Beneficial Ownership Information Report (BOIR)

OMB No. 1506-0076

Complete the report in its entirety with all required information. Fields marked with an asterisk (*) symbol are the fields that, at a minimum, must be completed by all companies to file the report. Reporting companies, however, must include all information 31 CFR 1010.380(b) requires them to provide, regardless of whether a field is marked with an asterisk (*) symbol. These information requirements are summarized above under HELP.

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Filing Information
2
Reporting Company Info
3
Company Applicant(s)
4
Beneficial Owner(s)
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Submit BOIR

Filing Information

, Please note the following before getting started:
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Instructions for Item 1 – Type of filing:

  • Check box 1a “Initial report” if this is the first BOIR filed for the reporting company.
  • Check box 1b “Correct prior report” if the report corrects inaccurate information from a previously filed BOIR.
  • Check box 1c “Update prior report” if the report updates a previously filed BOIR, for example, to include one or more new beneficial owners.
  • Check box 1d “Newly exempt entity” if, after having filed a BOIR, the reporting company is now exempt from BOI reporting requirements. If this checkbox is selected, then filer must fill out fields 1e–1h (reporting company information associated with most recent report) and no other fields in the BOIR.
  • If type of filing 1b, 1c, or 1d is selected, enter values for 1e “Legal name”, 1f “Tax identification type”, and 1g “Tax identification number” for the reporting company that match the most recently filed BOIR. For example, if the reporting company previously filed an initial report and then an updated report, the reporting company information in the next updated report should match the reporting company information provided on the most recently filed updated report rather than the initial report.
  • For 1f, select the tax identification type (i.e., a U.S. Employer Identification Number (EIN), a U.S. Social Security Number or Individual Taxpayer Identification Number (SSN-ITIN), or foreign taxpayer identification number (Foreign)) the reporting company reported in the most recently filed BOIR. If tax identification type entered in 1f is “Foreign”, select the corresponding foreign country/jurisdiction in 1h “Country/Jurisdiction (if foreign tax ID only)” associated with the foreign tax identification number.

Instructions for Item 2 – Date prepared:
This item is automatically populated with the current date.

Type of filling:
Reporting Company associated with latest report (not applicable for initial report)
e. Legal name
f. Tax Identification type
g. Tax Identification number
h. Country/Jurisdiction (if foreign tax ID only)
Date prepared (auto-filled)
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Filing Information
2
Reporting Company Info
3
Company Applicant(s)
4
Beneficial Owner(s)
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Submit BOIR

Part I. Reporting Company Information

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Reporting company information is entered in fields 3 through 16 of the BOIR.

Instructions for Item 3 – Request to receive FinCEN Identifier (FinCEN ID):
Check this box to receive a unique FinCEN Identifier for the reporting company. The FinCEN Identifier will be provided in the submission confirmation details provided to the filer after the BOIR is accepted.

Instructions for Item 4 – Foreign pooled investment vehicle:
Check this box if the reporting company is a foreign pooled investment vehicle required to report information pursuant to 31 CFR 1010.380(b)(2)(iii).

  • If the reporting company is a foreign pooled investment vehicle, the company need only report one beneficial owner who exercises substantial control over the entity. If more than one individual exercise substantial control over the entity, the entity shall report information with respect to the individual who has the greatest authority over the strategic management of the entity. The report should not include any information about company applicants.
Types
Legal name and alternate name(s)
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Instructions for Item 5 – Reporting company legal name:
Enter the reporting company’s full legal name as recorded on the articles of incorporation or other documents creating or registering the entity.

Instructions for Item 6 – Alternate name:
Enter any of the reporting company’s trade names, “doing business as” or DBA names, or “trading as” or T/A names. If the reporting company has multiple alternate names, use the “+” or “-“ buttons in the BOIR to add additional alternate name fields (one field for each alternate name). Do not include the acronyms DBA or AKA with the alternate name.

Reporting Company legal name
Alternate name (e.g. trade name, DBA)
Form of Identification
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Instructions for Item 7 – Tax identification type:
Select “EIN” if the reporting company has a U.S. Employer Identification Number (EIN). Select “SSN-ITIN” if the reporting company utilizes a U.S. Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN) as a tax identification number. Select “Foreign” if the reporting company has a tax identification number issued by a foreign jurisdiction and does not have a U.S. tax identification number.

Instructions for Item 8 – Tax identification number:
Enter the tax identification number for the reporting company.

Instructions for Item 9 – Country/Jurisdiction:
If the tax identification type in item 7 is “Foreign”, select the foreign country/jurisdiction that issued the foreign tax identification number.

7. Tax Identification type
8. Tax Identification number
9. Country/Jurisdiction (if foreign tax ID only)
Current U.S. address
11. Address (number, street, and apt. or suite no.)
12. City
13. U.S. or U.S. Territory
14. State
14. State
15. ZIP code
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Filing Information
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Reporting Company Info
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Company Applicant(s)
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Beneficial Owner(s)
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Submit BOIR
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Instructions for Item 16 – Existing reporting company:
Check this box if the reporting company was created or registered before January 1, 2024. Do not check the box if the reporting company was created or registered on or after January 1, 2024. Reporting companies that check this box are not required to report any company applicants; proceed to Part III.

16. Is Existing Reporting Company
(check if existing reporting company as of January 1, 2024)

17. (This item is reserved for future use)

Part II. Company Applicant Information

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Company applicant information is entered in fields 18 through 33 of the BOIR. Company applicants are individuals; no companies or legal entities may be reported as company applicants. Reporting companies may also provide FinCEN Identifiers for company applicants instead of this information. See detailed description below.

Use the “Add Company Applicant” or “Remove Company Applicant” keys at the top of this section to add or remove additional company applicants. No more than two company applicants should be reported.

If existing reporting company was checked in item 16, company applicant information is not required; proceed to Part III.

Company Applicant #1
Company applicant FinCEN ID

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Instructions for Item 18 – FinCEN ID:
Reporting companies may report the FinCEN ID for a company applicant instead of the information in fields 19 through 33. Enter the FinCEN ID as a single text string. If a FinCEN ID for the company applicant is not provided, information about the company applicant must be provided in fields 19 through 33.

18. FinCEN ID
Legal name and date of birth

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Instructions for Item 19 – Last name:
Enter the company applicant’s legal last name.

Instructions for Item 20 – First name:
Enter the company applicant’s legal first name.

Instructions for Item 21 – Middle name:
Enter the company applicant's middle name if the company applicant’s legal name has a middle name. Leave this item blank if the company applicant does not have a middle name.

Instructions for Item 22 – Suffix:
Enter the company applicant's middle name if the company applicant’s legal name has a middle name. Leave this item blank if the company applicant does not have a middle name.

Instructions for Item 23 – Date of birth:
Enter the company applicant’s date of birth using the format MM/DD/YYYY where MM = month, DD = day, and YYYY = year (e.g., 01/25/1970). The month, day, and year must be provided; no partial dates are accepted.

19. Individual's last name *
20. First name
21. Middle name
22. Suffix
23. Date of birth *
Current address
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Instructions for Item 24 – Address type:
Indicate address type as “Business address” or “Residential address” for the company applicant. For a company applicant who forms or registers an entity in the course of their business, such as paralegals, report the street address of such business. In any other case, the individual’s residential street address must be reported.

Instructions for Items 25 – 29 – Company applicant address:
Enter the company applicant’s street address information, including the city, country or jurisdiction, State, and ZIP code or foreign postal code. U.S. Territories are included in the drop-down menu for “Country/Jurisdiction.” The “State” (item 28) will be automatically populated when a U.S. Territory is selected in the “Country/Jurisdiction” (item 27). Item 28 “State” is required if the country selected in item 27 is the United States, Canada, or Mexico.

24. Address type *
25. Address (number, street, and apt. or suite no.) *
26. City *
27. Country/Jurisdiction *
28. State *
29. ZIP/Foreign postal code *
Form of identification and issuing jurisdiction
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Instructions for Item 30 – Identifying document type:
Select the company applicant’s identifying document type from the list of acceptable documents: a non-expired State-issued driver’s license, a non-expired State/local/Tribe-issued identification document issued for the purpose of identifying the individual, a non-expired U.S. passport, or, only if the company applicant does not have one of these identifying documents, a non-expired foreign passport.

Instructions for Item 31 – Identifying document number:
Enter the identifying document number from the company applicant’s identifying document.

Instructions for Item 32 – Identifying document issuing jurisdiction:
Enter in item 32a the country/jurisdiction that issued the company applicant’s identifying document. If a U.S. Territory issued the identifying document, select the applicable U.S. Territory in item 32a (the same U.S. Territory will then be automatically populated in item 32b “State” as a result). Enter in 32b the State issuing the identifying document when country/jurisdiction is United States, if applicable. If a local or Tribal government issued the identifying document, select “United States” in item 32a and then select the applicable local or Tribal description in item 32c. If the name of the relevant local or Tribal jurisdiction is not included in the drop-down menu in item 32c, select “Other” and enter the name of the local or Tribal jurisdiction in item 32d.

Instructions for Item 33 – Identifying document image:
Drag a file or click “choose from folder” to attach a clear, readable image of the page or side of the identifying document referenced in item 31 containing the unique identifying number and other identifying data. Use the “Remove” button to remove the attached image if necessary. An attachment to a BOIR cannot be larger than four (4) megabytes of data and must be in one of the following formats: JPG/JPEG, PNG, or PDF. Only one (1) attachment file may be added per company applicant. Attachment file names should not contain spaces, and can only contain letters, numbers, or the following characters !@#$%()_-.=+[]|;~

30. Identifying document type
31. Identifying document number

32. Identifying document issuing jurisdiction

a. Country/Jurisdiction
b. State
b. State
c. Local/Tribal
d. Other local/Tribal description
d. Other local/Tribal description
33. Identifying document image
Maximum file size: 3 MB
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Filing Information
2
Reporting Company Info
3
Company Applicant(s)
4
Beneficial Owner(s)
5
Submit BOIR

34. (This item is reserved for future use)

Part III. Beneficial Owner Information
Beneficial Owner #1
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Instructions for Item 35 – Parent/Guardian information instead of minor child:
If the beneficial owner for the reporting company is a minor child, you may check this box and complete Part III with information about a parent or legal guardian of the minor child.

Parent/Guardian Information
(check if the Beneficial Owner is a minor child and the parent/guardian information is provided instead)
Beneficial Owner FinCEN ID
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Instructions for Item 36 – FinCEN ID:
Reporting companies may provide a FinCEN Identifier for a beneficial owner instead of Items 37 through 51. Enter the FinCEN ID as a single text string. If a FinCEN ID for the beneficial owner is not provided, information about the beneficial owner must be provided in fields 37 through 51.

36. FinCEN ID
Exempt entity
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Instructions for Item 37 – Exempt entity:
Check this box if the beneficial owner holds its ownership interest in the reporting company exclusively through one or more exempt entities, and the name of that exempt entity or entities are being reported in lieu of the beneficial owner’s information. If checked, provide the legal name of the exempt entity in field 38.

Exempt entity
Legal name and date of birth
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Instructions for Item 38 – Individual’s last name or entity’s legal name:
Enter the beneficial owner's legal last name or the exempt entity's legal name. An entity’s legal name is the name on the articles of incorporation or other document that created or registered the entity. Do not abbreviate names unless an abbreviation is part of the legal name.

Instructions for Item 39 – First name:
Enter the beneficial owner's legal first name.

Instructions for Item 40 – Middle name:
Enter the beneficial owner's middle name if the beneficial owner’s legal name includes a middle name. Leave this item blank if the beneficial owner does not have a middle name.

Instructions for Item 41 – Suffix:
Enter the beneficial owner’s suffix such as JR, SR, III, etc., if the beneficial owner has a suffix to their legal name. Leave this item blank if the beneficial owner’s legal name does not include a suffix.

Instructions for Item 42 – Date of birth:
Enter the beneficial owner’s date of birth, using the format MM/DD/YYYY where MM = month, DD = day, and YYYY = year (e.g., 01/25/1970). The month, day, and year must be provided; no partial dates will be accepted.

38. Individual's last name or entity's legal name
39. First name
40. Middle name
41. Suffix
42. Date of birth
Residential address
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Instructions for Items 43 – 47 – Beneficial owner address:
Enter the beneficial owner’s residential street address information, including the city, country or jurisdiction, State, and ZIP code or foreign postal code. U.S. Territories are included in the drop-down menu for “Country/Jurisdiction.” The “State” (item 46) will be automatically populated when a U.S. Territory is selected in the “Country/ Jurisdiction” (item 45). Item 46 “State” is required if the country selected in item 45 is the United States, Canada, or Mexico.

*43. Address (number, street, and apt. or suite no.)
44. City
45. Country/Jurisdiction
46. State
46. State
47. ZIP/Foreign postal code
Form of identification and issuing jurisdiction
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Instructions for Item 48 – Identifying document type:
Select the beneficial owner’s non-expired identifying document type from the list of acceptable identification documents: a State-issued driver’s license, a State/local/Tribe-issued identification document issued for the purpose of identifying the individual, a U.S. passport, or, only if the beneficial owner does not have one of these three types of identifying documents, a foreign passport.

Instructions for Item 49 – Identifying document number:
Enter the identifying document number from the beneficial owner’s identifying document.

Instructions for Item 50 – Identifying document issuing jurisdiction:
Enter in item 50a the country/jurisdiction that issued the beneficial owner’s identifying document. If a U.S. Territory issued the identifying document, select the applicable U.S. Territory in item 50a (the same U.S. Territory will then be automatically populated in item 50b “State” as a result). Enter in 50b the State that issued the identifying document when country/jurisdiction is United States, if applicable. If a local or Tribal government issued the identifying document, select “United States” in 50a and then select the applicable local or Tribal description in item 50c. If the name of the relevant local or Tribal jurisdiction is not included in the drop-down menu in item 50c, select “Other” and enter the name of the local or Tribal jurisdiction in item 50d.

Instructions for Item 51 – Identifying document image:
Drag a file or click “choose from folder” to attach a clear, readable image of the page or side of the identifying document referenced in item 49 containing the unique identifying number and other identifying data. Use the “Remove” button to remove the attached image if necessary. An attachment to a BOIR cannot be larger than four (4) megabytes of data and must be in one of the following formats: JPG/JPEG, PNG, or PDF. Only one (1) attachment file may be added per beneficial owner. Attachment file names should not contain spaces, and can only contain letters, numbers, or the following characters !@#$%()_-.=+[]|;~

48. Identifying document type
49. Identifying document number

50. Identifying document issuing jurisdiction(*)

a. Country/Jurisdiction
b. State
b. State
c. Local/Tribal
d. Other local/Tribal description
d. Other local/Tribal description
51. Identifying document image
Maximum file size: 3 MB
1
Filing Information
2
Reporting Company Info
3
Company Applicant(s)
4
Beneficial Owner(s)
5
Submit BOIR

Complete all fields below before submitting. Directly after submission, a processing page will be displayed, followed by a page confirming the status of your report. This confirmation page will also give you an opportunity to download a transcript of your report.

Email
Confirm Email
First Name
Last Name *
I certify that I am authorized to file this BOIR on behalf of the reporting company. I further certify, on behalf of the reporting company, that the information contained in this BOIR is true, correct, and complete. *
COMPLIANCE REMINDER: The willful failure to report complete beneficial ownership information to FinCEN, the willful failure to update beneficial ownership information provided to FinCEN when previously reported information changes, or the willful provision of false or fraudulent beneficial ownership information to FinCEN, may result in civil or criminal penalties. A person may also be subject to civil or criminal penalties for willfully causing a reporting company to report incomplete or false beneficial ownership information to FinCEN.