Beneficial ownership certification form sample 2026

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  1. Click ‘Get Form’ to open the beneficial ownership certification form in the editor.
  2. Begin by filling in your name and title as the individual completing the certification. Ensure accuracy in spelling and include your middle initial if applicable.
  3. Next, provide the legal entity's name, any DBA (Doing Business As) name, tax ID number, and complete address including city, state, zip code, and country.
  4. For the Controlling Person section, enter their legal name, title, SSN/ITIN or alternative identification details. If using a passport or green card for identification, ensure to upload a copy.
  5. In the Beneficial Owner(s) section, list each individual who owns 25% or more of the entity’s equity interest. Fill out their legal names, ownership percentages, and identification details as required.
  6. Finally, review all information for completeness and accuracy before signing and dating the certification at the end of the form.

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Please fill details of Beneficial Owner holding more than 10% controlling interest (in case of company), 10% or more in case of trust or more than 15% controlling interest (in case of other entities), if Beneficial Owner is not identifiable or there are no natural person(s), who are Beneficial Owners, please fill
Beneficial Ownership in respect of a company means, an individual who, directly or indirectly, ultimately owns that company or exercises effective control over that company. (Section 55 of the General Laws Amendment Act, 22 of 2022, read with the amendments to the Companies Act and Companies Act Regulations).
Where may I obtain a copy of the form? A copy (pdf) may be downloaded from the FinCEN website at .fincen.gov under the Filing Information tab. The form may be completed on a computer using the free docHub Reader software.
The form includes identity information about the organizations beneficial owners that have a 25% ownership interest, identity information about one individual with managerial control, and a signature of the person providing and docHubing this information.

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