Information for Special Cases

Name

ID Type

ID No

Date of Issue

Date of Expiry

Place of Issue

Tel. No

Fax. No

Commercial Name

Line of Business

Country of Reg

ID Type

Legal Nature

Number

Date of Issue

Date of Expiry

No. of Employees

Date of Start

Residence Address

Postal Code

P.O. Box

Country

City

Fax. Number

Tel. Number

Language of Correspondence

Recurring

Through

Authorized Person Name

ID Type

ID No

Date of Issue

Date of Expiry

Place of Issue

Job Title

Job Title

Name

Fax. Number

Tel. Number

E-mail Address

Mobile No

Paid up Capital (in SAR)

Annual Turnover (in SAR)

Main Bank Name

City

Branch

IBAN Bank Account No

Is the customer a director or an officer of a publicly listed company?

Is the customer a director or a partner or an officer in Itqan Capital or other licensed company?

Any other financial information of the customer's financial position?

Shares

Debt Instruments

Foreign Exchange

Deposits

Trade Finance

Investment Funds

Commodities

Contracts for Derivatives and Options

Real-estate

Total

Investment Knowledge and Experience

Customer's Appetite for Risk

General Investment Objectives

What are the Customer's Preferred Investment Assets (Tick as Many as Required)

I agree to be classified as