Form Becu 6873 PDF Details

When completing your taxes this year, you may have been asked to complete Form Becu 6873. This form is for reporting qualified student loan interest payments made during the tax year. If you paid more than $600 in interest on a qualified student loan, you will need to report it on your return. Interest payments made to family members or friends do not qualify, so be sure to only include interest payments made to lenders or other financial institutions. Qualified student loans include those that were used for qualified educational expenses, such as tuition, fees, and room and board. There are a few other restrictions that apply, so be sure to consult the instructions for Form Becu 6873 before completing your return.

You will discover details about the type of form you would like to prepare in the table. It can show you how much time it will take to complete form becu 6873, what fields you will have to fill in and some further specific facts.

QuestionAnswer
Form NameForm Becu 6873
Form Length10 pages
Fillable?Yes
Fillable fields338
Avg. time to fill out35 min 5 sec
Other names6873_612 printable small business loan application form bangor savings bank

Form Preview Example

BUSINESS MEMBERSHIP

& ACCOUNT OPENING CHECKLIST

Welcome to BECU. Opening an account is easy. Here’s what you’ll need to get started:

FOR ALL NEW BUSINESS MEMBERSHIPS

¨BECU Business Membership Application (available online or at any BECU location)

¨Business Taxpayer Identification Number (EIN or TIN -- issued by the IRS, or SSN)

¨Unified Business Identifier (UBI) number (Refer to your business license)

¨NAICS code

(Locate your NAICS code on the census.gov/naics website, your Federal Tax return, or your Schedule C.)

INDIVIDUALS WHO MUST

SIGN THE APPLICATION

Sole Proprietorship or LLC opened with an SSN

¨Business Owner

LLC with EIN, General Partnership, Limited Partnership, or Corporation (including non-profit)

¨All Owners with 25% or more ownership OR

¨One Governing Person (as listed on the Washington Secretary of State website) for instances in which no one owns 25% or more

BASED ON YOUR BUSINESS TYPE

Sole Proprietorship

Business Owners and Authorized

Signers provide the following:

¨Personal identification

(current driver’s license or state-issued identification card)

¨Business Taxpayer Identification Number Partnership, LLC, or Corporation

Individual opening the membership, Business Owners with 25% or more ownership, and each Authorized Signer provide the following:

¨Personal identification

(current driver’s license or state-issued identification card)

¨Business Taxpayer Identification Number On behalf of the Business, provide:

¨Completed and signed BECU Certification Regarding Beneficial Owners of Legal Entity Members form

(available online or at any BECU location)

BUSINESSES IN WASHINGTON STATE

When processing your membership, BECU verifies the Business and Business Owners using one of two Washington state websites:

Sole Proprietorship or General Partnership: Department of Revenue My DOR website

¨Status is open and active

¨Verfiy Business name and address

¨Sole Proprietor on the application is listed as one of the Governing people

Corporation, LLC, or Limited Partnership: Secretary of State website

¨Status is open and active

¨Verify Business name and address

¨At least one of the individuals requesting to open a membership is listed as Governor

For more information, call 800-704-8080 or visit any BECU location.

Account opening and documentation requirements for your business may be different than stated above and may change based on the legal structure of your business. All accounts are subject to approval.

800-233-2328

Insured by NCUA

becu.org

BECU 680 06/2021

BUSINESS MEMBERSHIP

&DEPOSIT ACCOUNT ROLES - CORPORATIONS, LLCs, PARTNERSHIPS

When you apply for a business membership and open checking, savings, money market, or CD accounts with BECU, you specify what individuals can do. The authority you specify will apply to all deposit accounts unless you designate an individual as an Accounts-Only Authorized Signer.

Summary of Roles (see Business Account Agreements for more information):

1. Authorized Signer:

Best if: You want the individual to have authority to act on behalf of the business and to transact on all of your business accounts. The individual will have the authority to:

»Change business address and phone number

»Add or remove Agents or Non-Authorized Agents

»Open or close deposit accounts or services

»View or access information on all business accounts through ATMs, telephone, in person, or online banking, including viewing eStatements

»Perform transactions on all business accounts, including withdrawals, transfers, bill pay, wire transfers, write checks, placing/canceling stop payments, linking accounts for overdraft protection, changing account types, or ordering checks, debit cards, or ATM cards

2. Agent

Best if: You want the individual to have no authority to act on behalf of the business, be able to view information about all of your business accounts, and have only limited transaction authority on all the accounts. The individual will have the authority to:

»View or access information on all of your business accounts through telephone, in person, or (except for LLCs using an SSN) online banking

»Perform transfers between all accounts within the same business

3. Non-Authorized Agent

Best if: You want the individual to be able to view information about all of your business accounts, but have no authority to act on behalf of the business and no transaction authority on the accounts. The individual will have the authority to:

»View or access information on all of your business accounts through telephone, in person, or (except for LLCs using an SSN) online banking

4. Account-Only Authorized Signer:

Best if: You want the individual to only have authority to transact on a specific account. The individual will have the authority to:

»View or access information about the specific business accounts through ATM, telephone, or in person

»Perform transactions on that specific account including withdrawals, transfers, wire transfers, write checks, placing/canceling stop payments, linking accounts for overdraft protection, changing account types, or ordering checks, debit cards, or ATM cards

NOTE: Account-Only Authorized Signers cannot use online banking to view information about the account or perform transactions.

5. Only Owners or the Control Person can:

»Change the business name

»Add or remove Authorized Signers

800.233.2328

Insured by NCUA

becu.org

697 04/2019

BUSINESS MEMBERSHIP APPLICATION -

CORPORATIONS, LLCs, PARTNERSHIPS

Welcome to Boeing Employees’ Credit Union (BECU). All information is required unless otherwise noted. Please complete application, sign in ink, and bring to a BECU location to apply. If you have any questions, please contact a BECU representative at 800.233.2328.

Select your business type:

 

¨ General Partnership

¨ C. Corporation (Profit and Non-Profit)

¨Limited Partnership / Limited Liability Partnership / Limited Liability ¨ Limited Liability Company /

Limited Partnership / Professional Limited Liability Partnership

Professional Limited Liability Company

¨ S. Corporation

 

¨ Other (please specify):

 

 

 

 

 

1. Business Information and Ownership

 

 

 

BUSINESS NAME

 

DBA (if applicable)

 

 

 

 

 

FEDERAL TAX ID NUMBER

¨ EIN ¨ ITIN ¨ SSN

STATE UNIFIED BUSINESS IDENTIFIER (UBI) NUMBER

BUSINESS LOCATION / STREET ADDRESS

 

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

MAILING ADDRESS (if different from above)

 

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

BUSINESS PHONE

EMAIL ADDRESS (optional)*

 

*By providing your email address, you agree that BECU may electronically send you marketing information about our products and services.

2. Government Required Information

Federal law requires all financial institutions to help the government fight the funding of terrorism and money laundering activities by obtaining, verifying, and recording information that identifies each business that opens a membership.

ESTIMATED ANNUAL SALES / REVENUE

 

 

¨ Less than $100,000 ¨ $100,000 - $499,000 ¨ $500,000-$999,999

¨ $1,000,000-$3,000,000 ¨ Greater than $3,000,000

 

 

 

 

Is your business a non-profit, not-for-profit, or charitable organization?

 

NUMBER OF EMPLOYEES

¨ Yes ¨ No

 

 

 

 

 

 

 

STATE OF ENTITY FORMATION

DATE BUSINESS ESTABLISHED

 

COUNTRY WHERE BUSINESS ESTABLISHED

 

 

 

NAICS CODE*

TYPE OF BUSINESS / PRIMARY FUNCTION

 

 

 

 

 

¨ I acknowledge my business does not operate in any of the following restricted industries: money transfer services, businesses operating Internet

gambling sites or marijuana dispensaries/businesses. Initials

 

 

 

 

 

 

 

 

 

 

Does the business receive revenue from a marijuana related business?

What is the % of income or revenue from a marijuana related business?

¨ Yes

¨ No

 

 

 

 

 

 

 

 

 

 

 

Anticipated transaction information

 

 

 

 

 

Will your business send domestic wire transfers?

Monthly number of domestic wires sent:

Monthly $ amount of domestic wires sent:

¨ Yes ¨ No or N/A

 

 

 

 

 

 

 

 

 

 

Will your business send international wire transfers?

Monthly number of international wires sent:

Monthly $ amount of international wires sent:

¨ Yes ¨ No or N/A

 

 

 

 

 

 

 

 

 

 

Will your business have cash deposits?

Monthly number of cash deposits:

Monthly $ amount of cash deposits:

¨ Yes ¨ No or N/A

 

 

 

 

 

 

 

 

 

 

Will your business have cash withdrawals?

Monthly number of cash withdrawals:

Monthly $ amount of cash withdrawals:

¨ Yes ¨ No or N/A

 

 

 

 

 

 

 

 

 

 

What is the purpose or types of transactions for which your BECU account(s) will be used:

 

¨ Operating / General purpose ¨ Savings / Investment

 

 

 

 

 

 

 

Do you have accounts for this business with an institution other than BECU?

 

¨ Yes

¨ No

 

 

 

 

 

*North American Industry Classification System is the standard used by Federal Statistic Agencies to classify business establishments.

BECU 6873 04/2019

Page 1 of 5

3.Certificate of Authority (persons authorized to open this membership with BECU on behalf of the business)

By signing below, whether the business is a corporation, partnership, limited partnership, limited liability company, or other entity separate from its owner(s), you certify that the business, by Resolution or otherwise, duly adopted in accordance with its charter, bylaws, and applicable law, are authorized to enter into this Agreement, apply for and maintain membership, sign up for additional products and services with BECU, and to take all other actions and steps reasonable or necessary to do so, and deliver any instruments, or agreements as necessary to BECU. Any action hereto taken by you is hereby ratified and confirmed by the business. Unless or until BECU is given written notice otherwise, you shall have full power and authority to act on behalf of the business. It shall not be necessary for BECU to inquire further into your powers or powers of the business’s officers, directors, partners, managers, members, or agents purporting to act on its behalf.

SIGNATURE

 

FULL LEGAL NAME

 

 

 

 

TITLE / POSITION

 

 

DATE

 

 

 

 

 

NFC verification (select one):

Business Services Specialist verification

(select one):

 

¨ Individual shown as governor on the Washington

¨ BECU Resolution of Banking Authority - Corporations

BECU Use Only

Secretary of State or My DOR website

¨ Resolution of Banking Authority (provided by the business)

 

¨ BECU Delegation of Banking Authority

¨ Partnership agreements

¨BECU Resolution of Banking Authority - Limited Partnerships and LLCs

4.Membership Agreements (Continued on the next page.)

SECTION 4 REQUIRED SIGNATURES

 

¨ Corporation / LLC

¨ General Partnership / Limited Partnership

¨ Single owned: Owners’ signature

¨ Single owned: Owners’ signature

¨ Multi-owned: All owner’s with 25% or more ownership

¨ Multi-owned: All owner’s with 25% or more ownership

¨ Multi-owned (where no one has 25% or more ownership):

¨ Non-Profit: Person opening the business membership

Person opening the business membership

 

By signing below, you, the business, Business Owner, and each Authorized Signer(s), (collectively “You”), acknowledge and agree; that the information You provided is accurate, complete, and true and that You have instructed BECU as to the proper title of the account and we may rely on the information in our dealings with You, now, and in the future; that BECU may receive information about the business’ and each Business Owner’s credit history and performance from others, including credit reporting agencies; to the terms and conditions contained in this application; that You have reviewed and will retain for Your records the BECU Business Account Disclosure and Business Account Agreements, including Our Privacy Statement, Funds Availability Policy, and Electronic Funds Transfer Disclosure, and by signing below You acknowledge their receipt and agree to their terms and the business authorizes the persons identified in section 5 below as Authorized Signers.

Taxpayer Identification Number Certification and Backup Withholding Information

By signing below, You certify in accordance with the IRS W-9 instructions and under penalties of perjury that: 1. The number shown on this form is Your correct taxpayer identification number (or You are waiting for a number to be issued to you), and 2. You are not subject to backup withholding because: (a) You are exempt from backup withholding, or (b) You have not been notified by the Internal Revenue Service (IRS) that You are subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified You that You are no longer subject to backup withholding, and 3. You are a U.S. person (including a U.S. resident alien).

Certification Instructions: Cross out item 2 above if You have been notified by the IRS that You are currently subject to backup withholding because You have failed to report all interest and dividends on Your tax return. Cross out item 3 and complete a W-8 BEN if You are not a U.S. person.

The Internal Revenue Service does not require Your consent to any provision of this document other than the certifications required to avoid backup withholding.

IMPORTANT INFORMATION ABOUT YOUR PROCEDURES FOR OPENING A NEW ACCOUNT. Federal law requires all financial institutions to help the government fight the funding of terrorism and money laundering activities by obtaining, verifying, and recording information that identifies each person who opens an account. What this means to you: When you open an account we ask for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver’s license or other identifying documents.

MEMBERSHIP AGREEMENT SIGNATURES (Continued on the next page.)

INDIVIDUAL (1)

 

 

 

 

 

SSN / TIN

 

 

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

 

¨ Home ¨ Mobile ¨ Work

DATE OF BIRTH

MOTHER’S MAIDEN NAME

 

 

 

 

 

 

 

 

VALID PICTURE ID NUMBER

ID TYPE

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

STATE / PROVINCE

 

 

ZIP / POSTAL CODE

 

COUNTRY

 

 

 

 

 

 

 

 

 

Non-resident alien?

If non-resident alien,

country of origin:

 

Business ownership percentage:

Authorized Signer?

¨ Yes ¨ No

 

 

 

 

 

 

 

¨ Yes ¨ No

 

 

 

 

 

 

 

 

 

SIGNATURE

 

 

 

TITLE

 

 

 

DATE

 

 

 

 

 

 

 

 

 

BECU 6873 04/2019

Page 2 of 5

MEMBERSHIP AGREEMENT SIGNATURES (Continued from the previous page.)

 

 

 

INDIVIDUAL (2)

 

 

 

 

 

SSN / TIN

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

 

¨ Home

¨ Mobile

¨ Work

DATE OF BIRTH

MOTHER’S MAIDEN NAME

 

 

 

 

 

 

 

 

 

 

VALID PICTURE ID NUMBER

ID TYPE

 

 

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE / PROVINCE

 

 

ZIP / POSTAL CODE

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

Non-resident alien?

If non-resident alien,

country of origin:

 

 

Business ownership percentage:

Authorized Signer?

¨ Yes

¨ No

 

 

 

 

 

 

 

¨ Yes

¨ No

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

 

 

TITLE

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

INDIVIDUAL (3)

 

 

 

 

 

SSN / TIN

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

 

¨ Home

¨ Mobile

¨ Work

DATE OF BIRTH

MOTHER’S MAIDEN NAME

 

 

 

 

 

 

 

 

 

 

VALID PICTURE ID NUMBER

ID TYPE

 

 

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE / PROVINCE

 

 

ZIP / POSTAL CODE

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

 

 

Non-resident alien?

If non-resident alien,

country of origin:

 

 

Business ownership percentage:

Authorized Signer?

¨ Yes

¨ No

 

 

 

 

 

 

 

¨ Yes

¨ No

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

 

 

TITLE

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

INDIVIDUAL (4)

 

 

 

 

 

SSN / TIN

 

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

 

¨ Home

¨ Mobile

¨ Work

DATE OF BIRTH

MOTHER’S MAIDEN NAME

 

 

 

 

 

 

 

 

 

 

VALID PICTURE ID NUMBER

ID TYPE

 

 

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE / PROVINCE

 

 

ZIP / POSTAL CODE

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

Non-resident alien?

If non-resident alien,

country of origin:

 

 

Business ownership percentage:

Authorized Signer?

¨ Yes

¨ No

 

 

 

 

 

 

 

¨ Yes

¨ No

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

 

 

TITLE

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

INDIVIDUAL (5)

 

 

 

 

 

SSN / TIN

 

 

 

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

 

¨ Home

¨ Mobile

¨ Work

DATE OF BIRTH

MOTHER’S MAIDEN NAME

 

 

 

 

 

 

 

 

 

VALID PICTURE ID NUMBER

ID TYPE

 

 

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

 

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

 

 

STATE / PROVINCE

 

 

ZIP / POSTAL CODE

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

Non-resident alien?

If non-resident alien,

country of origin:

 

 

Business ownership percentage:

Authorized Signer?

¨ Yes

¨ No

 

 

 

 

 

 

 

¨ Yes

¨ No

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

 

 

TITLE

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

BECU 6873 04/2019

 

 

 

 

 

 

 

 

Page 3 of 5

5. Additional Authorized Signers (optional)

Authorized Signers are able to perform transactions, open or close deposit accounts or services, and add or remove Agents or Non-Authorized Agents on all business deposit accounts. Authorized Signers can view and access information on all business deposit and loan accounts. See Business Account Agreements for responsibilities, restrictions, and limitations on Authorized Signers. Each new Authorized Signer must sign below.

AUTHORIZED SIGNER (1)

 

 

 

 

SSN / TIN

 

 

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

 

¨ Home

¨ Mobile

¨ Work

DATE OF BIRTH

MOTHER’S MAIDEN NAME

 

 

 

 

 

 

 

 

 

VALID PICTURE ID NUMBER

ID TYPE

 

 

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

 

STATE / PROVINCE

 

 

ZIP / POSTAL CODE

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

Non-resident alien?

If non-resident alien,

country of origin:

 

 

 

 

 

¨ Yes

¨ No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

 

 

TITLE

 

 

 

DATE

 

 

 

 

 

 

 

 

AUTHORIZED SIGNER (2)

 

 

 

 

SSN / TIN

 

 

 

 

 

 

 

 

 

CONTACT NUMBER

 

¨ Home

¨ Mobile

¨ Work

DATE OF BIRTH

MOTHER’S MAIDEN NAME

 

 

 

 

 

 

 

VALID PICTURE ID NUMBER

ID TYPE

 

 

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

 

 

 

 

 

 

 

 

 

STREET ADDRESS

 

 

 

 

 

CITY

 

 

 

 

 

 

 

 

 

 

STATE / PROVINCE

 

 

ZIP / POSTAL CODE

 

COUNTRY

 

 

 

 

 

 

 

 

 

 

Non-resident alien?

If non-resident alien,

country of origin:

 

 

 

 

 

¨ Yes

¨ No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE

 

 

 

TITLE

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

6.Agents* and Non-Authorized Agents** (ID and address for authentication purposes)

*Agents have no authority to act on behalf of the business. Agents may access information on all business accounts in person, in Online Banking, or by calling BECU, and may perform transfers between all accounts within the same business.

**Non-Authorized Agents have no authority to act on behalf of the business and no transaction authority on the business accounts. Non-Authorized Agents may only access information on all your business accounts in person, in Online Banking, or by calling BECU.

NAME (1)

¨ Agent

SSN / TIN

DATE OF BIRTH MOTHER’S MAIDEN NAME

¨Non-Authorized Agent

VALID PICTURE ID NUMBER

ID TYPE

 

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

 

 

 

 

 

 

STREET ADDRESS

 

 

 

CITY

 

 

 

 

 

 

 

STATE / PROVINCE

 

ZIP / POSTAL CODE

 

COUNTRY

 

 

 

 

 

 

 

NAME (2)

 

¨ Agent

SSN / TIN

DATE OF BIRTH

MOTHER’S MAIDEN NAME

 

 

 

 

 

¨Non-Authorized Agent

VALID PICTURE ID NUMBER

ID TYPE

ISSUE DATE

EXPIR. DATE

STATE & COUNTRY ISSUED

STREET ADDRESS

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

BECU 6873 04/2019

Page 4 of 5

7. Deposit Products and Services

A Business Members Share Savings account is required to establish membership at BECU. Please refer to the BECU Business Account Disclosure for rates and fee schedule. Visit becu.org for additional information about our products and services.

ACCOUNT (1)

¨Business Member Share Savings (required)

ACCOUNT (2)

¨ Business Basic Checking

¨ Business Interest Checking

¨ Business Money Market Account

¨ Business Savings

 

 

 

 

ACCOUNT (3)

 

 

 

¨ Business Basic Checking

¨ Business Interest Checking

¨ Business Money Market Account

¨ Business Savings

 

 

 

 

ACCOUNT (4)

 

 

 

¨ Business Basic Checking

¨ Business Interest Checking

¨ Business Money Market Account

¨ Business Savings

8. ATM / Debit Cards for Authorized Signers

Use this section to select deposit account card types for Authorized Signers. Note: Selecting cards for Authorized Signers is optional.

INDIVIDUAL (1)

 

 

INDIVIDUAL (2)

 

 

¨ Debit Card

¨ ATM Card

¨ ATM Deposit-Only Card

¨ Debit Card

¨ ATM Card

¨ ATM Deposit-Only Card

 

 

 

 

 

 

INDIVIDUAL (3)

 

 

INDIVIDUAL (4)

 

 

¨ Debit Card

¨ ATM Card

¨ ATM Deposit-Only Card

¨ Debit Card

¨ ATM Card

¨ ATM Deposit-Only Card

 

 

 

 

 

INDIVIDUAL (5)

 

 

AUTHORIZED SIGNER (1)

 

¨ Debit Card

¨ ATM Card

¨ ATM Deposit-Only Card

¨ Debit Card

¨ ATM Card

¨ ATM Deposit-Only Card

 

 

 

 

 

AUTHORIZED SIGNER (2)

 

 

 

 

¨ Debit Card

¨ ATM Card

¨ ATM Deposit-Only Card

 

 

 

 

 

 

 

 

 

BECU Use Only

BASIS FOR ELIGIBILITY

NEW ACCOUNT NUMBERS

DATE

REP

Owners and authorized signers:

¨ OFAC on business name

 

 

¨ IDV verified

¨ QualiFile®

¨ ID verified

Reset

BECU 6873 04/2019

Submit your application in person at any BECU location to establish membership.

Page 5 of 5

 

To find a BECU location, visit becu.org/locations.

 

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

 

LEGAL ENTITY TYPE

 

LEGAL ENTITY EIN / SSN

 

 

Club Corp LLC Partnership

 

 

 

 

 

 

LEGAL ENTITY ADDRESS

 

 

CITY

 

 

 

 

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

 

 

 

 

 

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.

BECU 610 02/2019

Page 1 of 3

Section 3 is required.

3. Beneficial Owner with 25% or More Ownership

Provide the following information for each individual, if any, who, directly or indirectly, through any contract, arrangement, understanding, relationship, or otherwise, owns 25 percent or more of the equity interests of the Legal Entity listed above. If no individual meets this definition, please check the Beneficial Owner with 25% or more ownership not applicable check box below this section, and proceed to section 4. Beneficial Owner with Significant Responsibility.

BENEFICIAL OWNER NAME (1)

TITLE

PERCENT OWNERSHIP

DATE OF BIRTH

SSN

ADDRESS (residential or business street)

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

If you do not have a Social Security number: Refer to identification requirements in section 2 on this form and provide the required ID information below.

ID NUMBER

ID TYPE

COUNTRY OF ISSUANCE

BENEFICIAL OWNER NAME (2)

TITLE

PERCENT OWNERSHIP

DATE OF BIRTH

SSN

ADDRESS (residential or business street)

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

If you do not have a Social Security number: Refer to identification requirements in section 2 on this form and provide the required ID information below.

ID NUMBER

ID TYPE

COUNTRY OF ISSUANCE

BENEFICIAL OWNER NAME (3)

TITLE

PERCENT OWNERSHIP

DATE OF BIRTH

SSN

ADDRESS (residential or business street)

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

If you do not have a Social Security number: Refer to identification requirements in section 2 on this form and provide the required ID information below.

ID NUMBER

ID TYPE

COUNTRY OF ISSUANCE

BENEFICIAL OWNER NAME (4)

TITLE

PERCENT OWNERSHIP

DATE OF BIRTH

SSN

ADDRESS (residential or business street)

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

If you do not have a Social Security number: Refer to identification requirements in section 2 on this form and provide the required ID information below.

ID NUMBER

ID TYPE

COUNTRY OF ISSUANCE

Beneficial Owner with 25% or more ownership not applicable.

BECU 610 02/2019

Page 2 of 3

Sections 4, 5, and 6 are required.

4. Beneficial Owner with Significant Responsibility

Please provide information for one individual with significant responsibility for managing the Legal Entity listed above, whether or not they are the legal owner, such as:

An executive officer or senior manager (e.g., chief executive officer, chief financial officer, chief operating officer, managing member, general partner, president, vice president, treasurer); or

Any other individual who regularly performs similar functions.

If applicable, an individual listed under section 3. Beneficial Owner with 25% or more Ownership may also be listed in this section, 4. Beneficial Owner with Significant Responsibility.

NAME

DATE OF BIRTH

TITLE

SSN

ADDRESS (residential or business street)

CITY

STATE / PROVINCE

ZIP / POSTAL CODE

COUNTRY

If you do not have a Social Security number: Refer to identification requirements in section 2 on this form and provide the required ID information below.

ID NUMBER

ID TYPE

COUNTRY OF ISSUANCE

5. Information about the Individual Completing This Form

Persons 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 must complete this section.

NAME

TITLE

SSN

If you do not have a Social Security number: Refer to identification requirements in section 2 on this form and provide the required ID information below.

ID NUMBER

ID TYPE

COUNTRY OF ISSUANCE

6. Certification and Agreement by the Individual Who Completed Section 5 (above)

By signing below, I hereby certify, to the best of my knowledge, that the information provided on this form is complete and correct.

NAME

SIGNATURE

DATE

BECU Use Only

ID Verified

Org Number:

 

 

 

 

 

Reset

BECU 610 02/2019

Page 3 of 3

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Form Becu 6873 fields to fill in

Jot down the information in the COUNTRYWHEREBUSINESSESTABLISHED, DATEBUSINESSESTABLISHED, NUMBEROFEMPLOYEES, NAICSCODE, TYPEOFBUSINESSPRIMARYFUNCTION, Monthlyamountofdomesticwiressent, Monthlynumberofdomesticwiressent, Monthlynumberofcashwithdrawals, Monthlynumberofcashdeposits, Monthlyamountofcashdeposits, and Monthlyamountofcashwithdrawals area.

Form Becu 6873 COUNTRYWHEREBUSINESSESTABLISHED, DATEBUSINESSESTABLISHED, NUMBEROFEMPLOYEES, NAICSCODE, TYPEOFBUSINESSPRIMARYFUNCTION, Monthlyamountofdomesticwiressent, Monthlynumberofdomesticwiressent, Monthlynumberofcashwithdrawals, Monthlynumberofcashdeposits, Monthlyamountofcashdeposits, and Monthlyamountofcashwithdrawals fields to fill out

Inside the segment discussing FULLLEGALNAME, TITLEPOSITION, BECUUseOnly, PartnershipsandLLCs, Personopeningthebusinessmembership, and DATE, you are required to note some appropriate details.

FULLLEGALNAME, TITLEPOSITION, BECUUseOnly, PartnershipsandLLCs, Personopeningthebusinessmembership, and DATE in Form Becu 6873

The SSNTIN, VALIDPICTUREIDNUMBER, IDTYPE, ISSUEDATE, EXPIRDATE, STATECOUNTRYISSUED, STREETADDRESS, STATEPROVINCE, ZIPPOSTALCODE, CITY, COUNTRY, NonresidentalienYesNoSIGNATURE, Ifnonresidentaliencountryoforigin, TITLE, and YesNoDATE field is the place where each side can insert their rights and obligations.

part 4 to entering details in Form Becu 6873

Finish by reading all these fields and filling them in accordingly: SSNTIN, VALIDPICTUREIDNUMBER, IDTYPE, ISSUEDATE, EXPIRDATE, STATECOUNTRYISSUED, STREETADDRESS, STATEPROVINCE, ZIPPOSTALCODE, CITY, COUNTRY, NonresidentalienYesNoSIGNATURE, INDIVIDUAL, Ifnonresidentaliencountryoforigin, and TITLE.

part 5 to completing Form Becu 6873

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