Free Affidavit of Beneficial Ownership Template

Affidavit of Beneficial Ownership

I. Introduction

This Affidavit of Beneficial Ownership is executed by the undersigned affiant to confirm the details regarding the beneficial ownership of certain assets or accounts. The information provided herein is truthful, accurate, and complete to the best knowledge of the affiant.

II. Affiant Information

A. Personal Details

  • Full Name: [YOUR NAME]

  • Date of Birth: August 8, 2030

  • Address:Indianapolis, IN 46201

  • Contact Number: 222 555 7777

B. Identification

  • Government Issued ID Type: Driver's License

  • ID Number: 184752

  • Issuing Authority: Indiana

  • Date of Issue: February 1, 2066

  • Date of Expiry: March 1, 2071

III. Asset/Account Details

Details of the asset or account beneficially owned by the affiant are provided below:

A. Asset/Account Description

  • Type of Asset/Account: Bank Account

  • Account Number (if applicable): 1234567890

  • Location of Asset/Account: Bank of America, 123 Main Street, Phoenix, AZ 85001

B. Ownership Details

  • Ownership Percentage: 100%

  • Type of Ownership: Sole Ownership

IV. Declaration

I, the undersigned, hereby declare under the penalty of perjury that the information provided in this Affidavit of Beneficial Ownership is true and correct. I understand that providing false or misleading information may result in legal consequences.

V. Signature

[YOUR NAME]

Affiant

Notary Public
My commission expires: September 15, 2088

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