Request for issuing credit cards

Branch Name ................................ Branch No. .............. Date .....................

Do you have an account in Bank Albilad? Yes No

Kindly (√) the selected card to apply Primary Card Supplementary Card

Kindly (√) the selected segment Salary transfer Non-salary transfer Average Balance

Kindly (√) the selected Card Type Tamkeen Platinum

AlBilad Credit Card Silver Platinum Signature Infinite

Personal Information

First Name Father Grandfather Family

.................................................... ..................................................... ........................................................... ...................................................................

Please write the name in English as it should appear on the card (should not exceed 22 characters including blanks)

Date of Birth ......./........./............... Gender Male Female

ID Details

ID number ..................................................... Expiry Date ....................../....../...................

Nationality ......................................................... Place Of Birth ......................................................................

Are you a Tax Resident of any country or countries for tax purpose outside of Saudi Arabia? (It is required to fill the Tax Self-certification form in both cases “Yes” or “No”)

Yes No

Marital Status Educational Level

Single Married Other (Specify) ..................... Masters University Diploma

Number of dependents ...................................................... Secondary School Intermediate Elementary

Residence Information and Communication

Owned Leased Installments Type of Residence

Provided by Employer Other (Specify) .......................... Apartment Floor Villa

Do you Own a Car Yes No if yes, how many cars………..….

National Address : Building No. ........Unit No........... Street................................... Quarter .............. City ....................Postal Code ............... Additional No.............. Mobile ...........
Mailing Address : City ........................P.O. Box........................ Postal Code ............. KSA
Postal Address in Home Country For Non-Saudi : Country..................... City ..................... P.O. Box............ Postal Code .................Telephone No. Out of KSA.........................

Employer Information

Unemployed Government Military Semi- Government Private

Business Owner (self employeed) Independent Retired Student Housewife

Employer ................................................................... Position ................................................................

Monthly Salary ............................................................... Date of Joining ........../........./...............

Work Address:

City ............................... Quarter ............................ Street ........................................................................ Building No. ............

With VAT registration No. 300000712300003

Financial & Bank Details

Other Monthly Income ........................................ Total Monthly Income ...........................................

Account No. .............................................................................................................................................................................................

1-1-B081 - 82 ‫نموذج قم‬

Branch name. ................................................................ Branch No ...............................................................

Account Type Current Investment Other (Specify) ..............................

Card delivery channel Branch Registered Mail Courier

Customer Name ..................................................................... 1/6 Signature Customer.....................................................................

Bank Albilad is a Saudi Joint Stock Company, with National Unified No.7001473102, Head Office: Al Mutamarat 8229, Building No 2 ,RIYADH 3952 - 12711 ,KSA. Under monitoring and supervision of Saudi Central Bank authority and licensed by
Royal decree 48/M on 21/9/1425H (4/11/2004 G),
 Request for issuing credit cards

Supplementary Card Details

First Name Father Grandfather Family

............................................. ............................................. ................................................... ........................................................

Please write the name in English as it should appear on the card (should not exceed 22 characters including blanks)

Gender Male Female Relationship ...................................

ID Details

Date of Birth ........../........./............... ID / Iqama NO. ....................................................

Required Documents

- Attach a copy identity card for primary and supplementary cardholder

- Certification letter of salary and joining date.

- For Self-employed professionals, please attach a copy of commercial register.

Address where you would like to receive the account statement

Home P.O Box Work P.O Box

DECLARATION

I declare that all personal information and data are complete and correct, and shall notify the bank, in writing or through an authenticated communication, of any change in these data and information. I am responsible towards the bank for
1-
any damages due to my negligence. I also authorize Bank Albilad to deduct the financial commitments, resulting from the use of the principal and/or supplementary card/cards, from the current account related to the card or any other
account of my own in the bank, without consulting me, in case of delay in settling the payment of the commitments as of the dates determined in the account statements.

I agree to provide Bank Albilad with any required information, to which the credit card that will be given to me is related, or to revise it. I also agree that Bank Albilad discloses the information related to me, to my account or to any other
2-
account at the commissioner of the Saudi Credit Bureau Company (SIMAH) through the convention on information sharing, or of any other party adopted at Saudi Central Bank (SAMA).

I declare that I have checked and agreed and received the attached terms and conditions of issuance Bank Albilad Credit Card and Tamkeen cards and that I will use this card based on these terms and conditions.
3-

I declare that by activating the credit card, I have received and agreed on Bank Albilad Credit Card Agreement Summary.
4-

I declare that Bank Albilad may change the card type whenever it is necessary.
5-

I agree that Bank Albilad may send marketing SMS’s for products and offers of Albilad credit card and Tamkeen card from time to time.
6-

I acknowledge the right of Bank Albilad to reject this application if the application does not comply with the Bank's credit card policies
7-
I acknowledge that Bank AlBilad has the right to notify me of the statement of account and any amendments to Albilad Credit Card Agreement, Tamkeen Cards and all matters relating to the Credit Card by e-mail, text messages and any
8-
other means.
I declare that Bank Albilad will change card account depends on the following:
9-
✓ Active Account: The account would be considered active if last financial transaction was less than 24 months (2 years).
✓ Dormant Account: The account would be considered dormant if last financial transaction was more than 24 months (2 years).
✓ Unclaimed Account: The account would be considered unclaimed if last financial transaction was more than 60 months (5 years).
✓ Abandoned Account : it would be classified as Abandoned account in case it is complete 180 months (15 years) since the last financial transaction.

For Agent Customer Use only

I confirm that I received OTP code that’s sent to my registered mobile number, and submitted it to the bank’s agent employee.

❖ For Bank / Agent Use

The signature was made in front of me after verifying the customer signature according to his record in the bank, and after verifying the personality of the signatory according to his original identity card

Staff Name Signature Employee Number Date

.......................... .......................... .......................... ..........................

• For branch Use Only after verifying the personality of the signatory according to his original identity card
With VAT registration No. 300000712300003

Staff Name Signature Employee Number Date

........................ .......................... .......................... ..........................

❖ For Bank / Agent Use

❖ For Bank Albilad use Only
1-1-B081 - 82 ‫نموذج قم‬

Customer Name ..................................................................... 2/6 Signature Customer.....................................................................

Bank Albilad is a Saudi Joint Stock Company, with National Unified No.7001473102, Head Office: Al Mutamarat 8229, Building No 2 ,RIYADH 3952 - 12711 ,KSA. Under monitoring and supervision of Saudi Central Bank authority and licensed by
Royal decree 48/M on 21/9/1425H (4/11/2004 G),
 Bank AlBilad Credit Card and Tamkeen card Terms & Conditions

1- Definitions
“Bank” Bank AlBilad.
“Cardholder” The person to whom the credit card was issued upon his request. His name appears clearly on the card.
” Principal Credit Card and Card issued by the bank (in cooperation with any operator of a payment system: ex Visa or Mastercard) according to these terms and conditions. It holds the name of the card holder and is related to an open account at the bank.
Tamkeen card”
“Supplementary Credit Card(s)” The additional card(s) issued by the bank to the family members of the main card owner, who are allowed by him to use these cards according to these terms and conditions.
“Application” The application made by the Cardholder for a Credit Card.
“Account(s)” An opened current account held with the Bank by the Cardholder to be debited in respect of Credit Card Transactions.
“Transaction(s)” Means any cash withdrawal or payment made for goods or services using the Credit Card in any authorized manner of settlement by respectively debating or crediting the Account with such amounts (including any charges fees associated
with such transactions).
“Account Statement” The account extract by the bank to the cardholder, which shows the details of transactions
“Credit Limit” The maximum limit of amounts that the banks allows.
“SAMA” The Saudi Central Bank.
“SIMAH” The Saudi Credit Bureau.
“Terms and Conditions’ Bank Albilad Terms and conditions.
The convention The sample, terms and conditions of the credit card issued by Bank Albilad and all the exchanged documents between the bank and the card owner related to the demand and use of the card.

2- Credit Card Facilities

A. The principal and supplementary credit card are used by the cardholder, just to have in advance products and services or other particularities, from commercial companies/institutions that accept to deal with this credit card locally or abroad.

B. The credit card is also used by the cardholder to withdraw cash amounts, in the limits decided by ATMs that is accept these credit cards domestically and internationally, by using his own PIN code. The card owner commits not to withdraw any amounts (manually)
from any Albilad branch or other banks.

C. The cardholder authorize the bank to settle all transactions (including fees and charges) on their behalf, and to debit them on the account.

3- Credit Card
A. The bank issues the credit card after receiving a written application from the customer, and after the bank approval.

B. The credit card is and will remain a property of Bank Albilad.

C. The credit card cannot be transferred to other parties, thus it only can be used by its cardholder.

D. The cardholder commits to activate the card within sixty (60) days as of the date of its issuance, or it becomes automatically canceled. It is basically enforced for thirty-six (36) months as of the date of its issuance, and is automatically renewed for a similar period,
unless the bank decide to stop renew or the cardholder asked to cancel it as per a written notification, at least thirty (30) days before the date of the cancellation enforcement. The cardholder abides by giving the credit card back to the bank on its expiry date, after
destroying it in two halves passing by the magnetic tape. Cardholder also abides by settling any commitments resulting from credit card usage.

E. e) The cardholder is responsible for protecting the credit card, and to avoid, in all possible and necessary ways, any damage or misuse. The precautions include, for example but not limited to:

✓ signing the credit card when received. ✓ not allowing anyone else to use it.

✓ protecting it from the dangers of loss or stealing. ✓ always preserving its PIN code.

F. Signing the application and/or using the credit card after receiving it, means that the cardholder has read, understood and accepted these terms and conditions.

G. The cardholder cannot exceed the credit limit decided for the credit card. The bank will, from time to time, revise the credit limits as it sees appropriate.

4- Account Statement
The bank will issue an account statement that shows all the transactions that were made on the credit card and their related fees, charges and expenses, during the last billing cycle. This statement is considered as correct and binding on cardholder. For further explanation
or clarification, a demand must be written and delivered to the bank within thirty (30) days as of the issuance of the account statement.

5- Due Date
The cardholder is responsible for any financial charges or dues resulting from the use of the credit card. All charges or dues related to the credit card for every month become due on the salary day on salary of the next month, or according to the date mentioned in the
financial statement.

6- Financial commitments
A. The cardholder shall be responsible for paying all fees of the credit card, related to its issuance, renewal and annual fees. Cardholder also commits to pay fees of cash withdrawals (such fees are nor refundable or irreversible). The cardholder has authorized the bank
to deduct from the account the fees and expenses. The following table shows the fees related to the credit card:

VAT Tamkeen
Fess (SR) Silver Platinum Signature Infinite
Platinum

Principal Annual fees % 15 230 460 460 517.5 575

Supplementary Annual fees %1 5 57.5 115 115 115 115

Replacement Card %1 5 115 115 115 115 115

Replacement International Emergency %1 5 USD287.50

Reissuance card %1 5 115

1-1-B081 - 82 ‫نموذج قم‬

Cash withdrawal charges %1 5 23 SR Per Transaction

additional Statement %1 5 23

Transaction dispute %1 5 57.50

Optional Issuer Fees (OIF) for any %1.15

transactions other than Riyal This fees exactly as much BAB pays to Visa (ISA fees).

Example illustrating the calculation of OIF

Amount of the transaction Exchange rate Account in SAR Optional Issuer Fee (OIF) VAT Due amount

1000 Euro 3.982 3,982 SR 3,982*1.15%=45.8 SR 45.8*15%=6.87 3,982+45.8+6.87 = 4034.67 SR

*This is considered as an example to show how to convert the currency and not the real exchange rate
With VAT registration No. 300000712300003

Customer Name ..................................................................... 3/6 Signature Customer.....................................................................

Bank Albilad is a Saudi Joint Stock Company, with National Unified No.7001473102, Head Office: Al Mutamarat 8229, Building No 2 ,RIYADH 3952 - 12711 ,KSA. Under monitoring and supervision of Saudi Central Bank authority and licensed by Royal decree 48/M on 21/9/1425H (4/11/2004 G)
 Bank AlBilad Credit Card and Tamkeen card Terms & Conditions

Tamkeen Card payment process

Annual Percentage Rate Credit card Purchase Rate Minimum Repayment amount Month until balance Repaid
*N/A *N/A %5 or 200 SAR which higher *46 Months
• Month until balance Repaid: assuming card limit is 15 thousand which the maximum limit for this product is, The card was not reused during the payment period
• Credit card Purchase Rate: it’s not applicable for this product
• Annual Percentage Rate: it’s not applicable for this product

B. Issuance fees are immediately deducted when the credit card is issued and activated, and the cardholder is notified on the first financial statement. Annual fees are calculated according to the actual expenses of the
bank.
C. The bank has the right to revise and amend these fees, wholly or partially, and the amended fees of the revision are applied thirty (30) days after notifying the customer
D. If the cardholder uses the card to pay for purchases or services in any currency, an immediate deduction from the card account is performed, and the cardholder is responsible for the differences resulting from the diverse
exchange rates of currencies. Noting that the Exchange rates are calculated by VISA not calculated by the Bank.

7- Payment of Debt Balance

A. Taking into consideration what was mentioned in paragraph six (6) of these terms and conditions, the cardholder shall pay the bank all monthly due amounts for Credit Cards and pay installment of 5% or 200 SAR
(whichever is higher) for Tamkeen Cards In addition to the amount of any taxes need to be calculated and deducted according to any system in the Kingdom of Saudi Arabia for all credit cards. Payment delay or
nonpayment for a continuous period of three months is considered as a dereliction or a violation by the cardholder. Consequently, SIMAH will be provided with the name of the cardholder to be added on its lists of
banned persons. All banks in KSA have access to these lists, and the name of the cardholder is not removed from them unless he pays all due amounts.

B. The cardholder can pay dues related to the credit card wholly or partially before the date of payment, and if there are excessive paid amounts, they will be added to the available account.

8- Supplementary Credit Cards

A. Upon a request by the cardholder and the consent of the bank, a supplementary card can be issued to any member of the cardholder family (any first degree kinship for those above 18 years old). Those credit cards are
subject to the same terms and conditions of the primary credit card and have the same credit limits, as those supplementary credit cards are only a completing part of the primary credit card.

B. The account of the supplementary credit cards is the same as the primary credit card of the cardholder. Thus, any transaction made by the supplementary credit cardholders registered / noted in the account of the
primary credit card.

C. All fees related to the supplementary credit card are applied.

D. The primary credit cardholder is responsible for all activities and commitments resulting from the use of the supplementary credit card.
9- Stolen / Theft / lost / of the Credit Card:
A. The cardholder is considered as responsible for protecting the credit card from misuse by unauthorized users. In case of loss or stealing of the card, the cardholder should immediately notify the bank. The cardholder
can, if lives in KSA, call +966920001002 if using a landline phone, or 920001002 if using a mobile phone. The cardholder can also send a fax notice on 4798909 when using a landline phone in KSA, as it is preceded
by 011 from within the Kingdom, and 0096611 from outside the Kingdom. Any of Bank Albilad branches can be notified, by providing it with all of the required data/information.
B. The cardholder declares, with his knowledge and consent, that he/she will be the sole responsible for all financial commitments and charges resulting from the loss or stealing of the card, until the real notification of the
bank, by the abovementioned means, about its loss or stealing.

C. The cardholder pays the fees of the issuance of an alternative credit card, if it is issued upon his request.
10- Cardholder’s responsibilities

A. The cardholder declare that he/she will be responsible for compensating the bank for any losses or expenses it may pay as a result of any violation of these terms and conditions.

B. Without violating what was mentioned in paragraph (10-c) below, the cardholder is responsible for all losses resulting from the loss or stealing of the credit card, except the losses he is responsible for as a result of the
card loss or stealing, or its use by unauthorized parties, after notifying the bank of the loss or stealing by calling on the bank phone or visiting the nearest branch.
C. In case of undeclared use of the lost or stolen credit card, the maximum responsibility of the cardholder, before notifying the bank of the loss or stealing, will not exceed the authorized credit limit.

D. The cardholder is responsible for any transactions or uses resulting from fraud, neglect or terms violation. The cardholder is then responsible before the bank for any illegal or undeclared use.
E. The cardholder is forbidden from using the card in banned states and stores or for banned products. In these cases, the card is subject to being stopped.

11- Bank’s responsibilities

A. The bank is not responsible, in any case, towards any third party, in case the cardholder uses his card to buy any product or service, or uses it in ATMs, whether this responsibility is related to the credit card or any other
documents.

B. The bank is not responsible, in any case, towards the cardholder, in the following cases:
- any lack, damage or defect in cash withdrawals or products and services bought or paid for by the credit card.
any loss or damage resulting from the refusal of a merchant, institution, supplier or machine to use the credit card.
1-1-B081 - 82 ‫نموذج قم‬

-
- if the bank is not able to fulfill its commitments as per these terms and conditions, as a direct or indirect result of a damage in devices, authorization system, statement preparation or transfer connections, or as a
result of industrial or market conflicts, wars or other unforeseen circumstances out of the control of the bank, its employees or customers.
C. The abovementioned responsibilities limits remain effective until these terms and conditions are no more in force or until the credit card is cancelled.

12- Documents
The bank is not bound to send invoices, receipts or coupons to the cardholder. If this latter asks for copies of these documents, this will be subject to certain fees if the transactions are correct. In case they are not, the bank will
concede these fees.
13- Cancelling the credit card / reissuance/ stopping the effectiveness of terms and conditions

A. The bank has always the right to cancel/reissue the credit card or any supplementary credit cards, and to stop the effectiveness of these terms and conditions with or without a prior notification. In this case, the cardholder
is bound to return the credit cards and the supplementary credit cards (if present) to the bank after cutting them in two halves passing by the magnetic tape. As soon as this cancellation or termination happens, all
delayed payments related to the credit card or the supplementary credit cards become due to the bank and immediately required.
B. The cardholder may ask for cancelling the credit card or the supplementary credit cards, or for stopping the effectiveness of these terms and conditions through a written notice to which are attached the cards to be
With VAT registration No. 300000712300003

cancel to the bank after cutting them in two halves passing by the magnetic tape. As soon as this request is made, all delayed payments related to the credit card or the additional credit cards (if present) become due to
the bank and immediately required. If the customer decides not to receive the card and not activate it or benefit from it within ten working days, the fees and commissions due will be returned
C. Cancelling the credit card or stopping the effectiveness of these terms and conditions will not have any negative repercussions or impacts on the already made transactions or those that were decided to be made as per
a commitment before this cancellation or termination, and they will have no impact on activating the account, unless otherwise requested by the customer to the bank.
14- Notifications

All notifications are sent to the cardholder, to the address he wrote on this sample, as it is considered that any notification or speech sent to this address is immediately received by the customer. The bank will not be responsible
for any document sent and not received by the cardholder if he changes his address without notifying the bank in writing at least seven (7) days before the change happens. In this case, the cardholder has to show his/her
address and phone number. The bank will not be responsible if the card owner was not able to do this. The cardholder is considered as having accepted any notifications sent by the bank, if the cardholder did not show any
objection within thirty (30) days as of their issuance.

Bank Albilad is a Saudi Joint Stock Company, with National Unified No.7001473102, Head Office: Al Mutamarat 8229, Building No 2 ,RIYADH 3952 - 12711 ,KSA. Under monitoring and supervision of Saudi Central Bank authority and licensed by Royal decree 48/M on 21/9/1425H (4/11/2004 G)
 Bank AlBilad Credit Card and Tamkeen card Terms & Conditions
15- Commitments of the cardholder

A. The card owner is responsible for any commitments resulting from the issuance of the credit card.

B. All expenses resulting from using the credit card, including cash withdrawals, purchases or other transactions, are deducted from the account of the card owner at the bank, who is responsible in these cases for all

commitments related to these uses, whether it is him who made these transactions or someone else on behalf of him. The card owner admits to provide the bank with any information or statements it may ask for to

open or activate the bank account or for revision. The cardholder approves that he has authorized the bank to get any information about him from SIMAH or any other adopted part at SAMA. The cardholder also

authorizes it to disclose any information of him to SIMAH or any other adopted part at SAMA

C. The cardholder failure to sign on any receipts, advanced payments or coupons of purchase orders does not exempt him/her from his/her responsibility towards the bank concerning these sales and purchases, and the

card owner has to object on any amount registered on the account of the card within 30 days.

16- Cardholder Complaints

A. The cardholder might register any complaint or need for further explanation related to the credit card using any of the following means:

- No. 8001230000 (inside KSA) – no. 00966-920001002 (outside KSA) – Fax no. 0966-11-4798909.

- write to Customers Complaints Unit – Bank Albilad – Main Office – 8229 Al Mutamarat, No.: 2, RIYADH 3952- 12711, Kingdom of Saudi Arabia

B. The cardholder can present their complaint to one branch of Albilad providing it with the required information.

17- Amendment of Terms and Conditions:

The bank always keeps the right of changing and amending these terms and conditions after the consent of the legitimate body of it and the concerned regulators, or as per instructions issued by the Monetary Agency. This

change or amendment enter into force within (30) days as of the date of the customer notification. If the cardholder did not agree on these changes and amendments, the bank stops the effectiveness of these terms and

conditions and cancels the card(s) of the customer.

18- General Provisions

A. The bank has always the right, and in its sole and absolute discretion, to issue an alternative credit card or a new PIN within the terms and conditions he considers as appropriate, as he has the right to impose any fees

on them.

B. The factor of time is essential wherever it is mentioned in these terms and conditions, and it must be noted that any delay or misuse by the bank of its rights, privileges, powers or procedures stipulated in these terms

and conditions does not hinder or weaken these rights, privileges, powers or procedures, and is not considered as a concession of what was presented. It is also known that any single or partial use of these rights,

privileges, powers or procedures does not forbid any later use of any other rights, privileges, powers or procedures in the future. Rights, privileges, powers and procedures in these terms and conditions are additional

and do not forbid the execution of any rights, privileges, powers or procedures stipulated in the applicable laws and regulations.

C. If any term or condition of these terms and conditions was or becomes null or non-applicable for any reason as per the applicable law, this does not affect the legality, legitimacy or validity of other terms and conditions.

D. These terms and conditions were written in Arabic and English, but the card owner approves that the Arabic version dominates the English version and is revised in case of any conflict or dispute.

19- Applicable law and litigation

These terms and conditions, and all the related rights along with Bank Albilad rights are subject to the main and/or the additional credit card owner, and they are executed and explained in accordance with the applicable laws

and regulations in Kingdom of Saudi Arabia and the instructions issued by Saudi Central Bank ( SAMA ) , without contradicting the Islamic Sharia. Accordingly, any demands, conflicts or disputes, resulting from the application

of these terms and conditions, have to be submitted to the competent judicial authority in Kingdom of Saudi Arabia
1-1-B081 - 82 ‫نموذج قم‬

With VAT registration No. 300000712300003

Bank Albilad is a Saudi Joint Stock Company, with National Unified No.7001473102, Head Office: Al Mutamarat 8229, Building No 2 ,RIYADH 3952 - 12711 ,KSA. Under monitoring and supervision of Saudi Central Bank authority and licensed by Royal decree 48/M on 21/9/1425H (4/11/2004 G)
 Credit Card Agreement Summary

Credit card holder information (Fields should be filled when apply for the Card)

Cardholder name ................................................ ............ Date of Agreement ................................ ...........................

National ID / Iqama ................................................ ............ Agreement reference number ................................ ...........................

Credit Card information

Credit card limit Credit Limit will appear on account statement APR Only issuance fees

Administration fees N/A at the moment Term fees N/A

Full Amount For the country's credit cards and 5%,

Annual fees Refer to card type explained in financial commitments – clause no. (6) Minimum amount due
or 200 riyals, "Which is more" to enable credit cards

Foreign cogency conversion fees Depends on the country Settlement date On the salary day

Other fees Please refer to Charge Card application, Terms and Condition Late Payment fee N/A

The most prominent provision

Implications of transactions conducted in foreign currencies Article (Financial Obligations number 6) Page (3)

Implications of payment of the minimum due amount Article (Payment of Debt Balance number 7) Page (4)

Implications of non payment Article (Payment of Debt Balance number 7) Page (4)

Implications of cash withdrawals Article (Financial Obligations number 6) Page (3)

Implications of cash transfer Article (Financial Obligations number 6) Page (3)

Credit Card Features Please visit www.bankalbilad.com for more information on cards features and Tamkeen card

- No additional fees, other than the due amount, are paid for the card.

Note: Reading and reviewing this summary shall not substitute reading and reviewing the application and terms and conditions of charge cards, and does not exempt
*
from the mentioned commitments and obligations.

Cardholder signature upon reading and receiving of “Credit Card Agreement Summary”

Name ............................................................. Signature .......................................................... Date ..........................

Stamp

Al-Bilad Bank
8229 Al Mutamarat, No.: 2 RIYADH 3952- 12711 ...........................
Albilad Phone: 8001230000 www.bankalbilad.com

❖ For Bank branch / Agent Use

The signature was made in front of me after verifying the customer signature according to his record in the bank, and after verifying the personality of the signatory according to his original identity
card
With VAT registration No. 300000712300003

Staff Name Signature Employee Number Date

.......................... .......................... .......................... ..........................

• For Branch Use Only after verifying the personality of the signatory according to his original identity card

Staff Name Signature Employee Number Date

........................ .......................... .......................... ..........................

• For Bank / Agent Use

1-1-B081 - 82 ‫نموذج قم‬

• For Bank Albilad use Only

6/6
Bank Albilad is a Saudi Joint Stock Company, with National Unified No.7001473102, Head Office: Al Mutamarat 8229, Building No 2 ,RIYADH 3952 - 12711 ,KSA. Under monitoring and supervision of Saudi Central Bank authority and licensed by Royal decree 48/M on 21/9/1425H (4/11/2004 G)