Askari General Insurance Company Ltd.

Know Your Customer Form

To Comply with SECP Requirements about Anti-Money Laundering /Combatting the Financing of Terrorism
(AML/CFT)
Individual Customer
Section-1 (To be Filled By Customer) Date:

No: Customer Due Diligence Information

1 Name of Individual (In Block
Letters-As per CNIC) NAHEED AHSAN W/O AHSAN BASIR SHEIKH F-626
2 Identity Document: (ID No) 3 0 0 5 1 9 6 0
CNIC Passport NICOP 42000-0492104-8 Date of Birth
D D M M Y Y Y Y
Issuance Date 2 8 0 5 2 0 1 0
D D M M Y Y Y Y

Expiry Date 3 0 0 4 2 0 2 1
D D M M Y Y Y Y

3 Address

House # 1065, Road D, Phase III, Bahria Town, Islamabad

Resident Non-Resident
4 Contact No. Mobile: 0300-5105180 Landline: 051-2725050 Fax:

5 Email of Individual ahsanbasir49@gmail.com

6 NTN No of Individual
7 Occupation Salaried Individual
Non- Salaried Individual (Please Specify)
Self Employed in Own Business
Company Name
Address & Contact #:

8 Name of Beneficiary (If Different Name Identity Documents Issuance Expiry Date

from Policy Holders, other than CNIC/NICOP/PASSPORT Date

Bank or leasing Company) (please

Attach separate sheet in case of
More than 2 beneficiary)

I declare that, the detail/information provided is accurate in all context. In case of any discrepancies, I will take full responsibility. Further, if any change in above
information occurs, I am bound to notify the Askari General Insurance Company Limited. I also declare the non-involvement in any money laundering/terrorist
financing activity. I am not facing any financial/legal action in context of money laundering/terrorist financing from any regulatory/legal body. Identity document
copy of Individual & beneficial owner (if mentioned) (CNIC/Passport/NICOP) is attached herewith.

Client’s Signature/Thumb Impression