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BECU Source of Funds Declaration

This document is a source of funds declaration form for a bank credit union. It requests information such as the member and depositor's name, address, ID, occupation, and contact details. It also asks for payment details including account numbers, currency, transaction type, payment method and total amount deposited. The member is required to declare the source of the deposited funds, such as from the sale of property, an inheritance, business proceeds, or other sources. By filling out this form, the member consents to the bank disclosing this information to law enforcement as required by anti-money laundering regulations.

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368 views1 page

BECU Source of Funds Declaration

This document is a source of funds declaration form for a bank credit union. It requests information such as the member and depositor's name, address, ID, occupation, and contact details. It also asks for payment details including account numbers, currency, transaction type, payment method and total amount deposited. The member is required to declare the source of the deposited funds, such as from the sale of property, an inheritance, business proceeds, or other sources. By filling out this form, the member consents to the bank disclosing this information to law enforcement as required by anti-money laundering regulations.

Uploaded by

shanice
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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BANK EMPLOYEES’ CREDIT UNION CO-OPERATIVE SOCIETY LIMITED

Source of Funds Declaration


PLEASE COMPLETE IN CAPITAL LETTERS

BRANCH LOCATION TRANSACTION DATE dd/mm/yy

NAME OF MEMBER
NAME OF MEMBER DATE OF BIRTH dd/mm/yy

ADDRESS

ID#
DP ID PP OTHER
TELEPHONE # H( ) W( ) C( )

OCCUPATION/TYPE OF BUSINESS RESIDENCY STATUS: RESIDENT NON-RESIDENT

NAME OF DEPOSITOR
NAME OF DEPOSITOR DATE OF BIRTH dd/mm/yy

ADDRESS

ID#
DP ID PP OTHER
TELEPHONE # H( ) W( ) C( )

PAYMENT DETAILS

ACCOUNT NUMBER(S) PAYMENT DETAILS

TTD USD GBP

TRANSACTION TYPE CAD BBD ECD

DEPOSIT SHARES LOAN PAYMENT


CASH $

CHEQUE $
PAYMENT TYPE
CASH CHEQUE WIRE TRANSFER TOTAL AMT.
DEPOSITED $

DECLARATION OF SOURCE OF FUNDS

SALE OF PROPERTY PARTICULARS

ATTORNEY’S ESCROW ACCOUNT

PROCEEDS FROM BUSINESS TRADE

PROCEEDS OF AN INHERITANCE/TRUST FUND

PROCEEDS FROM CONTRACTUAL OBLIGATION

PROCEEDS FROM INVESTMENTS AT


FINANCIAL INSTITUTION
OTHER (specify)

By reason of the requirements of the Proceeds of Crime Act 2000, Anti Terrorism Act 2005, Central Bank of Trinidad and Tobago guidelines on Combating Money Laundering and
Terrorism Financing, the Bank Employees’ Credit Union Co-operative Society Limited’s guidelines on Money Laundering and Terrorism Financing May 8th 2006 requires it to be
satisfied as to the source of funds before accepting deposits of funds for the transfer or for the purchase of any other currency or instrument. Consent is hereby given to
disclose the information contained herein to Law Enforcement Agencies.

MEMBER’S SIGNATURE TRANSACTION CONDUCTED BY (BLOCK/SIGNATURE) TRANSACTION AUTHORISED BY (BLOCK/SIGNATURE)

OFFICIAL USE ONLY

*TRANSACTION ACCEPTED *TRANSACTION DECLINED *DETAILS

*TRANSACTION INCOMPLETE

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