Scribd Logo
Upload

Welcome to Scribd!

  • 16 views

    Kyc Form

    Uploaded by

    prashant.tiwari

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Kyc Form

    Uploaded by

    prashant.tiwari
    16 views1 page

    Original Title

    KYC FORM

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    16 views1 page

    Kyc Form

    Uploaded by

    prashant.tiwari

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    KNOW YOUR CUSTOMER FORM

    First name Last name ‫ﺍﻷﺳﻢ ﺍﻷﺧﻴﺮ‬ ‫ﺍﻷﺳﻢ ﺍﻷﻭﻝ‬


    Customer Name: * * :‫ﺃﺳﻢ ﺍﻟﻌﻤﻴﻞ‬

    Date of Birth: Place of birth: :‫ﻣﻜﺎﻥ ﺍﻟﻤﻴﻼﺩ‬ :‫ﺗﺎﺭﻳﺦ ﺍﻟﻤﻴﻼﺩ‬


    Profession: :‫ﺍﻟﻮﻇﻴﻔﺔ‬
    Nationality: * * :‫ﺍﻟﺠﻨﺴﻴﺔ‬
    Proof of Identiy: * Passport Number: :‫ * ﺭﻗﻢ ﺟﻮﺍﺯ ﺍﻟﺴﻔﺮ‬:‫ﺃﺛﺒﺎﺕ ﺍﻟﺸﺨﺼﻴﺔ‬
    ID Number: :‫ ﺭﺧﺼﺔ ﻗﻴﺎﺩﺓ‬/‫ﺑﻄﺎﻗﺔ ﺷﺨﺼﻴﺔ‬
    Address: * * :‫ﺍﻟﻌﻨﻮﺍﻥ‬

    PO BOX: :‫ﺻﻨﺪﻭﻕ ﺍﻟﺒﺮﻳﺪ‬


    City: :‫ﺍﻟﻤﺪﻳﻨﺔ‬
    State: :‫ﺍﻟﺪﻭﻟﺔ‬

    Telephone No. :(‫ﺭﻗﻢ ﺍﻟﻬﺎﺗﻒ )ﻣﻨﺰﻝ‬


    Mobile No.* *:(‫ﺭﻗﻢ ﺍﻟﻬﺎﺗﻒ )ﻣﺘﺤﺮﻙ‬
    Fax No. :‫ﻓﺎﻛﺲ‬
    e-mail address: :‫ﺍﻟﺒﺮﻳﺪ ﺍﻷﻟﻜﺘﺮﻭﻧﻲ‬

    Name of the Agent: :‫ﺃﺳﻢ ﺍﻟﻮﻛﻴﻞ‬


    Proof of Identiy: Passport Number: :‫ﺭﻗﻢ ﺟﻮﺍﺯ ﺍﻟﺴﻔﺮ‬ :‫ﺃﺛﺒﺎﺕ ﺍﻟﺸﺨﺼﻴﺔ‬
    ID Number: :‫ ﺭﺧﺼﺔ ﻗﻴﺎﺩﺓ‬/‫ﺑﻄﺎﻗﺔ ﺷﺨﺼﻴﺔ‬

    Property Name: * * :‫ﺃﺳﻢ ﺍﻟﻤﺸﺮﻭﻉ‬


    Unit number: * * :‫ﺭﻗﻢ ﺍﻟﻮﺣﺪﺓ‬

    Amount Paid in cash: * * :‫ﺍﻟﻤﺒﻠﻎ ﺍﻟﻤﺪﻓﻮﻉ‬

    Payment description: * * :‫ﺗﻔﺎﺻﻴﻞ ﺍﻟﺪﻓﻌﺔ‬

    Source of Cash: * * :‫ﻣﺼﺪﺭ ﺍﻷﻣﻮﺍﻝ‬

    Customer ‫ﺗﻮﻗﻴﻊ‬
    Signature: * * :‫ﺍﻟﻌﻤﻴﻞ‬

    Date: :‫ﺍﻟﺘﺎﺭﻳﺦ‬

    Mandatory field * * ‫ﺑﻴﺎﻧﺎﺕ ﺍﻟﺰﺍﻣﻴﺔ‬

    Disclaimer :‫ﺃﻗﺮﺍﺭ‬
    The Customer acknowledges that all details mentioned above is correct ‫ﻳﻘﺮ ﺍﻟﻌﻤﻴﻞ ﺑﺄﻥ ﺟﻤﻴﻊ ﺍﻟﺘﻔﺎﺻﻴﻞ ﺍﻟﻤﺬﻛﻮﺭﺓ ﺃﻋﻼﻩ ﺻﺤﻴﺤﺔ‬
    and the customers is fully responsible if otherwise ‫ﻭﺃﻧﻪ ﻣﺴﺆﻝ ﻣﺴﺆﻭﻟﻴﺔ ﻛﺎﻣﻠﺔ ﺇﺫﺍ ﺛﺒﺖ ﺧﻼﻑ ﺫﻟﻚ‬

    P.O BOX 2195, Executive Heights, TECOM area, Near Greens, Sheikh Zayed Road, Dubai, UAE
    Tel:+971 4 3731000 Fax:+971 4 3731290

    You might also like