Patriots Act Identification Form Details

The Patriots Act Form is a necessity for all businesses and organizations in order to properly document the details of any emergency or crisis. The form can be customized to fit the specific needs of your company, and should be updated regularly with any new information or changes. Having a well-organized Patriots Act Form will help ensure that your business is able to react swiftly and effectively in the event of an emergency.

Here is some data that might be useful if you're looking to learn just how long it will require you to fill out patriots act form and what number of PDF pages it contains.

QuestionAnswer
Form NamePatriots Act Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namespatriots disclosure form, patriot act disclosure form, patriots disclosure identification form, patriot act form

Form Preview Example

Patriots Act Disclosure

Borrower Identification

To help the government fight the funding of terrorism and money laundering activities, federal law requires all financial institutions to obtain, verify and record information that identifies each person who opens an account.

Please provide the following information. We required two forms of identification for each borrower to comply with Section 326 of the Act.

Borrower’s Name

 

 

Loan Number

 

 

 

 

Address

 

 

Date of Birth

 

 

 

 

City, State Zip

 

 

Social Security #/Tax ID #

 

IMPORTANT - Information listed below must be exactly as indicated on the document.

Primary Forms of Identification - must display Borrower’s name

 

Document

Country/State of

ID Number

Date of Birth

Expiration Date

 

 

 

Origin

 

 

 

 

 

State Issued Driver License

 

 

 

 

 

 

 

State Issued ID Card

 

 

 

 

 

 

 

Military ID Card

 

 

 

 

 

 

 

Passport

 

 

 

 

 

 

 

US Alien Registration Card

 

 

 

 

 

 

 

Canadian Driver License

 

 

 

 

 

 

 

Secondary Forms of Identification-must display Borrower’s name

 

 

 

 

Document

Name of Issuer on

ID Number

Issuance Date

Expiration Date

 

 

 

 

Form

 

 

 

 

 

Social Security Card

U.S. Govt.

 

 

 

 

 

Government Issued Visa

 

 

 

 

 

 

 

Birth Certificate

 

 

 

 

 

 

 

Non-US/Canadian Driver License

 

 

 

 

 

 

 

Most Recent Signed Tax Returns

Fed

State

TIN:

 

 

 

 

Property Tax Bill

 

 

APN:

 

 

 

 

Voter Registration Card

 

 

 

 

 

 

 

Organizational Membership Card

 

 

 

 

 

 

 

Bank/Investment/Loan Statements

 

 

 

 

 

 

 

Paycheck stub with name

 

 

 

 

 

 

 

Most Recent W-2

 

 

 

 

 

 

 

Home/car/renter insurance papers

 

 

 

 

 

 

 

Recent utility bill

 

 

 

 

 

 

 

Comments:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I certify that I have personally viewed and accurately recorded the information from the documents identified above, and have reasonably confirmed the identity of the applicant.

Signature

 

Title

 

 

 

Printed Name

 

Date

*For persons without a SSN/TIN, the ID number must be from one of the following: passport, alien ID card, or any other government issued document evidencing nationality or residence and bearing a photograph or similar safeguard.

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