Personal Declaration Form for Directors/Officers (2025 Version)

Summary

This is a standard form issued by the Bermuda Monetary Authority (BMA) that must be completed by any individual proposed to serve as a director or officer of a Bermuda-regulated financial services entity governed by the Insurance Act 1978 or the Investment Funds Act 2006. It collects personal, employment, passport and background information to support the BMA's assessment of the individual's fitness and propriety.

• Format requirement: The form must be completed digitally; handwritten submissions are not accepted.
• Personal and employment details: Requires name, date and place of birth, current and past three years of residential addresses, employment history, and passport details for all held passports.
• Background disclosures: Requires yes/no disclosure with details on matters such as bankruptcy proceedings, refused registrations, criminal or civil investigations, regulatory breaches or convictions, licence refusals or revocations, professional body censure, and resignation while under investigation.
• PEP status: Requires disclosure of whether the individual, an immediate family member, or a close associate is or has been a Politically Exposed Person, including category and role, and requires an ongoing commitment to notify the BMA of any change in PEP status.
• Other relevant matters: Requires disclosure of any other circumstances or conduct that could reasonably affect the individual's suitability for the proposed role.
• Certification: Requires the individual's signature certifying that the information and supporting documentation are true, accurate and complete.

The form itself does not impose ongoing regulatory requirements beyond the declaration process, but signing it creates a continuing obligation to notify the BMA of changes in PEP status.

Key obligations

• Each individual proposed as a director or officer of a Bermuda-regulated entity under the Insurance Act 1978 or Investment Funds Act 2006 must complete and sign a separate Personal Declaration Form.
• The form must be completed digitally; handwritten submissions will not be accepted.
• The individual must attach a resume outlining current employment and work history, unless retired or unemployed.
• The individual must disclose details of any bankruptcy proceedings, refused registrations, criminal or civil investigations or proceedings, regulatory breaches or convictions, licence refusals or revocations, professional body censure or investigation, and resignation while under investigation.
• The individual must disclose PEP status (their own, or that of an immediate family member or close associate), including category and role.
• The individual must commit to informing the BMA of any change in their PEP status.
• The individual must certify that the information and documentation provided are true, accurate and complete by signing and dating the form.

Applies to

directors of regulated financial services entities, officers of regulated financial services entities, insurers (Insurance Act 1978), investment funds (Investment Funds Act 2006)