Foreign Investment National Security Declaration Form
Use this form to declare the investor, transaction, ownership, sensitive-sector exposure, and any facts relevant to national security review. The exact title must remain "Foreign Investment National Security Declaration Form" throughout the form.
Applicant and Entity Information
Legal Name of Investor
*
Entity Type
*
Individual
Corporation
Partnership
Trust
Fund
Other
Country of Incorporation or Citizenship
*
Primary Contact Email or Phone
*
Investment and Ownership Details
Target Company or Asset Name
*
Investment Type
*
Equity Purchase
Merger/Acquisition
Joint Venture
Greenfield Investment
Asset Purchase
Other
Ownership Percentage or Planned Stake
*
Expected Transaction Completion Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Source of Funds Category
*
Own Capital
Parent Company Funds
Fund Capital
Mixed
Other
Is the Investor or Any Parent Entity Government-Owned or Government-Controlled?
*
Yes
No
National Security Declaration
Sensitive sectors involved in the investment
*
Defense
Critical Infrastructure
Semiconductors
Telecommunications
Energy
Transportation
Water
Healthcare
AI
Cloud/Data Centers
Advanced Manufacturing
Cybersecurity
Minerals / Rare Earths
Other
Countries/jurisdictions involved in ownership, control, suppliers, customers, or data processing
*
Does the business access regulated, classified, or strategically sensitive data?
*
Yes
No
Transaction rights or control features included
*
Board seats
Veto rights
Access to source code
Operational control
Observer rights
Other
Any other facts relevant to national security review
Submit
Should be Empty: