Date Form Securities Center Depository Securities Messrs following the with accordance in me by owned securities the freeze Please Issuer's Name Security Type - Select -اسهمسنداتحقوق اكتتابصكوك إسلامية No. of Securities To be Freezed Security No. Name of the Securities’ Owner SDC No. Name of Authorized Signatory for Judicial Entities Signature Official Stamp for Judicial Entities Agency Information Agency Type Caretaker Custodian Agent Trustee Receiver Guardian Liquidator Agent’s Name SDC No. Nationality Signature I, the signatoryabove, acknowledge that the data and information stated above are correct, accurate and complete and I assume the full responsibility arising therefrom withoutholding the Securities Depository Center responsible for the invalidity, inaccuracy and/or incompleteness of the said data and information. Important Notice: The securities shallremain frozen until the owneror his/her agent submits an application to unfreeze the securities to the Securities Depository Center.The owner of the frozen securities may not dispose of the securities until the securities are unfrozen by the Securities Depository Center. 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 Date 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. Required documents يرجى إرفاق الوثائق المطلوبة One file only.300 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.
