blocking
Reputational Harm: Public trust and client loss
Contractual Risk: Breach of client onboarding requirements
Criminal Liability: Willful evasion may trigger criminal charges

Common Mistakes to Avoid When Preparing a PEP Declaration

  • Using nicknames or partial names that fail to match screening databases and produce false negatives or duplicates.
  • Leaving related-person sections blank; immediate family omissions can conceal indirect exposure and trigger rework.
  • Failing to update the form when a declarant’s public office changes, which undermines the integrity of ongoing monitoring.
  • Relying on a single weak authentication method for high-risk declarants instead of layered identity verification.

Key Timelines and Review Expectations

Set clear deadlines for collection and periodic refreshes to satisfy ongoing due diligence requirements.

Initial Collection:

Collect at onboarding before account activation or high-risk transactions

Periodic Refresh:

Annual or sooner upon material change in status

Event-Driven Update:

Update immediately when new public office or relation is identified

Verification Window:

Allow 3–5 business days for identity verification and analyst review

Record Retention:

Retain signed declarations per your retention schedule and applicable law

Processing Stages from Submission to Compliance File

A clear stage model helps assign responsibility and ensures timely completion of verification and retention steps.

01

Submission

Declarant completes and signs the form; system logs timestamp

02

Identity Verification

Compliance team or automated check confirms identity and role details

03

Risk Review

Analyst classifies risk and determines enhanced due diligence needs

04

File Closure

Final signed declaration and evidence archived in the compliance file

Comparing eSignature Pricing and Key Capabilities

Select a vendor that aligns with your volume, authentication needs, and compliance obligations; signNow is listed first for comparison of common plan features.

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 trial Varies by vendor Varies by vendor Varies by vendor Varies by vendor
Bulk Send Yes Yes Yes Yes Yes
Audit Trail Yes Yes Yes Yes Yes
HIPAA Compliant Yes Yes Yes No No
Envelope Cap No envelope cap 100 envelopes/user/year Varies by plan Varies by plan Varies by plan

Frequently Asked Questions About the Politically Exposed Person Declaration

Answers to common questions about scope, signature validity, updates, and secure handling of PEP declarations.


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