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Beneficial Owner Declaration Form
"I need a Beneficial Owner Declaration Form for my Indonesian technology startup that's preparing for Series A funding in March 2025, with three individual shareholders and one institutional investor, ensuring compliance with latest Indonesian regulations."
1. Declaration Details: Date, place, and reference number of the declaration
2. Declaring Entity Information: Legal name, registration number, address, and business type of the entity making the declaration
3. Authorized Representative Details: Information about the person authorized to make the declaration on behalf of the entity
4. Beneficial Owner Information: Personal details of beneficial owners including full name, identification number, nationality, tax ID, and residential address
5. Nature of Beneficial Ownership: Details of how beneficial ownership is held (shares, voting rights, control) and percentage of ownership
6. Chain of Ownership Structure: Description or diagram of how beneficial ownership is exercised through the corporate structure
7. Declaration of Truth: Formal statement confirming the accuracy of provided information and commitment to update if changes occur
8. Signature Block: Space for signature, name, position of authorized representative and company seal
1. Intermediate Entity Details: Information about intermediate companies in the ownership chain, required when beneficial ownership is exercised through multiple entities
2. Multiple Citizenship Declaration: Additional section for beneficial owners holding multiple citizenships
3. Political Exposure Status: Declaration of whether any beneficial owner is a politically exposed person (PEP)
4. Historical Ownership Changes: Details of recent changes in beneficial ownership, if applicable
5. Trust Structure Details: Additional information required when beneficial ownership involves trust structures
1. Schedule A - Identity Documents: Copies of required identity documents for beneficial owners (passport, national ID, etc.)
2. Schedule B - Corporate Documents: Supporting corporate documents proving ownership structure (share certificates, corporate registry extracts)
3. Schedule C - Ownership Diagram: Visual representation of the complete ownership structure showing all relevant entities and percentages
4. Schedule D - Power of Attorney: If applicable, authorization document for the person signing the declaration
5. Schedule E - Supporting Declarations: Any additional sworn statements or specific forms required by Indonesian authorities
Authors
Control
Corporate Entity
Declaration
Direct Ownership
Indirect Ownership
Substantial Control
Voting Rights
Share Ownership
Ultimate Beneficial Owner
Authorized Representative
Chain of Ownership
Controlling Interest
Corporate Documents
Declaring Entity
Due Diligence
Politically Exposed Person
Shareholders
Verification Documents
Ownership Interest
Corporate Control
Significant Influence
Intermediate Entity
Legal Arrangement
Trust Structure
Nominee Arrangement
Business Entity
Beneficial Interest
Material Change
Controlling Person
Entity Information
Ownership Details
Control Structure
Verification Requirements
Supporting Documentation
Change Notification
Compliance Statement
Representations and Warranties
Privacy and Data Protection
Authorizations
Attestation
Identity Verification
Update Requirements
Regulatory Compliance
Documentation Requirements
Certification
Confidentiality
Legal Authority
Accuracy Confirmation
Disclosure Obligations
Information Access
Record Keeping
Regulatory Reporting
Signature Requirements
Banking and Financial Services
Insurance
Manufacturing
Mining and Resources
Technology
Retail
Real Estate
Healthcare
Education
Transportation
Energy
Agriculture
Construction
Professional Services
Telecommunications
Hospitality
Legal
Compliance
Corporate Secretariat
Risk Management
Finance
Corporate Governance
Regulatory Affairs
Executive Office
Administrative
Due Diligence
Corporate Secretary
Compliance Officer
Legal Director
Chief Legal Officer
Company Director
Chief Executive Officer
Chief Financial Officer
Risk Manager
Corporate Governance Officer
Regulatory Affairs Manager
Due Diligence Officer
Board Secretary
General Counsel
Managing Director
Finance Director
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