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Patriots Act Disclosure Borrower Identification free printable template

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Last updated May 12, 2026 · Reviewed by pdfFiller editorial team

Key takeaways

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  • The Patriots Act Disclosure Form helps financial institutions verify customer identities to prevent money laundering and terrorism financing.
  • This document implements Section 326 of the USA PATRIOT Act, requiring banks to maintain a written Customer Identification Program.
  • Individuals must provide their full legal name, date of birth, residential or business address, and a valid taxpayer identification number.
  • Non-U.S. persons may provide a passport number, alien identification card number, or other government-issued documents evidencing nationality or residence.
  • Customers must provide identification documents, such as a driver's license or passport, for the financial institution to verify their identity.
  • Borrowers or account holders sign the form to attest to the accuracy of the personal information provided to the institution.
  • Financial institutions are required to maintain records of the collected customer information and the methods used for identity verification.

What is Patriots Act Disclosure Borrower Identification?

Patriots Act Disclosure Form, also known as the Customer Identification Program (CIP) Form, is a document used by financial institutions to comply with federal requirements for identifying and verifying individuals or entities opening new accounts. It serves as a tool for banks, credit unions, and other regulated entities to meet the mandates of Section 326 of the USA PATRIOT Act. The primary purpose is to assist the federal government in preventing terrorism financing and money laundering by ensuring that the person or business opening an account is accurately identified.

This form captures specific data including the customer's full legal name, date of birth for individuals, and a physical residential or business address. It also records a taxpayer identification number for U.S. persons or alternative government-issued documentation for non-U.S. persons, such as a passport or alien identification card. Often referred to as a borrower identification form in lending contexts, it requires institutions to verify this information against official documents like a driver's license to maintain accurate and secure internal records.

Department of the Treasury (through the Financial Crimes Enforcement Network - FinCEN) in consultation with federal functional regulators.

Who needs the Patriots Act Disclosure Borrower Identification — and who doesn't

Not everyone files Patriots Act Disclosure Borrower Identification. The checklist below tells you whether it applies to your situation — and points you to the right alternative if it doesn't.

You need this Patriots Act Disclosure Borrower Identification if…

  • you are a financial institution subject to the Bank Secrecy Act that is required to establish and maintain a written Customer Identification Program
  • you are an individual or entity opening a new account at a bank, savings association, or credit union that must verify your identity under federal law
  • you are a broker-dealer, mutual fund, or futures commission merchant collecting specific identifying information to prevent terrorism financing and money laundering
  • you are a borrower who must provide a signature to attest to the accuracy of your legal name, address, and identification number for a financial institution's records

You do not need this Patriots Act Disclosure Borrower Identification if…

  • you are a regulated financial institution, such as a bank regulated by a federal functional regulator or state bank supervisor
  • you are a governmental agency, instrumentality, or entity
  • you are an issuer of publicly traded securities
  • you are an existing customer of a bank or its parent holding company opening a new account

Why you need the Patriots Act Disclosure Borrower Identification

Why people fill out Patriots Act Disclosure Borrower Identification, and what tends to go wrong when they don't.

  • Satisfy Federal Regulations Completing this form ensures that financial institutions meet mandatory standards under the USA PATRIOT Act. These regulations are designed to prevent illegal activities like money laundering and the financing of terrorism.
  • Support Identity Verification The form collects specific information, including your legal name, address, and taxpayer identification number. Providing these details allows the institution to verify your identity and maintain the records required by law.
  • Sign and Share Use pdfFiller to fill, eSign, and share this document with your financial institution. The platform provides a convenient way to complete the form in your browser and manage your records digitally.

What each section of Patriots Act Disclosure Borrower Identification means

Every section explained — what it's asking, the records you'll need on hand, and the mistakes that most often cause a rejection or follow-up request.

Full Legal Name Enter the complete legal name of the individual or business entity opening the account to ensure proper identification according to bank secrecy regulations.
Individual Date of Birth Individual applicants must provide their full date of birth, which serves as a primary identifier for verifying the identity of the person opening the account.
Residential or Business Address Provide a physical street address. Individuals may use a post office box, while entities must list the street address of their principal place of business.
Taxpayer Identification Number U.S. persons must provide a Taxpayer Identification Number. Non-U.S. residents may provide a passport number, alien identification card, or other government-issued document number.

How to fill out Patriots Act Disclosure Borrower Identification using pdfFiller

A walkthrough from the first field to the signature line. With your records in front of you, most people finish in under ten minutes.

  1. Open the Document Click Get Form to open the Patriots Act Disclosure Form in the pdfFiller editor. You can then use the platform's tools to complete the required identity verification fields.
  2. Enter Legal Name Click on the Customer’s Name field and type your full legal name or the name of the business entity exactly as it appears on your official government-issued identification documents.
  3. Provide Date of Birth Select the Date of Birth section to input your birth date, ensuring the information on this borrower identification form matches your records for accurate and successful identity verification.
  4. Fill Address Details Navigate to the Address section to provide your residential street address or principal place of business, which is a mandatory requirement for federal customer identification and reporting programs.
  5. Input Identification Number Type your Taxpayer Identification Number or passport details into the Identification Number field, including the country of issuance and document number as required for non-U.S. citizens and entities.
  6. Sign the Form Use the Sign tool to create and place a legally binding e-signature on the document, confirming that the provided information is accurate for anti-money laundering and compliance purposes.
  7. Save and Share Click the Done button to save your progress, then download the finalized PDF to your device or use pdfFiller to share it securely with your financial institution via email.

Required disclosures & attachments

The fields Patriots Act Disclosure Borrower Identification won't be accepted without — and the disclosures filers most often miss.

  • Copies of Identification Documents These documents are required so the financial institution can verify the identity of any individual or entity opening a new account using a driver's license, passport, or other government-issued identification.

Deadlines, key dates & penalties for Patriots Act Disclosure Borrower Identification

When Patriots Act Disclosure Borrower Identification is due, what late filing actually costs, and how to request more time if you need it.

Penalties for Non-Compliance Failure to adhere to Customer Identification Program requirements under the Bank Secrecy Act and its implementing regulations can result in significant civil and criminal penalties. These consequences may include substantial monetary fines reaching up to $25,000 per day for certain violations, as well as various other regulatory enforcement actions.

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Key terms used in Patriots Act Disclosure Borrower Identification

A one-sentence glossary of the Patriots Act Disclosure Borrower Identification terms and concepts you'll see throughout this guide.

Customer Identification Program (CIP)
A written program financial institutions must establish and maintain to identify and verify individuals or entities opening accounts.
Identification Number
A Taxpayer Identification Number for U.S. persons, or a passport or government-issued document number for non-U.S. persons.
Financial Institution
Entities such as banks, credit unions, and broker-dealers that are subject to the Bank Secrecy Act and its regulations.
Verification
The process of confirming a customer's identity using documents like a driver's license or through various non-documentary methods.
Bank Secrecy Act (BSA)
Federal legislation requiring financial institutions to maintain programs and records to help prevent money laundering and terrorism financing.
Non-U.S. Person
An individual providing a passport, alien identification card, or other government-issued document evidencing nationality or residence.

Frequently asked questions about Patriots Act Disclosure Borrower Identification

Quick answers to the questions we hear most often about completing the Patriots Act Disclosure Borrower Identification.

The Patriots Act Disclosure Form (Customer Identification Program Form) is used by financial institutions to verify the identity of customers opening new accounts to prevent money laundering and terrorism financing. By collecting and validating personal details, institutions comply with federal mandates under Section 326 of the USA PATRIOT Act. This process helps ensure that the financial system is not being used for illegal activities.

Most individuals and entities opening a new account at a financial institution subject to the Bank Secrecy Act must provide their identifying information. This includes customers at banks, credit unions, savings associations, and broker-dealers. The requirement applies to both U.S. citizens and non-U.S. persons, although certain regulated financial institutions or government agencies may be exempt from these specific procedures.

The form typically requires the customer's full legal name, date of birth for individuals, a physical residential or business address, and an identification number. For U.S. persons, this is usually a Taxpayer Identification Number. Non-U.S. persons may provide a passport number, alien identification card number, or another government-issued document number that proves nationality or residence.

Certain entities such as government agencies, publicly traded companies, and other regulated financial institutions may be exempt from standard Customer Identification Program procedures. Additionally, existing customers of a bank or its subsidiary may not need to provide this information again when opening a new account. These exemptions are determined by the institution's specific compliance policies and federal regulations.

While federal law does not explicitly mandate a signature on the form itself, most financial institutions require borrowers to sign it to attest to the accuracy of the provided information. This signature serves as part of the institution's internal verification and documentation process. You can use pdfFiller to securely sign the document and share it with your financial institution electronically.

Financial institutions must verify your identity using documents such as a valid driver's license, passport, or other government-issued identification card. In some cases, institutions may use non-documentary methods to confirm your identity. They are required to maintain records of the specific documents used and the verification methods applied during the account opening process.

You can fill out, sign, and share the Patriots Act Disclosure Form online using pdfFiller. The platform allows you to enter your personal information directly into the document, add a legally binding e-signature, and send the completed form to your financial institution via email, link, or fax. pdfFiller also provides secure, encrypted storage to protect your sensitive identification data.

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