Date For Natural & Judicial Persons Name Nationality Investor Type Natural Person Judicial person ID Type Passport Identity Card Family Book Registration Certificate Other ID No ID Place of Issue ID Issue Date ID Expiry Date Address City Country P. O. Box Zip Code Phone Fax Mobile E-mail Name of Authorized Signatory for Judicial Entities Signature Official Stamp for Judicial Entities Other Nationality (If Applicable) Name SDC No. Nationality For Natural Persons National No. (If Applicable) Gender Male Female Mother’s Name Date of Birth Agency Information Agency Type Caretaker Custodian Agent Trustee Receiver Guardian Liquidator Agent’s Name SDC No.: Nationality Signature I, the signatory above, acknowledge that the data and information stated above are correct, complete and accurate and I assume the full responsibility arising therefrom without holding the Securities Depository Center responsible for the invalidity, inaccuracy and/or incompleteness of the said data and information. For Securities Depository Center’s Use For Securities Depository Center’s Use Operation Name Signature Date Entry Name Signature Date Audit Name Signature Date Approval Name Signature Signature Important Notice: All information and data should be filled accurately and clearly. In cases where there is an agent, the power of attorney issued by the competent authorities shall be attached, and if it is issued outside the Kingdom, it shall be duly certified. The following valid identification documents must be attached to this form:Natural Persons:- For Jordanians: Passport, Family Book, or Identity Card issued by the Civil Status and Passport Department, provided that it contains the National Number.- For Non-Jordanians: Passport.Judicial Entities:- For Jordanians: Registration Certificate at the official competent authorities.- For non-Jordanians: Certificate of registration, duly certified. الوثائق المطلوبة يرجى إرفاق الوثائق المطلوبة One file only.110 MB limit.Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods. CAPTCHA Get new captcha! What code is in the image? Enter the characters shown in the image. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
