CERTIFICATION REGARDING BENEFICIAL
OWNERS OF LEGAL ENTITY MEMBERS
Please complete and return this form with the other required documents. Questions? Please contact us at 800.233.2328.
1. Legal Entity Information
LEGAL ENTITY NAME |
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LEGAL ENTITY TYPE |
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LEGAL ENTITY EIN / SSN |
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Club Corp LLC Partnership |
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LEGAL ENTITY ADDRESS |
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CITY |
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STATE / PROVINCE |
ZIP / POSTAL CODE |
COUNTRY |
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2. General Instructions
What is this form?
To help the government fight financial crime, Federal regulation requires certain financial institutions to obtain, verify, and record information about the Beneficial Owners of Legal Entity members. Legal Entities can be abused to disguise involvement in terrorist financing, money laundering, tax evasion, corruption, fraud, and other financial crimes. Requiring the disclosure of key individuals who own or control a Legal Entity (i.e., the Beneficial Owners) helps law enforcement investigate and prosecute these crimes.
Who is a Beneficial Owner?
Beneficial owners are each individual, if any, who owns, directly or indirectly, 25 percent or more of the equity interests of the Legal Entity member (e.g., each natural person that owns 25 percent or more of the shares of a corporation).
Who is a Beneficial Owner with significant responsibility?
An individual with significant responsibility for managing the Legal Entity member (e.g., a chief executive officer, chief financial officer, chief operating officer, managing member, general partner, president, vice president, or treasurer).
Who is required to complete and sign this form?
This form must be completed by the person opening a new account, establishing a loan, or maintaining an account by adding or removing an authorized signer or changing the business’s name on behalf of a Legal Entity with any of the following U.S. financial institutions: (i) a bank or credit union; (ii) a broker or dealer in securities; (iii) a mutual fund; (iv) a futures commission merchant; or (v) an introducing broker in commodities. If the account or loan has an automatic renewal feature, you agree that the account holder will notify BECU of any changes to the information provided on this form. If BECU receives no notification of any changes, BECU will treat the automatic renewal as certification that the information is current and accurate.
For the purposes of this form, a Legal Entity includes a corporation, limited liability company, or other entity that is created by a filing of a public document with a secretary of state or similar office, a general partnership, and any similar business entity formed in
the United States or a foreign country. Legal Entity does not include sole proprietorships, unincorporated associations, or natural persons opening accounts on their own behalf.
What information am I required to provide?
This form requires you to provide the name, address, date of birth and Social Security number (or passport number or other similar information, in the case of non-U.S. Persons) for the Beneficial Owner(s) and Beneficial Owner with significant responsibility.
The number of individuals that satisfy this definition of Beneficial Owner may vary. Under section (i), depending on the factual circumstances, up to four individuals (but as few as zero) may need to be identified. Regardless of the number of individuals identified under section (i), you must provide the identifying information of one individual under section (ii). It is possible that in some circumstances the same individual might be identified under both sections (e.g., the President of Acme, Inc. also holds a 30 percent equity interest). Thus, a completed form will contain the identifying information of at least one individual (under section (ii)), and up to five individuals (i.e., one individual under section (ii) and four 25 percent equity holders under section (i)).
What are the identification requirements?
•For U.S. persons, provide Social Security number (SSN) only.
•For non-U.S. persons, provide SSN, a passport number, and country of issuance. In lieu of a passport, non-U.S. persons may also provide an alien identification card number, or number, and country of issuance or any other government-issued document evidencing nationality or residence and bearing a photograph or similar safeguard.
BECU may also ask to see a copy of a driver’s license or other identifying document for each Beneficial Owner listed on this form.