‫اﺳﺘﻤﺎرة ﻃﻠﺐ ﺑﻄﺎﻗﺔ‬

CREDIT CARD APPLICATION

‫اﻟﺘﺎرﻳﺦ‬ ‫@اﺳﺘﺨﺪم ﻓﻘﻂ ا
ﺣﺮف اﻟﻮاﺿﺤﺔ ﻓﻲ ﻣﻞء اﻻﺳﺘﻤﺎرة‬ *‫إﻟﺰاﻣﻲ‬
Date *USE ONLY BLOCK CAPITAL LETTERS TO FILL THE APPLICATION *Mandatory
‫ﻧﻮع اﻟﻌﻤﻴﻞ‬ ‫اﻓﺮاد‬ ‫ﺻﺎﺣﺐ ﻋﻤﻞ ﺧﺎص‬ ‫ﻣﻮﻇﻒ‬ ‫ﻋﻤﻴﻞ ﺟﺪﻳﺪ‬ ‫ﻋﻤﻴﻞ ﺣﺎﻟﻲ‬
Customer Type: Individual Self-Employed Staff New Customer Existing Customer (CIF)

PERSONAL DETAILS ‫اﻟﻤﻌﻠﻮﻣﺎت اﻟﺸﺨﺼﻴﺔ‬

Title Mr. ‫اﻟﺴﻴﺪ‬ Mrs. ‫اﻟﺴﻴﺪة‬ Ms. ‫ﻧﺴﺔ‬¥‫ا‬ Doctor ‫اﻟﺪﻛﺘﻮر‬ H.E. ‫ﺻﺎﺣﺐ اﻟﺴﻌﺎدة‬

Name (as per passport)* ‫اﻻﺳﻢ ا§ول‬ ‫اﻻﺳﻢ ا§وﺳﻂ‬ ‫اﻻﺳﻢ ا§ﺧﻴﺮ‬ *(‫اﻻﺳﻢ )اﺳﻢ ﺣﺴﺐ ﺟﻮاز اﻟﺴﻔﺮ‬
(please leave a space between names) First Name Middle Name Last Name (‫)ﻳﺮﺟﻰ ﺗﺮك ﻣﺴﺎﻓﺔ ﺑﻴﻦ ا
ﺳﻤﺎء‬

*‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬ *‫اﺳﻢ ا§م‬

Date of Birth* Mother’s Maiden Name*
‫اﻟﺤﺎﻟﺔ اﻻﺟﺘﻤﺎﻋﻴﺔ‬ ‫أﻋﺰب‬ ‫ﻣﺘﺰوج‬ (‫أﺧﺮى )اذﻛﺮ‬ ‫ﻋﺪد اﻟﻤﻌﺎﻟﻴﻦ‬
Marital Status Single Married Other (specify) Number of Dependants
‫اﻟﺠﻨﺲ‬ ‫ذﻛﺮ‬ ‫أﻧﺜﻰ‬ ‫اﻟﺠﻨﺴﻴﺔ‬ ‫ﻋﺪد ﺳﻨﻮات اﻗﺎﻣﺔ ﻓﻲ اﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة‬
Gender Male Female Nationality Number of Years in the UAE
‫اﻟﺘﻌﻠﻴﻢ‬ ‫ﺧﺮﻳﺞ‬ ‫دراﺳﺎت ﻋﻠﻴﺎ‬
Education Graduate Post Graduate Other (specify) (‫أﺧﺮى )اذﻛﺮ‬

Email* (To receive your monthly statement and other notification from aafaq.) (‫اﻟﺒﺮﻳﺪ اﻟﻜﺘﺮوﻧﻲ@ )ﻟﺘﻠﻘﻲ اﻟﻜﺸﻒ اﻟﺸﻬﺮي اﻟﺨﺎص ﺑﻚ وﻣﺮاﺳﻼت أﺧﺮى ﻣﻦ آﻓﺎق‬
(*T&C for e-statement and communication will apply.) .(‫)@ ﺗﻄﺒﻖ اﻟﺸﺮوط وا§ﺣﻜﺎم اﻟﺨﺎﺻﺔ ﺑﺎﻟﻜﺸﻒ اﻟﻜﺘﺮوﻧﻲ واﻟﻤﺮاﺳﻼت‬

Preferred Language* *‫اﻟﻠﻐﺔ اﻟﻤﻔﻀﻠﺔ‬

(Language selection may be used for sending communications from English ‫اﻧﺠﻠﻴﺰﻳﺔ‬ Arabic ‫اﻟﻌﺮﺑﻴﺔ‬ ،‫)ﻳﻤﻜﻦ اﺳﺘﺨﺪام اﺧﺘﻴﺎر اﻟﻠﻐﺔ رﺳﺎل ﻣﺮاﺳﻼت ﻣﻦ آﻓﺎق )ﻣﺜﻞ اﻟﺮﺳﺎﺋﻞ اﻟﻨﺼﻴﺔ‬
aafaq (like, SMS, mailers, promotions, etc.) (‫ إﻟﺦ‬،‫ اﻟﻌﺮوض اﻟﺘﺮوﻳﺠﻴﺔ‬،‫اﻟﺮﺳﺎﺋﻞ اﻟﺒﺮﻳﺪﻳﺔ‬

‫اﻗﺎﻣﺔ‬ ‫ﻣﻮاﻃﻦ إﻣﺎراﺗﻲ‬ ‫واﻓﺪ‬ ‫ﻫﻞ اﻧﺖ ﺷﺨﺺ ذو ﺻﻔﺔ ﺳﻴﺎﺳﻴﺔ أو ﻟﺪﻳﻚ ﻗﺮاﺑﺔ ﻣﻊ أﺣﺪ ذو ﺻﻔﺔ ﺳﻴﺎﺳﻴﺔ؟‬
Residency UAE National Expatriate Are you a Politically Exposed Person (PEP) or closely associated with any PEP ? Yes ‫ﻧﻌﻢ‬ No ‫ﻻ‬

*‫رﻗﻢ ﺟﻮاز اﻟﺴﻔﺮ‬ ‫ﺗﺎرﻳﺦ اﺻﺪار‬

Passport Number* Issue Date
‫ﻣﺤﻞ اﺻﺪار‬ ‫ﺗﺎرﻳﺦ اﻻﻧﺘﻬﺎء‬
Place of Issue Expiry Date
*‫رﻗﻢ ﺑﻄﺎﻗﺔ اﻟﻬﻮﻳﺔ اﻣﺎراﺗﻴﺔ‬ ‫ﺗﺎرﻳﺦ اﻻﻧﺘﻬﺎء‬
Emirates ID Number* Expiry Date
‫رﻗﻢ اﻟﺘﺄﺷﻴﺮة‬ ‫ﺗﺎرﻳﺦ اﻻﻧﺘﻬﺎء‬
Visa Number Expiry Date

RESIDENCE DETAILS IN UAE * * ‫ﺗﻔﺎﺻﻴﻞ اﻟﺴﻜﻦ ﻓﻲ ا

ﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة‬

‫ﻧﻮع اﻟﺴﻜﻦ‬ ‫ﻣﺆﺟﺮ‬ ‫ﺳﻜﻦ اﻟﺸﺮﻛﺔ‬ ‫ﻣﻠﻚ‬ ‫ﻣﻊ اﻟﻮاﻟﺪﻳﻦ‬ ‫ﻋﺪد اﻟﺴﻨﻮات ﻓﻲ اﻟﻌﻨﻮان اﻟﺤﺎﻟﻲ‬
Residence Type Rented Company Accommodation Owned Living with Parents Number of Years in Current Address
‫اﻟﻔﻴﻼ‬/‫رﻗﻢ اﻟﺸﻘﺔ‬ ‫اﺳﻢ اﻟﺒﻨﺎﻳﺔ‬
Flat/Villa No. Building Name
‫ﺻﻨﺪوق اﻟﺒﺮﻳﺪ‬ ‫اﻟﺸﺎرع‬
P.O. Box Street
‫أﻗﺮب ﻣﻌﻠﻢ ﺑﺎرز‬
Nearest Landmark

‫اﻟﻤﻨﻄﻘﺔ‬ ‫اﻣﺎرة‬
Area Emirate
‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻤﺘﺤﺮك‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬ ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﺜﺎﺑﺖ‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬
Mobile Number Country Code City Code Number Country Code City Code Number
Landline Number

HOME COUNTRY DETAILS*(For Expatriates) (‫ﺻﻠﻲ* )ﻟﻠﻤﻐﺘﺮﺑﻴﻦ‬ ‫ﺗﻔﺎﺻﻴﻞ اﻟﻤﻮﻃﻦ ا‬

‫اﻟﺸﺨﺺ اﻟﺬي ﻳﻤﻜﻦ اﻻﺗﺼﺎل ﺑﻪ‬ ‫اﻟﺼﻠﺔ‬

Contact Person Relationship
‫ اﻟﻤﻨﺰل‬/‫رﻗﻢ اﻟﺸﻘﺔ‬ ‫اﺳﻢ اﻟﺒﻨﺎﻳﺔ‬
Flat/Villa No. Building Name
‫ﺻﻨﺪوق اﻟﺒﺮﻳﺪ‬ ‫أﻗﺮب ﻣﻌﻠﻢ ﺑﺎرز‬
P.O. Box Nearest Landmark
‫اﻟﺸﺎرع‬
Street
CRD-FRM-001-001

‫اﻟﻤﻨﻄﻘﺔ‬
Area
‫اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺪوﻟﺔ‬
City Country
‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﺜﺎﺑﺖ‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬ ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻤﺘﺤﺮك‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬
Landline Number Country Code City Code Number Country Code City Code Number
Mobile Number

Customer Signature: ‫ﺗﻮﻗﻴﻊ اﻟﻌﻤﻴﻞ‬

Page 1 of 4
‫اﺳﺘﻤﺎرة ﻃﻠﺐ ﺑﻄﺎﻗﺔ‬
CREDIT CARD APPLICATION

COMPANY DETAILS* * ‫ﺗﻔﺎﺻﻴﻞ اﻟﺸﺮﻛﺔ‬

Employment Status Salaried ‫ﻳﻌﻤﻞ ﺑﺮاﺗﺐ‬ Self Employed ‫ﺻﺎﺣﺐ ﻣﻬﻨﺔ ﺣﺮة‬ Other (specify) (‫أﺧﺮى )اذﻛﺮ‬ ‫اﻟﻮﻇﻴﻔﺔ‬

‫اﺳﻢ اﻟﺸﺮﻛﺔ‬ ‫ اﻟﺸﺮﻛﺔ اﻟﺤﺎﻟﻴﺔ‬/‫ﻋﺪد ﺳﻨﻮات اﻟﻌﻤﻞ ﻓﻲ اﻟﻤﺆﺳﺴﺔ‬

Organisation Name Year in Current Organisation
‫اﻟﻤﻨﺼﺐ‬ ‫ رﻗﻢ اﻟﺮﺧﺼﺔ اﻟﺘﺠﺎرﻳﺔ‬/‫رﻗﻢ اﻟﻤﻮﻇﻒ‬
Designation Employee Number/Trade License Number
‫اﻟﺒﺮﻳﺪ اﻟﻜﺘﺮوﻧﻲ‬ ‫ﺗﺎرﻳﺦ اﻻﻟﺘﺤﺎق‬
Email Address Date of Joining
‫رﻗﻢ اﻟﻤﻜﺘﺐ‬ ‫اﺳﻢ اﻟﺒﻨﺎﻳﺔ‬
Office No. / Floor Building Name
‫اﻟﺸﺎرع‬
Street
‫أﻗﺮب ﻣﻌﻠﻢ ﺑﺎرز‬
Nearest Landmark
‫ﺻﻨﺪوق اﻟﺒﺮﻳﺪ‬ ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻻرﺿﻲ‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬
P.O. Box Office Number Country Code City Code Number

‫اﻟﻤﻨﻄﻘﺔ‬ ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻤﺘﺤﺮك‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬

Country Code City Code Number
Area Mobile Number
‫اﻣﺎرة‬ ‫رﻗﻢ ﺑﺪﻳﻞ‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬
Country Code City Code Number
Emirate Alternate Number

INCOME DETAILS* *‫ﺗﻔﺎﺻﻴﻞ اﻟﺪﺧﻞ‬

‫ اﻟﺪﺧﻞ اﻟﺸﻬﺮي اﺟﻤﺎﻟﻲ‬/‫اﻟﺮاﺗﺐ‬ ‫ اﻟﺮﺑﺢ‬/‫ﺻﺎﻓﻲ اﻟﺪﺧﻞ‬

Monthly Gross Salary/Income Net Income/Profit
‫إﻳﺮادات أﺧﺮى وﻣﺼﺎدرﻫﺎ‬ ‫ﻧﺴﺒﺔ اﻟﻤﺴﺎﻫﻤﺔ‬
Other Income and Source Share Percentage
‫ﻳﻮم ﺗﺤﻮﻳﻞ اﻟﺮاﺗﺐ‬
Salary day

OTHER FINANCIAL COMMITMENTS ‫ﺧﺮى‬ ‫اﻻﻟﺘﺰاﻣﺎت اﻟﻤﺎﻟﻴﺔ ا‬

Existing facility with aafaq / any other bank or financial institution. ‫ ﺗﻤﻮﻳﻼت أو ﻗﺮوض ﻣﻦ آﻓﺎق أو ﻣﻦ أي ﻣﺆﺳﺴﺔ أﺧﺮى؟‬Ä‫ﻫﻞ ﻟﺪﻳﻚ ﺣﺎﻟﻴ‬
(if yes, please provide details as below)
Yes ‫ﻧﻌﻢ‬ No ‫ﻻ‬
(‫ ﻳﺮﺟﻰ ذﻛﺮ اﻟﺘﻔﺎﺻﻴﻞ ﻋﻠﻰ اﻟﻨﺤﻮ اﻟﻤﺒﻴﻦ أدﻧﺎه‬،‫)ﻓﻲ ﺣﺎل ﻧﻌﻢ‬

‫اﻟﻤﺼﺮف‬/‫اﺳﻢ اﻟﻤﺆﺳﺴﺔ‬ ‫ اﻟﺒﻄﺎﻗﺔ‬/‫ﻧﻮع اﻟﻤﻨﺘﺞ‬ ‫ اﻟﺒﻄﺎﻗﺔ‬/‫رﻗﻢ اﻟﺤﺴﺎب‬ (‫اﻟﻘﺴﻂ اﻟﺸﻬﺮي )درﻫﻢ إﻣﺎراﺗﻲ‬ (‫اﻟﺮﺻﻴﺪ اﻟﻤﺘﺒﻘﻲ )درﻫﻢ إﻣﺎراﺗﻲ‬
Bank/Institution Name Product/Card Type Account No/Card No Monthly Installment (AED) Outstanding Balance (AED)

REFERENCES DETAILS IN THE UAE ‫ﺗﻔﺎﺻﻴﻞ اﻟﺠﻬﺎت اﻟﻤﺮﺟﻌﻴﺔ ﻓﻲ دوﻟﺔ ا

ﻣﺎرات‬

Friend/Relative Reference contact 1 ١ ‫ اﻗﺎرب‬/‫ﺑﻴﺎﻧﺎت اﻻﺗﺼﺎل ﺑﺎﻟﺠﻬﺔ اﻟﻤﺮﺟﻌﻴﺔ ﻣﻦ اﺻﺪﻗﺎء‬

‫اﻻﺳﻢ‬
Name
‫اﻟﺼﻠﺔ‬ ‫ اﻣﺎرة‬/‫اﻟﻤﺪﻳﻨﺔ‬
Relationship City/Emirate
‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﺜﺎﺑﺖ‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬ ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻤﺘﺤﺮك‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬
Country Code City Code Number Country Code City Code Number
Landline Number Mobile Number

Friend/Relative Reference contact 2 ٢ ‫ اﻗﺎرب‬/‫ﺑﻴﺎﻧﺎت اﻻﺗﺼﺎل ﺑﺎﻟﺠﻬﺔ اﻟﻤﺮﺟﻌﻴﺔ ﻣﻦ اﺻﺪﻗﺎء‬

‫اﻻﺳﻢ‬
Name
CRD-FRM-001-001

‫اﻟﺼﻠﺔ‬ ‫ اﻣﺎرة‬/‫اﻟﻤﺪﻳﻨﺔ‬
Relationship City/Emirate
‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﺜﺎﺑﺖ‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬ ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻤﺘﺤﺮك‬ ‫رﻣﺰ اﻟﺪوﻟﺔ‬ ‫رﻣﺰ اﻟﻤﺪﻳﻨﺔ‬ ‫اﻟﺮﻗﻢ‬
Country Code City Code Number Country Code City Code Number
Landline Number Mobile Number

Customer Signature: ‫ﺗﻮﻗﻴﻊ اﻟﻌﻤﻴﻞ‬

Page 2 of 4
‫اﺳﺘﻤﺎرة ﻃﻠﺐ ﺑﻄﺎﻗﺔ‬
CREDIT CARD APPLICATION
AAFAQ CARD PRODUCTS/ TYPE ‫ ﻧﻮع ﺑﻄﺎﻗﺔ آﻓﺎق‬/‫ﻣﻨﺘﺠﺎت‬

1) Business Covered Card ‫ اﻋﻤﺎل‬/ SME ‫اﻟﺒﻄﺎﻗﺔ اﻟﻤﻐﻄﺎة‬ 2) Retail Covered Card ‫ﺑﻄﺎﻗﺔ اﻟﺘﺠﺰﺋﺔ اﻟﻤﻐﻄﺎة‬

PERSONAL DETAILS ‫اﻟﻤﻌﻠﻮﻣﺎت اﻟﺸﺨﺼﻴﺔ‬

‫اﻻﺳﻢ اﻟﻤﻔﻀﻞ ﻋﻠﻰ اﻟﺒﻄﺎﻗﺔ‬ ‫اﻟﺤﺪ اﻟﻤﻄﻠﻮب‬
Preferred Name on the card Desired Limit
‫اﻟﻤﺪﻳﻨﺔ اﻟﻤﻔﻀﻠﺔ‬
Favorite City

BALANCE TRANSFER DETAILS ‫ﺗﻔﺎﺻﻴﻞ ﺗﺤﻮﻳﻞ اﻟﺮﺻﻴﺪ‬

‫رﻗﻢ اﻟﺒﻄﺎﻗﺔ اﻟﺒﻨﻜﻴﺔ ا§ﺧﺮى‬ ‫ﺗﺎرﻳﺦ اﻧﺘﻬﺎء ﺻﻼﺣﻴﺔ اﻟﺒﻄﺎﻗﺔ‬
Other Bank Card No. Card Expiration Date
‫ اﻟﻤﺆﺳﺴﺔ‬/‫اﻟﺒﻨﻚ‬
Bank\Institution Name
(‫ﻣﺒﻠﻎ ﺗﺤﻮﻳﻞ اﻟﺮﺻﻴﺪ )ﺑﺎﻟﺪرﻫﻢ‬
Balance Transfer Amount (AED)
‫اﻻﺳﻢ ﻋﻠﻰ اﻟﺒﻄﺎﻗﺔ اﻟﺒﻨﻜﻴﺔ ا§ﺧﺮى‬
Name on Other Bank Card

SUPPLEMENTARY CARD ‫اﻟﺒﻄﺎﻗﺔ اﻟﺘﺎﺑﻌﺔ‬

Title Mr. ‫اﻟﺴﻴﺪ‬ Mrs. ‫اﻟﺴﻴﺪة‬ Ms. ‫ﻧﺴﺔ‬¥‫ا‬ Other (specify) ‫)اذﻛﺮ( أﺧﺮى‬ ‫اﻟﻠﻘﺐ‬

‫اﻻﺳﻢ اﻟﻤﻔﻀﻞ ﻋﻠﻰ اﻟﺒﻄﺎﻗﺔ‬ ‫اﻟﺼﻠﺔ‬

Preferred Name on Card Relationship
‫ﺗﺎرﻳﺦ اﻟﻤﻴﻼد‬ ‫اﻟﺠﻨﺲ‬ ‫ذﻛﺮ‬ ‫أﻧﺜﻰ‬
Card Limit to be ‫ﺣﺪ اﻟﺒﻄﺎﻗﺔ اﻟﻤﺮاد‬
Date of Birth Gender Male Female Assigned (amount) (‫ﺗﻌﻴﻴﻨﻪ )اﻟﻤﺒﻠﻎ‬

‫رﻗﻢ اﻟﻬﻮﻳﺔ اﻣﺎراﺗﻴﺔ‬ ‫ﺗﺎرﻳﺦ اﻻﻧﺘﻬﺎء‬

Emirates ID Number Expiry Date

PAYMENT OPTION ‫ﺧﻴﺎر اﻟﺪﻓﻊ‬

Direct Debit* @‫اﻟﺨﺼﻢ اﻟﻤﺒﺎﺷﺮ‬
Kindly debit my below account through DDA (Direct Debit Authority) for the mentioned minimum .‫يرجى الخصم املبارش من حسايب أدناه لسداد الحد األدىن من بطاقة االئتامن املذكورة يف أو قبل تاريخ االستحقاق‬
credit card payment on or before due date. (DDA form attached) (‫)منوذج الخصم املبارش املرفق‬

‫ اﻟﻤﺆﺳﺴﺔ‬/‫اﻟﺒﻨﻚ‬
Bank\Institution Name

‫ﻳﺒﺎن‬¥‫رﻗﻢ ا‬
IBAN No.
(٪٥ ‫اﻟﺪﻓﻌﺎت اﻟﺸﻬﺮﻳﺔ )ﺑﺤﺪ أدﻧﻰ‬
Monthly Payments (minimum of 5%) 5% 10% 25% 50% 100%
* Mandatory a minimum 5% Direct debit of outstanding will be deducted monthly from my above mentioned bank / ‫ كحد أدىن بشكل إلزامي من توكيل الخصم املبارش للمبلغ املستحق بصفة شهرية من حسايب‬٪٥ ‫* سيتم خصم‬
institution account. .‫املؤسسة املذكورة أعاله‬/‫لدى البنك‬

Customer Signature: : ‫ﺗﻮﻗﻴﻊ اﻟﻌﻤﻴﻞ‬

FOR AAFAQ USE ONLY ‫ﻻﺳﺘﺨﺪام آﻓﺎق ﻓﻘﻂ‬

‫رﻗﻢ ﻣﻠﻒ اﻟﻌﻤﻴﻞ‬ ‫ﻧﺴﺒﺔ اﻟﺪﻳﻦ‬ ‫ﻗﻨﺎة اﻟﺘﻮزﻳﻊ‬
CIF Number DBR (Ratio) Source channel

‫رﻣﺰ ﻣﻨﺘﺞ اﻟﺒﻄﺎﻗﺔ‬ ‫اﻟﺤﺪ اﻟﻤﻮاﻓﻖ ﻋﻠﻴﻪ‬ ‫اﻟﺒﻄﺎﻗﺔ ا§ﺳﺎﺳﻴﺔ‬ ‫اﻟﺒﻄﺎﻗﺔ اﺿﺎﻓﻴﺔ‬
Card Product Code Limit Approved Primary Card Supplimentary Card

‫اﻟﻘﺮار‬ ‫اﻟﻤﻮاﻓﻘﺔ‬ ‫اﻟﺮﻓﺾ‬ ‫رﻗﻢ ﺑﻄﺎﻗﺔ اﻟﻤﻮﻇﻒ‬

Decision Approved Decline Staff ID Number
CRD-FRM-001-001

‫ﺗﻤﺖ اﻟﻤﺮاﺟﻌﺔ‬
‫واﻟﺘﻮﺻﻴﺔ ﻣﻦ ﻗﺒﻞ‬ ‫ﻣﻮاﻓﻘﺔ اﺳﺘﺜﻨﺎﺋﻴﺔ‬
Review & Exception ‫اﻟﻤﻮاﻓﻘﺔ ﻣﻦ‬
Recommend by Approval Approved by

‫اﻟﺘﺎرﻳﺦ‬ ‫اﻟﺘﺎرﻳﺦ‬ ‫اﻟﺘﺎرﻳﺦ‬

Date Date Date

Page 3 of 4
 ‫اﺳﺘﻤﺎرة ﻃﻠﺐ ﺑﻄﺎﻗﺔ‬
CREDIT CARD APPLICATION
DECLARATION
1. I/We hereby choose to apply for the issue of an aafaq Islamic Finance P.S.C Card(s) and declare
that the details furnished above are true & correct to / the best of my/our knowledge and belief and
I/We undertake to inform you of any changes therein, immediately. Further, the use of my Card(s)
and any Supplementary Card issued on my card account with aafaq, will be subject to the Card
Terms and Conditions of aafaq Islamic Finance P.S.C (which may be amended from time to time).
I/We accept aafaq Islamic Finance’s Terms and Conditions in respect of all products, services and
channels (including all future product/service inclusions). I/We hereby agree to be bound by them.
2. I/We hereby agree that aafaq Islamic Finance reserves the right to alter, modify or cancel any or
all of the Terms and Conditions before executing financing agreement of Cards and STI
(short-term Investment) account opening at any time and without notice. aafaq Islamic Finance
P.S.C shall destroy the security cheque(s) as held issued in favour of aafaq Islamic Finance.
3. I/we agree to pay the fees applicable irrespective of any usage of the card upon approval.
4. I/We acknowledge and agree that I/We am automatically enrolled for Multi-Takaful package
(Insurance) and that I am bound by the Multi-Takaful package (Insurance terms & conditions*.
I/We understand that the insurance shall be offered free of charge every month only on condition
that I/we spend a stipulated amount as retail transactions through aafaq credit card every month,
else a nominal charge will be applicable every month for which I authorize aafaq Islamic Finance
to debit my applied credit card account. I understand that I can opt out of the insurance by
intimating aafaq Islamic Finance.
I confirm that I have read and agree to abide by any charges appropriate and applicable as per
5.
schedule of charges available in aafaq’s website.
6. I/We have very carefully read and have fully understood the General Terms and Conditions
relating to my chosen/approved credit card and its related facilities, features, benefits all other
services or product for which I am applying (either a hard copy of which I have obtained from aafaq
Islamic Finance or electronic copy of which I have downloaded or which is disclosed on aafaq's
website.
7. In case any of the above information is found to be false of untrue or misleading or misrepresenting,
I/we are aware that I/we may be held liable for it.
8. I/We understand that disbursement of finance will be subject to satisfactory regulatory checks and
completion of all required documents.
9. I/We understand that aafaq Islamic Finance P.S.C shall have the right to refuse acceptance of the
application, and/or cancel it any time without being obliged to give any explanation.
10. (Here in after referred to as the Account Holder or Customer or Cardholder)
Through this Undertaking, the above Account Holder (who may be a Customer and/ or obligor as
applicable), hereby entitles and authorizes aafaq Islamic PJSC (the “Company”), without the
need to obtain any additional written or oral permits, to obtain, request, verify, transfer, disclose
and communicate in general, any such Information (as defined herein), as the Company deems
fits in its absolute discretion with:
(a) any credit information bureau or any such other person or entity, whether inside the United
Arab Emirates or abroad, which maintains or is supposed to maintain any of the information
contained in this Undertaking relating to the Account Holder and/or the Customer and/ or
Cardholder and/ or his authorised signatory(ies).
I/We hereby authorise aafaq Islamic Finance, without the need to get any verbal
(b)
permits, to obtain or disclose any of the information referred to in this declaration from
any governmental or semi-governmental authorities. body, organization, company,
credit bureau, or any service provider such as electricity, water and telecommunications
companies. whether inside the UAE or abroad, which maintain or are supposed to
maintain any such information relating to me/us. aafaq Islamic Finance may
communicate with such bodies to obtain or disclose any of information referred to in this
(c) declaration without prejudice to the foregoing.
any branches, subsidiaries, affiliates, representative offices, agents of the Company,
including any appointed third parties, wherever situated.
11. The Company shall be entitled to use any or all of the Information for any such purpose
where the Information may be required, including:
(a) granting or commencing to grant any finance, banking facilities or any other banking services
offered by the Company,
(b) assessing the Account Holder’s/Customer/Cardholder credit position,
(c) collecting any amounts or finance and/or any amounts due and payable to the Company,
(d) internal use (including for use in connection with the provision of any products or services to
the Account Holder/Customer/Cardholder),
(f) data processing,
(e) statistical and risk analysis purposes,
(g) global cash services, and
(h) dealings in securities on any exchange securities market(s) and any other relevant
authorities and agencies pertaining there to.
(i) Marketing and promotion of aafaq products and services
12. For the purposes of this Undertaking, “Information” shall mean any personal, financial, legal
or credit information relating to the Account Holder/Customer/ Cardholder whether the
Account Holder/Customer/Cardholder is an individual or a legal or corporate entity, including
any information lawfully obtained from any third parties, such as any local or international
credit bureaus.
13. This undertaking shall remain full force and effect against the Account Holder/ Customer/-
Cardholder and may not be terminated or amended without the Company’s prior written
consent.
14. aafaq Islamic Finance shall be entitled to use any or all of the information for the purpose
of granting/or commencing to grant me any facilities or any other aafaq Islamic
Financing services offered by aafaq Islamic Finance or to use this information for the
purpose of assessing my credit position and collect any amounts or facilities payable to
aafaq Islamic Finance. aafaq Islamic Finance and any of its branches, parent company,
subsidiaries, affiliates, representative offices, agents or any third parties selected by any
of them or aafaq shall be entitled to obtain, transfer and disclose any credit, legal or
financial or any other information relating to me/us whether now or in future, or relating
to any existing relationship with aafaq Islamic Finance or after its termination, or even if
my application for any services or finance is rejected by aafaq Islamic finance and/or
whether such information is obtained by aafaq Islamic finance in the past or now or in
the future.
15. This Undertaking shall be subject to and interpreted in accordance with the Federal Credit
Information Law No. 6 of 2010, as may be amended from time to time, and any other
applicable laws of the United Arab Emirates. Any disputes arising between the Company and
the Account Holder/Customer/ Cardholder with regards to this Undertaking shall be referred to
the exclusive jurisdiction of the courts of the United Arab Emirates.
Account Holder/Customer/Cardholder Signature ‫ﺣﺎﻣﻞ ﺑﻄﺎﻗﺔ‬/‫اﻟﻌﻤﻴﻞ‬/‫ﺗﻮﻗﻴﻊ ﺻﺎﺣﺐ اﻟﺤﺴﺎب‬
Page 4 of 4
‫إﻗﺮار‬
‫ ﻧﻘﺮ ﻧﺤﻦ ﺑﺄﻧﻨﺎ اﺧﺘﺮﻧﺎ أن ﻧﺘﻘﺪم ﺑﻄﻠﺐ إﺻﺪار ﺑﻄﺎﻗﺔ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ وأﻗﺮ ﺑﻤﻮﺟﺒﻪ ﺑﺄن اﻟﺘﻔﺎﺻﻴﻞ اﻟﻤﻮﺿﺤﺔ‬/‫أﻗﺮ أﻧﺎ‬ .١
‫ ﻛﻤﺎ‬.‫ ﻛﻤﺎ وأﺗﻌﻬﺪ ﺑﺈﺑﻼﻏﻚ ﻋﻠﻰ اﻟﻔﻮر ﺑﺄي ﺗﻐﻴﻴﺮات ﺗﻄﺮأ ﻋﻠﻴﻬﺎ‬،‫ ﻧﺎ‬/ ‫أﻋﻼه ﺻﺤﻴﺤﺔ وﺣﻘﻴﻘﻴﺔ إﻟﻰ ﺣﺪ ﻛﺒﻴﺮ ﻣﻦ ﻣﻌﺮﻓﺘﻲ‬
‫وﻳﺨﻀﻊ اﺳﺘﺨﺪام ﺑﻄﺎﻗﺘﻲ واﻟﺒﻄﺎﻗﺎت اﺿﺎﻓﻴﺔ اﻟﺼﺎدرة ﻋﻦ ﺣﺴﺎﺑﻲ ﻟﺸﺮوط وأﺣﻜﺎم ﺑﻄﺎﻗﺎت آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬
‫ ﻧﻘﺒﻞ ﺑﺸﺮوط وأﺣﻜﺎم ﺑﻄﺎﻗﺔ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﻜﺎﻓﺔ‬/‫ وأﻗﺒﻞ‬.(‫ﺧﺮ‬¥ ‫)اﻟﺘﻲ ﻳﻤﻜﻦ ﺗﻌﺪﻳﻠﻬﺎ ﻣﻦ وﻗﺖ‬
‫ ﻧﻮاﻓﻖ ﺑﻤﻮﺟﺒﻪ ﻋﻠﻰ‬/‫ﻼ( وأواﻓﻖ‬ ً ‫ اﻟﺨﺪﻣﺎت اﻟﻤﺪرﺟﺔ ﻣﺴﺘﻘﺒ‬/‫اﻟﻤﻨﺘﺠﺎت واﻟﺨﺪﻣﺎت واﻟﻘﻨﻮات )ﺑﻤﺎ ﻓﻲ ذﻟﻚ ﻛﺎﻓﺔ اﻟﻤﻨﺘﺠﺎت‬
.‫اﻻﻟﺘﺰام ﺑﻬﺎ‬
‫ ﻧﻮاﻓﻖ ﺑﻤﻮﺟﺒﻪ ﻋﻠﻰ أن ﻟﺸﺮﻛﺔ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ اﻟﺤﻖ ﻓﻲ ﺗﻐﻴﻴﺮ ﺑﻌﺾ أو ﻛﺎﻓﺔ اﻟﺸﺮوط وا§ﺣﻜﺎم أو‬/‫وأواﻓﻖ‬ .٢
‫ ﻛﻤﺎ ﺗﻠﻐﻲ آﻓﺎق اﺳﻼﻣﻴﺔ‬،‫ﺗﻌﺪﻳﻠﻬﺎ أو إﻟﻐﺎﺋﻬﺎ ﻗﺒﻞ إﺑﺮام اﺗﻔﺎﻗﻴﺔ ﺗﻤﻮﻳﻞ اﻟﺒﻄﺎﻗﺎت وﻓﺘﺢ اﻟﺤﺴﺎب ﻓﻲ أي وﻗﺖ وﺑﺪون إﺷﻌﺎر‬
.‫ﻟﻠﺘﻤﻮﻳﻞ ﺷﻴﻚ اﻟﺘﺄﻣﻴﻦ اﻟﺼﺎدر ﻟﺼﺎﻟﺤﻬﺎ‬
.‫ ﻧﻮاﻓﻖ ﻋﻠﻰ دﻓﻊ اﻟﺮﺳﻮم اﻟﻤﻌﻤﻮل ﺑﻬﺎ ﺑﻐﺾ اﻟﻨﻈﺮ ﻋﻦ أي اﺳﺘﺨﺪام ﻟﻠﺒﻄﺎﻗﺔ ﺑﻌﺪ اﻟﻤﻮاﻓﻘﺔ‬/‫وأواﻓﻖ‬ .٣
‫ ﻧﻘﺮ ﻋﻠﻰ‬/ ‫ ﻛﻤﺎ وأﻗﺮ‬.‫ ﻧﻮاﻓﻖ ﻋﻠﻰ أﻧﻪ ﺳﻴﺘﻢ ﺗﺴﺠﻴﻠﻲ ﺑﺸﻜﻞ ﺗﻠﻘﺎﺋﻲ ﻓﻲ ﺣﺰﻣﺔ اﻟﺘﺄﻣﻴﻦ اﻟﻤﺘﻌﺪدة‬/‫ ﻧﻘﺮ وأواﻓﻖ‬/ ‫أﻗﺮ‬ .٤
‫ ﻛﻞ ﺷﻬﺮ ﻓﻘﻂ ﺑﺸﺮط أن‬Ä‫ ﻧﺪرك أن اﻟﺘﺄﻣﻴﻦ ﻣﻘﺪم ﻣﺠﺎﻧ‬/‫ وأدرك‬.‫ اﻟﺘﺰاﻣﻨﺎ ﺑﺸﺮوط وأﺣﻜﺎم ﺣﺰﻣﺔ اﻟﺘﺄﻣﻴﻦ اﻟﻤﺘﻌﺪدة‬/‫اﻟﺘﺰاﻣﻲ‬
‫ وإﻻ ﺳﻴﺘﻢ ﺗﻄﺒﻴﻖ‬،Ä‫ ﻋﻠﻰ ﺗﻌﺎﻣﻼت ﻋﻤﻠﻴﺎت اﻟﺸﺮاء ﺑﺎﻟﺘﺠﺰﺋﺔ ﻣﻦ ﺧﻼل ﺑﻄﺎﻗﺔ آﻓﺎق اﻻﺋﺘﻤﺎﻧﻴﺔ ﺷﻬﺮﻳ‬Ï‫ ﻣﺤﺪد‬Ä‫ ﻧﻨﻔﻖ ﻣﺒﻠﻐ‬/‫أﻧﻔﻖ‬
‫ وأدرك أﻧﻪ‬.‫ ﻧﺨﻮل آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ ﻟﺨﺼﻤﻬﺎ ﻣﻦ ﺣﺴﺎب ﺑﻄﺎﻗﺘﻲ اﻻﺋﺘﻤﺎﻧﻴﺔ‬/‫رﺳﻮم ﻣﺤﺪدة ﻛﻞ ﺷﻬﺮ واﻟﺘﻲ أﺧﻮل‬
.‫ﺑﺈﻣﻜﺎﻧﻲ اﻻﻧﺴﺤﺎب ﻣﻦ اﻟﺘﺄﻣﻴﻦ ﻋﻦ ﻃﺮﻳﻖ إﺧﻄﺎر آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬
‫أؤﻛﺪ أﻧﻨﻲ اﻃﻠﻌﺖ ﻋﻠﻰ اﻟﺮﺳﻮم اﻟﻤﻨﺎﺳﺒﺔ واﻟﻤﻄﺒﻘﺔ و واﻓﻘﺖ ﻋﻠﻴﻬﺎ ﺑﺤﺴﺐ ﺟﺪول اﻟﺮﺳﻮم اﻟﻤﺘﻮﻓﺮ ﻋﻠﻰ ﻣﻮﻗﻊ آﻓﺎق‬ .٥
: .‫اﻟﻜﺘﺮوﻧﻲ‬
‫ اﻟﺒﻄﺎﻗﺔ اﻟﻤﻮاﻓﻖ‬/‫ اﻟﺸﺮوط وا§ﺣﻜﺎم اﻟﻌﺎﻣﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﺧﺘﻴﺎري‬Ä‫ ﻧﺤﻦ ﺑﺄﻧﻨﻲ ﻗﺪ ﻗﺮأت ﺑﻌﻨﺎﻳﺔ ﺷﺪﻳﺪة وﻓﻬﻤﺖ ﺗﻤﺎﻣ‬/‫أﻗﺮ أﻧﺎ‬ .٦
‫)ﺳﻮاء ﺗﻠﻚ اﻟﺘﻲ‬
ً ‫ﻋﻠﻴﻬﺎ وﺗﺴﻬﻴﻼﺗﻬﺎ وﻣﺰاﻳﺎﻫﺎ وﺧﺼﺎﺋﺼﻬﺎ وﻛﺎﻓﺔ اﻟﺨﺪﻣﺎت أو ﻣﻨﺘﺞ ا§ﺧﺮى اﻟﺘﻲ أﻃﻠﺐ اﻟﺤﺼﻮل ﻋﻠﻴﻬﺎ‬
‫ﺣﺼﻠﺖ ﻋﻠﻰ ﻧﺴﺨﺔ ورﻗﻴﺔ ﻣﻨﻬﺎ ﻣﻦ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ أو ﻗﻤﺖ ﺑﺘﻨﺰﻳﻞ ﻧﺴﺨﺔ اﻟﻜﺘﺮوﻧﻴﺔ ﻣﻨﻬﺎ ﻣﻦ اﻻﻧﺘﺮﻧﺖ أو اﻟﻮاردة‬
.(‫ﻋﻠﻰ ﻣﻮﻗﻊ آﻓﺎق اﻻﻟﻜﺘﺮوﻧﻲ‬
‫ ﻧﺎ ﻗﺪ ﻧﻜﻮن ﻣﺴﺆوﻟﻴﻦ‬/ ‫ ﻧﺎ ﻋﻠﻰ ﻋﻠﻢ ﺑﺄﻧﻨﻲ‬/‫ ﻓﺈﻧﻲ‬،‫ﻓﻲ ﺣﺎل ﺗﺒﻴﻦ أن أي ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻮاردة أﻋﻼه ﻏﻴﺮ ﺻﺤﻴﺤﺔ أو ﻣﻀﻠﻠﺔ‬ .٧
‫ﻋﻦ ذﻟﻚ‬
‫أدرك وأﺗﻔﻬﻢ أن ﺻﺮف اﻟﺘﻤﻮﻳﻞ ﻳﻌﺘﻤﺪ ﻋﻠﻰ ﺣﺼﻮل اﻟﻌﻤﻴﻞ ﻋﻠﻰ ﻧﺘﻴﺠﺔ ُﻣﺮﺿﻴﺔ ﻟﻠﻔﺤﻮﺻﺎت اﻟﺘﻨﻈﻴﻤﻴﺔ وإﺗﻤﺎم ﺟﻤﻴﻊ‬ .٨
‫اﻟﻤﺴﺘﻨﺪات اﻟﻤﻄﻠﻮﺑﺔ‬
‫ أو إﻟﻐﺎﺋﻬﺎ ﻓﻲ أي وﻗﺖ دون اﻟﺘﺰام ﻣﻨﻬﺎ‬/‫ و‬،‫ ﻧﻘﺮ أن ﻟﺸﺮﻛﺔ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ اﻟﺤﻖ ﻓﻲ رﻓﺾ أو ﻗﺒﻮل اﻻﺳﺘﻤﺎرة‬/‫وأﻗﺮ‬ .٩
.‫ﺑﺘﻘﺪﻳﻢ أي ﺗﺒﺮﻳﺮ ﻟﺬﻟﻚ‬
(‫)ﻳﺸﺎر إﻟﻴﻪ ﻓﻴﻤﺎ ﺑﻌﺪ ﺑﺼﺎﺣﺐ اﻟﺤﺴﺎب أو اﻟﻌﻤﻴﻞ أو ﺣﺎﻣﻞ اﻟﺒﻄﺎﻗﺔ‬ . ١٠
‫أو اﻟﻤﻠﺘﺰم اﻟﺬي ﻳﺤﺼﻞ أو ﻳﺮﻏﺐ ﻓﻲ‬/ ‫ )واﻟﺬي ﻗﺪ ﻳﻜﻮن اﻟﻌﻤﻴﻞ و‬،‫ﺑﻤﻮﺟﺐ ﻫﺬا اﻟﺘﻌﻬﺪ ﻳﺨﻮل وﻳﻔﻮض ﺻﺎﺣﺐ اﻟﺤﺴﺎب أﻋﻼه‬
.
‫خ" )اﻟﺸﺮﻛﺔ( دون اﻟﺤﺎﺟﻪ ﻟﻠﺤﺼﻮل ﻋﻠﻰ‬.‫م‬.‫"ش‬ ‫ ﺷﺮﻛﺔ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬،(‫اﻟﺤﺼﻮل ﻋﻠﻰ ﺗﻤﻮﻳﻞ ﺣﺴﺐ ﻣﻘﺘﻀﻰ اﻟﺤﺎل‬
،‫ واﻓﺼﺎح ﻋﻦ‬،‫ وﺗﺤﻮﻳﻞ‬،‫ واﻟﺘﺤﻘﻖ ﻣﻦ‬،‫ وﻃﻠﺐ‬،‫أي ﺗﺼﺎرﻳﺢ أو ﻣﻮاﻓﻘﺔ ﻣﻜﺘﻮﺑﺔ أو ﺷﻔﻮﻳﺔ إﺿﺎﻓﻴﺔ ﻣﻦ أﺟﻞ اﻟﺤﺼﻮل ﻋﻠﻰ‬
‫وﺗﺒﺎدل أي ﻣﻌﻠﻮﻣﺎت ﺑﺸﻜﻞ ﻋﺎم )ﻛﻤﺎ ﻳﺘﻢ ﺗﺤﺪﻳﺪﻫﺎ ﻓﻲ ﻫﺬا اﻟﺘﻌﻬﺪ( وﻓﻘﺎ ﻟﻤﺎ ﺗﺮاه آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ ﻣﻨﺎﺳﺒﺎ ﺣﺴﺐ‬
‫ﺗﻘﺪﻳﺮﻫﺎ اﻟﻤﻄﻠﻖ ﻣﻊ‬
‫ ﺳﻮاء ﻳﺘﻮاﺟﺪ داﺧﻞ دوﻟﺔ اﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة أو‬،‫)أ( أي ﻣﻜﺘﺐ اﺳﺘﻌﻼم اﺋﺘﻤﺎﻧﻲ أو أي ﺷﺨﺺ أو ﻛﻴﺎن آﺧﺮ‬
‫واﻟﺬي ﻳﺤﺘﻔﻆ أو ﻣﻦ اﻟﻤﻔﺘﺮض أن ﻳﺤﺘﻔﻆ ﺑﺄي ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻮاردة ﻓﻲ ﻫﺬا اﻟﺘﻌﻬﺪ واﻟﺘﻲ ﻟﻬﺎ ﺻﻠﺔ ﺑﺼﺎﺣﺐ‬،‫ﺧﺎرﺟﻬﺎ‬
‫اﻟﻤﺨﻮﻟﻴﻦ ﺑﺎﻟﺘﻮﻗﻴﻊ ﻋﻨﻪ‬/‫أو اﻟﻤﺨﻮل‬/‫أو ﺣﺎﻣﻞ اﻟﺒﻄﺎﻗﺔ و‬/‫أو اﻟﻌﻤﻴﻞ و‬/‫اﻟﺤﺴﺎب و‬
‫ ﻧﺨﻮل آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ دون اﻟﺤﺎﺟﺔ ﻟﻠﺤﺼﻮل ﻋﻠﻰ أي ﺗﺼﺎرﻳﺢ ﺷﻔﻮﻳﺔ ﻟﻠﺤﺼﻮل ﻋﻠﻰ أي ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت‬/‫)ب( وأﺧﻮل‬
‫اﻟﻤﺸﺎر إﻟﻴﻬﺎ ﻓﻲ ﻫﺬا اﻗﺮار أو اﻟﻜﺸﻒ ﻋﻨﻬﺎ ﻣﻦ أي ﺳﻠﻄﺔ ﻣﻦ اﻟﺴﻠﻄﺎت اﻟﺤﻜﻮﻣﻴﺔ أو ﺷﺒﻪ اﻟﺤﻜﻮﻣﻴﺔ أو ﻫﻴﺌﺔ أو‬
)
‫ ﺳﻮاء داﺧﻞ اﻣﺎرات‬،‫ﻣﻨﻈﻤﺔ أو ﺷﺮﻛﺔ أو ﻣﻜﺘﺐ اﺋﺘﻤﺎن أو أي ﻣﺰود ﺧﺪﻣﺔ ﻣﺜﻞ ﺷﺮﻛﺎت اﻟﻜﻬﺮﺑﺎء واﻟﻤﻴﺎه واﻻﺗﺼﺎﻻت‬
‫ﻓﺎق‬¥ ‫ وﻳﺠﻮز‬،‫ ﺑﻨﺎ‬/‫ ﺑﺤﻴﺚ ﺗﺤﻔﻆ أو ﻣﻦ اﻟﻤﻔﺘﺮض أن ﺗﺤﻔﻆ ﺗﻠﻚ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺘﻌﻠﻘﺔ ﺑﻲ‬،‫اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة أو ﺧﺎرﺟﻬﺎ‬
‫اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ اﻟﺘﻮاﺻﻞ ﻣﻊ ﻫﺬه اﻟﻬﻴﺌﺎت ﻟﻠﺤﺼﻮل ﻋﻠﻰ أي ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺸﺎر إﻟﻴﻬﺎ ﻓﻲ ﻫﺬا اﻗﺮار أو اﻟﻜﺸﻒ‬
.‫ﻋﻨﻬﺎ دون اﺧﻼل ﺑﻤﺎ ﺗﻘﺪم‬
‫ﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ ﺑﻤﺎ ﻓﻲ ذﻟﻚ أي‬¥ ‫)ت( )أي ﻓﺮوع أو ﺷﺮﻛﺎت ﺗﺎﺑﻌﺔ أو ﺷﺮﻛﺎت ﻓﺮﻋﻴﺔ أو ﻣﻜﺎﺗﺐ ﻣﻤﺜﻠﺔ ﻋﻨﺎ أو وﻛﻼء‬
‫ ﺣﻴﺜﻤﺎ ﻳﻜﻮن ﻣﻮﻗﻌﻬﺎ‬،‫أﻃﺮاف ﺛﺎﻟﺜﺔ ﻣﺨﺘﺎره‬
: ‫ ﺑﻤﺎ ﻓﻲ ذﻟﻚ‬،‫ﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ اﺳﺘﺨﺪام أي أو ﻛﺎﻓﺔ اﻟﻤﻌﻠﻮﻣﺎت §ي ﻏﺮض ﻳﺴﺘﺪﻋﻲ ﺗﻘﺪﻳﻢ ﻣﺜﻞ ﻫﺬه اﻟﻤﻌﻠﻮﻣﺎت‬¥ ‫ﻳﺤﻖ‬ . ١١
‫)أ( ﺗﻘﺪﻳﻢ أو اﻟﺸﺮوع ﻓﻲ ﺗﻘﺪﻳﻢ أي ﺗﻤﻮﻳﻞ أو ﺗﺴﻬﻴﻼت أو أي ﺧﺪﻣﺎت أﺧﺮى ﻣﺘﺎﺣﺔ ﻣﻦ ﻗﺒﻞ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬
‫ ﺣﺎﻣﻞ اﻟﺒﻄﺎﻗﺔ‬/ ‫ اﻟﻌﻤﻴﻞ‬/ ‫)ب( ﺗﻘﻴﻴﻢ اﻟﻮﺿﻊ اﻻﺋﺘﻤﺎﻧﻲ ﻟﺼﺎﺣﺐ اﻟﺤﺴﺎب‬
‫ﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬¥ ‫)ت( ﺗﺤﺼﻴﻞ أي ﻣﺒﺎﻟﻎ ﻣﺴﺘﺤﻘﺔ ﻋﻦ أي ﺗﻤﻮﻳﻞ أو أي ﻣﺴﺘﺤﻘﺎت ﻣﺎﻟﻴﺔ أﺧﺮى‬
/ ‫ اﻟﻌﻤﻴﻞ‬/‫)ث( اﻻﺳﺘﺨﺪام اﻟﺪاﺧﻠﻲ )ﺑﻤﺎ ﻓﻲ ذﻟﻚ اﻻﺳﺘﺨﺪام اﻟﻤﺘﻌﻠﻖ ﺑﺘﻘﺪﻳﻢ أي ﻣﻨﺘﺠﺎت أو ﺧﺪﻣﺎت إﻟﻰ ﺻﺎﺣﺐ اﻟﺤﺴﺎب‬
‫ﺣﺎﻣﻞ اﻟﺒﻄﺎﻗﺔ‬
‫)ج( ﻣﻌﺎﻟﺠﺔ اﻟﺒﻴﺎﻧﺎت‬
‫)ح( §ﻏﺮاض إﺣﺼﺎﺋﻴﺔ وﺗﺤﻠﻴﻞ اﻟﻤﺨﺎﻃﺮ‬
‫ و‬،‫)خ( ﺧﺪﻣﺎت اﻟﻨﻘﺪ اﻟﻌﺎﻟﻤﻴﺔ‬
‫وراق اﻟﻤﺎﻟﻴﺔ وأي ﻫﻴﺌﺎت ووﻛﺎﻻت ذات ﻋﻼﻗﺔ ﺑﺬﻟﻚ‬Ü‫ أﺳﻮاق ﻣﺎﻟﻴﺔ ﻟ‬/ ‫)د( اﻟﺘﻌﺎﻣﻞ ﻓﻲ ا§وراق اﻟﻤﺎﻟﻴﺔ ﻓﻲ أي ﺳﻮق‬
‫)ذ( ﺗﺴﻮﻳﻖ وﺗﺮوﻳﺞ ﻣﻨﺘﺠﺎت وﺧﺪﻣﺎت آﻓﺎق‬
‫ إن ﺗﻌﺒﻴﺮ "اﻟﻤﻌﻠﻮﻣﺎت" ﻳﻌﻨﻲ أي ﻣﻌﻠﻮﻣﺎت ﺷﺨﺼﻴﺔ أو ﻣﺎﻟﻴﺔ أو ﻗﺎﻧﻮﻧﻴﺔ أو اﺋﺘﻤﺎﻧﻴﺔ ﺗﺘﻌﻠﻖ ﺑﺼﺎﺣﺐ‬،‫§ﻏﺮاض ﻫﺬا اﻟﺘﻌﻬﺪ‬ . ١٢
‫ ﺑﻤﺎ ﻓﻲ ذﻟﻚ أي ﻣﻌﻠﻮﻣﺎت‬،‫ﺣﺎﻣﻞ اﻟﺒﻄﺎﻗﺔ ﺳﻮاء ﻛﺎن ﺻﺎﺣﺐ اﻟﺤﺴﺎب ﺷﺨﺼﺎ أو ﻛﻴﺎن ﻗﺎﻧﻮﻧﻲ أو إﻋﺘﺒﺎري‬/‫اﻟﻌﻤﻴﻞ‬/‫اﻟﺤﺴﺎب‬
.‫ ﻣﺜﻞ أي ﻣﻜﺘﺐ اﺋﺘﻤﺎن ﻣﺤﻠﻲ أو دوﻟﻲ‬،‫ﺗﻢ اﻟﺤﺼﻮل ﻋﻠﻴﻬﺎ ﺑﺸﻜﻞ ﻗﺎﻧﻮﻧﻲ ﻣﻦ أي أﻃﺮاف ﺛﺎﻟﺜﺔ‬
‫ ﺣﺎﻣﻞ اﻟﺒﻄﺎﻗﺔ وﻻ ﻳﺤﻖ ﻟﻪ إﻟﻐﺎؤه أو ﺗﻌﺪﻳﻠﻪ دون‬/‫ اﻟﻌﻤﻴﻞ‬/‫ﻳﺒﻘﻲ ﻫﺬا اﻟﺘﻌﻬﺪ ﺳﺎرﻳﺎ وﻧﺎﻓﺬا ﻓﻲ ﻣﻮاﺟﻬﺔ ﺻﺎﺣﺐ اﻟﺤﺴﺎب‬ . ١٣
.‫اﻟﺤﺼﻮل ﻋﻠﻰ ﻣﻮاﻓﻘﻪ ﺧﻄﻴﺔ ﻣﺴﺒﻘﺔ ﻣﻦ ﺷﺮﻛﺔ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬
‫ أو ﺑﺪء ﻣﻨﺤﻲ أي ﺗﺴﻬﻴﻼت أو أي ﺧﺪﻣﺔ‬/‫ﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ اﺳﺘﺨﺪام ﺑﻌﺾ أو ﻛﺎﻓﺔ اﻟﻤﻌﻠﻮﻣﺎت ﻟﻐﺮض ﻣﻨﺤﻲ‬¥ ‫وﻳﺠﻮز‬ . ١٤
‫ﻣﻦ ﺧﺪﻣﺎت آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ ا§ﺧﺮى اﻟﺘﻲ ﺗﻘﺪﻣﻬﺎ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ أو اﺳﺘﺨﺪام ﻫﺬه اﻟﻤﻌﻠﻮﻣﺎت ﻟﻐﺮض‬
‫ﻓﺎق اﺳﻼﻣﻴﺔ‬¥ ‫ وﻳﺠﻮز‬.‫ﺗﻘﻴﻴﻢ وﺿﻌﻲ اﻻﺋﺘﻤﺎﻧﻲ وﺗﺤﺼﻴﻞ أي ﻣﺒﺎﻟﻎ أو ﺗﺴﻬﻴﻼت واﺟﺒﺔ اﻟﺪﻓﻊ إﻟﻰ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬
‫ﻟﻠﺘﻤﻮﻳﻞ أو أي ﻓﺮع ﻣﻦ ﻓﺮوﻋﻬﺎ أو اﻟﺸﺮﻛﺔ ا§م أو اﻟﺸﺮﻛﺎت اﻟﺘﺎﺑﻌﺔ أو اﻟﺸﺮﻛﺎت اﻟﺸﻘﻴﻘﺔ أو ﻣﻜﺎﺗﺐ اﻟﺘﻤﺜﻴﻞ أو اﻟﻮﻛﻼء أو أي‬
‫أﻃﺮاف أﺧﺮى ﻣﺨﺘﺎرة ﻣﻦ ﻗﺒﻞ أي ﻣﻨﻬﻢ أو آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ اﻟﺤﺼﻮل ﻋﻠﻰ أي ﻣﻌﻠﻮﻣﺎت ﻣﺎﻟﻴﺔ أو ﻗﺎﻧﻮﻧﻴﺔ أو اﺋﺘﻤﺎﻧﻴﺔ‬
‫ن أو ﻓﻲ اﻟﻤﺴﺘﻘﺒﻞ أو ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ ﺑﺄي ﻋﻼﻗﺔ ﻗﺎﺋﻤﺔ ﻣﻊ اﻟﺒﻨﻚ أو ﺑﻌﺪ‬¥‫ ﺑﻨﺎ ﺳﻮاء ا‬/‫أو أي ﻣﻌﻠﻮﻣﺎت أﺧﺮى ﻣﺘﻌﻠﻘﺔ ﺑﻲ‬
‫ أو إذا ﺗﻢ اﻟﺤﺼﻮل ﻋﻠﻰ ﺗﻠﻚ‬/‫ أو ﺣﺘﻰ إذا ﺗﻢ رﻓﺾ ﻃﻠﺒﻲ §ي ﺧﺪﻣﺔ أو ﺗﻤﻮﻳﻞ ﻣﻦ ﺟﺎﻧﺐ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ و‬،‫اﻧﺘﻬﺎﺋﻬﺎ‬
CRD-FRM-001-001
.‫اﻟﻤﻌﻠﻮﻣﺎت ﻣﻦ ﺟﺎﻧﺐ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ ﻓﻲ اﻟﻤﺎﺿﻲ أو اﻟﺤﺎل أو اﻟﻤﺴﺘﻘﺒﻞ‬
‫ واﻟﺬي ﻣﻦ اﻟﻤﻤﻜﻦ ﺗﻌﺪﻳﻠﻪ‬،‫ ﺑﺸﺄن اﻟﻤﻌﻠﻮﻣﺎت اﻻﺋﺘﻤﺎﻧﻴﺔ‬٢٠١٠ ‫ ﻟﺴﻨﻪ‬٦ ‫ §ﺣﻜﺎم اﻟﻘﺎﻧﻮن رﻗﻢ‬Ä‫ ﻳﺨﻀﻊ ﻫﺬا اﻟﺘﻌﻬﺪ وﻳﻔﺴﺮ وﻓﻘ‬. ١٥
‫ وﻳﺤﺎل أي ﻧﺰاع ﻳﻨﺸﺄ ﺑﻴﻦ ﺷﺮﻛﺔ آﻓﺎق اﺳﻼﻣﻴﺔ‬،‫ و§ي ﻗﻮاﻧﻴﻦ أﺧﺮى ﻣﻄﺒﻘﺔ ﻓﻲ دوﻟﺔ اﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة‬،‫ﺧﺮ‬¥ ‫ﻣﻦ وﻗﺖ‬
‫ﺣﺎﻣﻞ اﻟﺒﻄﺎﻗﺔ ﺑﺨﺼﻮص ﻫﺬا اﻟﺘﻌﻬﺪ ﻟﻼﺧﺘﺼﺎص اﻟﻘﻀﺎﺋﻲ اﻟﺤﺼﺮي ﻟﻤﺤﺎﻛﻢ دوﻟﺔ‬/‫اﻟﻌﻤﻴﻞ‬/‫ﻟﻠﺘﻤﻮﻳﻞ وﺻﺎﺣﺐ اﻟﺤﺴﺎب‬
.‫اﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة‬
Date ‫اﻟﺘﺎرﻳﺦ‬
‫اﻟﺒﻄﺎﻗﺔ اﻟﻤﻐﻄﺎة – اﻟﺘﻌﻬﺪ ﺑﺎﻟﺸﺮاء‬
PROMISE TO PURCHASE – COVERED CARD
Annexure II

I/We ,with address at PO Box , , , :‫ب‬.‫ ﻋﻨﻮاﻧﻨﺎ ص‬/‫وﻋﻨﻮاﻧﻲ‬ ‫ ﻧﺤﻦ‬/‫أﻧﺎ‬

,UAE hereby irrevocably and unconditionally promise to purchase ‫م ﻧﺘﻌﻬﺪ ﺑﺸﻜﻞ ﻏﻴﺮ ﻣﺸﺮوط وﻻ رﺟﻌﺔ ﻓﻴﻪ ﺑﺸﺮاء اﻟﺴﻠﻊ ﻣﻦ وﻗﺖ ﺧﺮ)ﻋﻠﻰ اﻟﻨﺤﻮ‬.‫ع‬.‫إ‬
the Commodities from time to time (as defined below) from aafaq Islamic Finance
Company P.O.Box 282400 Dubai, UAE (“aafaq") in accordance with the details
‫م )اﻟﻤﺴﺘﻔﻴﺪ( وﻓﻖ‬.‫ع‬.‫ إ‬،‫دﺑﻲ‬ ‫ب‬.‫اﻟﻤﺒﻴﻦ أدﻧﺎه( ﻣﻦ آﻓﺎق اﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ ص‬
mentioned below: :‫اﻟﺘﻔﺎﺻﻴﻞ اﻟﻤﺒﻴﻨﺔ أدﻧﺎه‬

Commodities: means the Sharia compliant Commodities available on the DMCC ‫ ﺗﻌﻨﻲ اﻟﺴﻠﻊ اﻟﻤﺘﻮاﻓﻘﺔ ﻣﻊ أﺣﻜﺎم اﻟﺸﺮﻳﻌﺔ ا–ﺳﻼﻣﻴﺔ اﻟﻤﺘﺎﺣﺔ ﻋﻠﻰ ﻣﻨﺼﺔ اﻟﺘﺪﻓﻖ‬:‫اﻟﺴﻠﻊ‬
Trade flow (Islamic) Platform, which shall be the subject matter of the Murabaha ‫اﻟﺘﺠﺎري ﻓﻲ ﻣﺮﻛﺰ دﺑﻲ ﻟﻠﺴﻠﻊ اﻟﻤﺘﻌﺪدة )ا–ﺳﻼﻣﻴﺔ( اﻟﺘﻲ ﺗﻤﺜﻞ ﻣﻮﺿﻮع ﻣﻌﺎﻣﻠﺔ اﻟﻤﺮاﺑﺤﺔ‬
transaction which shall have the value of the Cost Price (mentioned below). (‫واﻟﺘﻲ ﻳﺠﺐ أن ﺗﻜﻮن ﻟﻬﺎ ﻗﻴﻤﺔ ﺳﻌﺮ اﻟﺘﻜﻠﻔﺔ )اﻟﻤﺬﻛﻮر أدﻧﺎه‬

Cost Price (Card Limit): AED ‫درﻫﻢ‬ :(‫ﺳﻌﺮ اﻟﺘﻜﻠﻔﺔ )ﺣﺪ اﻟﺒﻄﺎﻗﺔ‬

Profit Rate: % per month ‫ ﺷﻬﺮﻳﺎ‬٪ :‫ﻣﻌﺪل اﻟﺮﺑﺢ‬

‫اﻻﺳﺘﺤﻘﺎق‬
ً ‫ آﺧﺮ ﻳﻮم ﻣﻦ ﺷﻬﺮ‬+ ‫ﺳﻨﻮات‬ :‫اﻟﻤﺪة‬
Tenor: Years + last day of the month of maturity
.‫ ﺗﺴﺪد ﻧﺴﺒﺔ اﻟﺮﺑﺢ ﻣﻦ ﺳﻌﺮ اﻟﺒﻴﻊ ﺷﻬﺮﻳ® وﺳﻌﺮ اﻟﺘﻜﻠﻔﺔ ﻋﻨﺪ اﻻﺳﺘﺤﻘﺎق‬:‫اﻟﺪﻓﻊ‬
Payment: Profit portion of the sale price to be paid monthly and Cost Price at maturity.

I/We acknowledge that aafaq, relying on this Promise, intends to acquire the
Commodities and then sell them to me/us, duly represented by my agent
BACK OFFICE FZ LLC (the “Agent”) acting for and on my/our behalf on the DMCC
Tradeflow platform (the “DMCC Platform”) under a Murabaha transaction.
I/We agree that from time to time for any exercise of this Promise by aafaq, aafaq
ﺧﺮ ﻋﻠﻰ أي ﻣﻤﺎرﺳﺔ ﻟﻬﺬا اﻟﺘﻌﻬﺪ ﻣﻦ ﻗﺒﻞ اﻟﻤﺴﺘﻔﻴﺪ‬/‫ ﻧﺤﻦ أواﻓﻖ‬/‫أﻧﺎ‬
shall notify us in case there is a change in the above.
I/We undertake that I/We shall be responsible for all the actual costs and expenses
associated with the Murabaha transaction.
I/We undertake that we indemnify aafaq for all actual losses suffered by aafaq
arising out my/our default under this Promise.
I/We agree that this Promise is governed by the laws of the Emirate of Dubai and
the applicable federal laws of the United Arab Emirates to the extent that these laws
are not inconsistent with the principles of Sharia (as set out in the Sharia Standards
published by the Accounting and Auditing Organization of Islamic Financial
Institutions and as interpreted by the Fatwa & Sharia Supervisory Board of aafaq),
in which case principles of Sharia shall prevail and I/We agree that courts of the
Emirate of Dubai shall have exclusive jurisdiction on any dispute arising out of or in
connection with this Promise.
‫ ﺗﻌﺘﺰم اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺴﻠﻊ ﺛﻢ‬،‫ ﺑﺎﻻﻋﺘﻤﺎد ﻋﻠﻰ ﻫﺬه اﻟﺘﻌﻬﺪ‬،‫ ﻧﺤﻦ ﻧﻘﺮ ﺑﺄن اﻟﻤﺴﺘﻔﻴﺪ‬/ ‫أﻧﺎ‬
BACK OFFICE FZ LLC ‫ ﻣﻤﺜﻠﺔ ﻋﻠﻰ اﻟﻨﺤﻮ اﻟﻮاﺟﺐ ﻣﻦ ﻗﺒﻞ وﻛﻴﻞ أﻋﻤﺎﻟﻲ‬،‫ ﻟﻨﺎ‬/ ‫ﺑﻴﻌﻬﺎ ﻟﻲ‬
‫)اﻟﻮﻛﻴﻞ( واﻟﺬي ﻳﺘﺼﺮف ل وﻧﻴﺎﺑﺔ ﻋﻨﻲ ﻟﺪى ﻣﺮﻛﺰ دﺑﻲ ﻟﻠﺴﻠﻊ اﻟﻤﺘﻌﺪدة ﺑﻤﻮﺟﺐ اﺗﻔﺎﻗﻴﺔ‬
.‫اﻟﻤﺮاﺑﺤﺔ‬
،‫ ﻧﻮاﻓﻖ ﻣﻦ وﻗﺖ
.‫وﻳﺒﻠﻐﻨﺎ اﻟﻤﺴﺘﻔﻴﺪ ﻓﻲ ﺣﺎﻟﺔ وﺟﻮد أي ﺗﻐﻴﻴﺮ ﻓﻴﻤﺎ ذﻛﺮ أﻋﻼه‬
‫ ﻧﺘﺤﻤﻞ ﻣﺴﺆوﻟﻴﺔ ﻛﺎﻓﺔ اﻟﺘﻜﺎﻟﻴﻒ واﻟﻤﺼﺎرﻳﻒ‬/‫ أﻧﻨﺎ أﺗﺤﻤﻞ‬/‫ ﻧﺘﻌﻬﺪ ﺑﺄﻧﻨﻲ‬/‫ ﻧﺤﻦ أﺗﻌﻬﺪ‬/‫أﻧﺎ‬
.‫اﻟﻔﻌﻠﻴﺔ اﻟﻤﺘﻌﻠﻘﺔ ﺑﻤﻌﺎﻣﻠﺔ اﻟﻤﺮاﺑﺤﺔ‬
‫ ﻧﻌﻮض اﻟﻤﺴﺘﻔﻴﺪ ﻋﻦ ﻛﺎﻓﺔ اﻟﺨﺴﺎﺋﺮ اﻟﻔﻌﻠﻴﺔ‬/‫ أﻧﻨﺎ أﻋﻮض‬/‫ ﻧﺘﻌﻬﺪ ﺑﺄﻧﻨﻲ‬/‫ ﻧﺤﻦ أﺗﻌﻬﺪ‬/‫أﻧﺎ‬
.‫ ﺗﻘﺼﻴﺮﻧﺎ ﺑﻤﻮﺟﺐ ﻫﺬا اﻟﺘﻌﻬﺪ‬/‫اﻟﺘﻲ ﻳﺘﻜﺒﺪﻫﺎ اﻟﻤﺴﺘﻔﻴﺪ ﻧﺘﻴﺠﺔ ﺗﻘﺼﻴﺮي‬
‫ ﻧﻮاﻓﻖ ﻋﻠﻰ أن ﻫﺬا اﻟﺘﻌﻬﺪ ﻳﺨﻀﻊ ﻟﻘﻮاﻧﻴﻦ إﻣﺎرة دﺑﻲ واﻟﻘﻮاﻧﻴﻦ اﻻﺗﺤﺎدﻳﺔ‬/‫ ﻧﺤﻦ أواﻓﻖ‬/‫أﻧﺎ‬
‫ﻟﺪوﻟﺔ ا–ﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة ﺑﺎﻟﻘﺪر اﻟﺬي ﻻ ﺗﺘﻌﺎرض ﻓﻴﻪ ﻫﺬه اﻟﻘﻮاﻧﻴﻦ ﻣﻊ ﻣﺒﺎدئ‬
‫اﻟﺸﺮﻳﻌﺔ )ﻛﻤﺎ ﻫﻮ ﻣﻨﺼﻮص ﻋﻠﻴﻪ ﻓﻲ اﻟﻤﻌﺎﻳﻴﺮ اﻟﺸﺮﻋﻴﺔ اﻟﺼﺎدرة ﻋﻦ ﻫﻴﺌﺔ اﻟﻤﺤﺎﺳﺒﺔ‬
‫واﻟﻤﺮاﺟﻌﺔ ﻟﻠﻤﺆﺳﺴﺎت اﻟﻤﺎﻟﻴﺔ ا–ﺳﻼﻣﻴﺔ وﻛﻤﺎ ﺗﻔﺴﺮه ﻫﻴﺌﺔ اﻟﻔﺘﻮى واﻟﺮﻗﺎﺑﺔ اﻟﺸﺮﻋﻴﺔ‬
‫ ﻧﻮاﻓﻖ ﻋﻠﻰ أﻧﻪ‬/‫ ﻧﺤﻦ أواﻓﻖ‬/‫ وأﻧﺎ‬،‫ﻟﻠﻤﺴﺘﻔﻴﺪ( وﻓﻲ ﻫﺬه اﻟﺤﺎﻟﺔ ﺗﺴﻮد ﻣﺒﺎدئ اﻟﺸﺮﻳﻌﺔ‬
‫ﻳﻜﻮن ﻟﻤﺤﺎﻛﻢ دﺑﻲ اﺧﺘﺼﺎص ﻗﻀﺎﺋﻲ ﺣﺼﺮي ¿ي ﻧﺰاع ﻳﻨﺸﺄ ﻋﻦ ﻫﺬا اﻟﺘﻌﻬﺪ أو ﻓﻴﻤﺎ ﻳﺘﻌﻠﻖ‬
.‫ﺑﻪ‬

Customer Name: :‫اﺳﻢ اﻟﻌﻤﻴﻞ‬

Signature: Date: :‫اﻟﺘﺎرﻳﺦ‬ :‫اﻟﺘﻮﻗﻴﻊ‬

For Official Use ‫ﻟﻼﺳﺘﺨﺪام اﻟﺮﺳﻤﻲ‬

Sale Date: :‫ﺗﺎرﻳﺦ اﻟﺒﻴﻊ‬

Reference: :‫ﻣﺮﺟﻊ اﻟﻤﺮاﺑﺤﺔ‬

Authorised Signatories ‫اﻟﻤﺨﻮﻟﻴﻦ ﺑﺎﻟﺘﻮﻗﻴﻊ‬

Name: :‫اﻻﺳﻢ‬
Signature: :‫اﻟﺘﻮﻗﻴﻊ‬

Name: :‫اﻻﺳﻢ‬
CRD-FRM-001-003

Signature: :‫اﻟﺘﻮﻗﻴﻊ‬

Page 1 of 1
 FATCA Form – Individual/ Joint/Sole Proprietor Account
The Foreign Account Tax Compliance Act (FATCA) was enacted into U.S. law on March 18, 2010. It is aimed at preventing U.S. taxpayers from using accounts held outside of the U.S.
to evade taxes. Any financial institution that fails to comply with FATCA will face a 30% withholding tax on a wide range of U.S. sourced payments to its clients. Under U.S. federal
tax law, the Central Bank of UAE is required to request certain taxpayer information from certain persons who maintain an account/Borrowing relationship(s) with aafaq Islamic
Finance (whether such persons are U.S. taxpayers or not). Information collected will be used solely to fulfil the requirements under U.S. federal tax law and will not be used for any
other purpose.

SECTION A

Instructions for Section A:

1. This section must be completed by any individual who wish to take a finance with aafaq.
2. Please complete this form separately for each Co-borrower / applicant.

A. Name of Customer (IN BLOCK LETTERS):__________________________________________________________________ ‫ ﻣﻘﺪم اﻟﻄﻠﺐ‬/ ‫اﺳﻢ اﻟﻌﻤ ﻞ‬

B. Country of tax residence :  USA ( ‫ ) أﻣ ﺎ‬ Other ( ‫_________________ ) اﺧﺮى‬ :‫اﺋﺐ ﻋ اﻷﻗﺎﻣﺔ‬ ‫ﺴﺘﻮﺟﺐ‬ ‫اﻟﺪول اﻟﻠ‬

C. Place of Birth: City ( ‫ _______________________)اﻟﻤﺪﻳﻨﺔ‬State (‫ _______________________) اﻟﻮﻻ ﺔ‬Country (‫______________________)اﻟ ﻠﺪ‬ :‫ﻣ ﺎن اﻟﻤ ﻼد‬

Please tick ‘√’ to appropriate check box Documentation Required

1. Are you a US Citizen? ‫؟‬ ‫ﻞ اﻧﺖ ﻣﻮاﻃﻦ أﻣ‬  Yes (‫)ﻧﻌﻢ‬  No (‫) ﻻ‬ If yes, please provide Form W-9.
2. Are you a US Resident? ‫ﻞ ﺗﻘ ﻢ أﻣ ﺎ؟‬
 Yes (‫)ﻧﻌﻢ‬  No (‫) ﻻ‬
2
3. Do you hold a US Permanent Resident Card (Green Card)?
 Yes (‫)ﻧﻌﻢ‬  No (‫) ﻻ‬
. ‫ﻞ ﺗﺤﻤﻞ ﺟ ﺴ ﺔ أﻣ ﻜ ﺔ او اﻗﺎﻣﺔ داﺋﻤﺔ )اﻟ ﻄﺎﻗﺔ اﻟﺨ اء( ؟‬
If yes,
• Please provide Form W-9, or
4. Were you born in USA? ‫أﻣ ﺎ ؟‬ ‫ﻞ وﻟﺪت‬  Yes (‫)ﻧﻌﻢ‬  No (‫) ﻻ‬ • In case you claim to be a Non-US Person; please fill Section B of this
form and provide Non-US Passport and Certificate of Loss of
Nationality (i.e. Form I-407).
6. Do you have any Power of Attorney/ Authorized Signatory/ If yes,
Mandate holder having US Address? • Please provide Form W-9, or
‫ﺗﻮﻛ ﻞ اوﺳﻠﻄﺔ او ﺻﺎﺣﺐ ﻋﻼﻗﺔ ﻟﺪ ﻪ ﺣﺴﺎب أﻣ ﺎ؟‬/ ‫ﻞ ﻟﺪ ﻚ ﺗﻔ ﺾ‬  Yes (‫)ﻧﻌﻢ‬  No (‫) ﻻ‬ • In case you claim to be a Non-US Person; please fill Section B of this
form supported by other documentary evidence establishing the non-
US status.
7. Do you have US residence/ mailing/ Sole care of address? If yes,
 Yes (‫)ﻧﻌﻢ‬  No (‫) ﻻ‬
‫ﻞ ﻟﺪ ﻚ ﻋﻨﻮان او ﺑ ﺪ اﻣ ﺎ؟‬ • Please provide Form W-9, or
8. Do you have US telephone number? • In case you claim to be a Non-US Person; please fill Section B of this
‫ﻞ ﻟﺪ ﻚ رﻗﻢ ﺎﺗﻒ أﻣ ﺎ؟‬  Yes (‫)ﻧﻌﻢ‬  No (‫) ﻻ‬ form and provide non-US Passport and other documentary evidence
establishing the non-US status.

SECTION B
Instructions for Section B:
This section must be filled by any individual who mark(s) any of the item number 4, 5, 6, 7 & 8 as ‘Yes’ but claims to be a Non-US Person along with documentary evidence.

I _________________________________ declare that I have examined the information on this form and to the best of my knowledge and belief it is true, correct and complete. I
further certify that I am not a US Person and will provide Form W-8BEN within 30 calendar days if required by IRS through aafaq Islamic Finance (the "Company". I undertake to
notify the Compnay within 30 calendar days if this certification becomes incorrect.

Declaration:
• I hereby confirm the information provided above is true, accurate and complete.
• Subject to applicable local laws, I hereby give my / our consent to aafaq Islamic Finance, to share my information with domestic or overseas regulators or tax authorities where
necessary to establish my tax liability in any jurisdiction.
• Where required by domestic or overseas regulators or tax authorities, I give my / our consent and agree that aafaq Islamic Finance may withhold from my finance / borrowing or
request for such amounts as may be required according to applicable laws, regulations and directives.
• I undertake to notify the Company within 30 calendar days if there is a change in any information which I have provided to the aafaq.
• I will indemnify and hold harmless from any loss, action, cost, expense (including, but not limited to sums paid in settlement of claims, reasonable attorneys’ and consultant fees,
and expert fees), claim, damages, or liability which arises or is incurred by the aafaq in discharging its obligations under FATCA and/or as a result of disclosures to the US tax
authorities.

Customer’s Signature: ______________________________________Dated:____________________________

:‫اﻟﺘﺎر ــﺦ‬ :‫ﺗﻮﻗﻴﻊ اﻟﻌﻤ ﻞ‬

US Taxpayer Identification Number-TIN (in case of US Person):_________________________________________________ ‫ﺣﺎﻟﺔ ﺷﺨﺺ‬ ) ‫اﺋﺐ واﻟﻘﺼﺪﻳﺮ‬ ‫اﻟﻮﻻ ﺎت اﻟﻤﺘﺤﺪة رﻗﻢ ﺗﻌ ﻒ داﻓﻊ اﻟ‬
‫) أﻣ‬
 KEY FACTS STATEMENT (KFS) - CREDIT CARD
WARNING: Read this document carefully and sign only if you clearly understand and agree to the content of the Key Fact
Statement (KFS), which is available in English and Arabic. You may also use this document to compare different Credit Cards
offered by other Financial Institutions and /or Banks. You have the right to receive KFS from other Financial Institutions and
/or Banks for comparison.

PRODUCT INFORMATION

CREDIT CARD is a payment instrument allowing cardholders to pay for purchases or cash withdrawals and pay back to aafaq
by the Payment Due Date mentioned in the monthly Credit Card Statement. Aafaq Islamic Finance offers multiple Card types,
and all products offer reward programs, lifestyle benefits and facilities such as easy payment plan (EPP) and balance
transfers.

DETAILS AAFAQ PLATINUM BUSINESS COVERED ROYAL WORLD ELITE

CARD CARD COVERED CARD
(Monthly Profit (Annual fee & Monthly (Annual fee & Monthly
Rate) 1 Profit Rate) 1 Profit Rate) 1

FEES & CHARGES – in AED

Monthly Fixed Fees 0 0 0
Monthly Profit Rate1 3.25% 3.25% 3.25%
Annual Fees 0 399 5000
4th onwards Supplementary Card
100 100 N/A
fee (first 3 free)
Cash withdrawal limit 40% 40% 40%
Cash withdrawal fees per
transaction. (Maximum amount per 100 100 1,000
withdrawal is AED 3000)
Late Fees No No No
Over Limit Fees No No No
Non-AED transaction Fee 3.50% 3.50% 3.50%
Card replacement Fee 50 50 3,000
Cheque and Direct Debit return Fee 100 100 100
Copy of Sales voucher / slip 25 25 25
Cancellation fees (before tenure
200 200 200
ends): EPP / BT / FOP
Duplicate e-statement (per month
15 15 15
statement)
Paper statement (per month
25 25 25
statement)
Agency fee (Murabaha transaction) 5 5 5

1|Page
 KEY FACTS STATEMENT (KFS) - CREDIT CARD
DETAILS AAFAQ PLATINUM BUSINESS COVERED ROYAL WORLD ELITE
CARD CARD COVERED CARD
(Monthly Profit (Annual fee & Monthly (Annual fee & Monthly
Rate) 1 Profit Rate) 1 Profit Rate) 1
Transaction Dispute investigation
25 25 25
fee
Payment Holiday Fee 300 300 300
Liability Letter Fee 50 50 50
OTHER INFORMATION
Aafaq Star Bonus Program Yes Yes Yes
Save back Rewards
1% on Domestic Transactions (UAE) Yes Yes Yes
2% on International Transactions
Monthly regular E-Statement Free Free Free
Statement date (Every Month) 12th 12th 12th
Payment due date (from the
24 days 24 days 24 days
statement date)
Maximum repayment period 54 days 54 days 54 days
Min monthly payment (of monthly
5% (min AED 100) 5% (min AED 100) 5% (min AED 100)
balance)

2|Page
 KEY FACTS STATEMENT (KFS) - CREDIT CARD

AAFAQ CREDIT CARD – FINANCE FACILITY

Min Processing Payment
Amount Tenure Amounts Fee (AED) holiday fee
Finance Facility (AED) Max Amount * (AED) (Months) Table (AED) (Fixed) (AED)
2,000-10,000 200
10,001-15,000 350
Balance Transfer (BT) 2,000 90% of Available limit 3,6,9,12 15,001-25,000 550 300
25,001-40,000 750
40,001-above 950
2,000-5,000 250
5,001-10,000 450
Finance on Phone (FOP) 2,000 20,000* 3,6,9 300
10,001-15,000 650
15,001-20,000 850

Mazaya EPP Transaction

1,000 Transaction amount 3,6,9,12 0 300
(for Mazaya EPP Merchants) Amount

Transaction
Normal EPP 1,000 Transaction amount 3,6,9,12 250 300
Amount
#
A fixed monthly fee will be charged every month irrespective of card usage or not.
1
Monthly Profit Rate means the rate at which the Murabaha Finance will be provided to the Customer for the Covered Card.
Fees and charges are subject to change without prior notification.
Fees & T&C's as applicable are excluding VAT charges.

DISCLAIMERS:

1. All Fees mentioned above and on www.aafaq.ae are exclusive of Value Added Tax (VAT). A VAT of 5% shall be applicable on
all Fees levied by the aafaq and will be billed in your monthly Card statement.

2. aafaq Islamic Finance reserves the right to revise the fees & charges and rewards, Terms and Conditions at any time by
providing a sixty (60) days prior written notice to your registered contact details.

3. Annual Fees are applicable after Card activation for new Cards and subsequently each anniversary except free Cards.

4. Monthly Fees are applicable when you do not pay the Total Outstanding Due in full on or before the Payment Due Date.

3|Page
 KEY FACTS STATEMENT (KFS) - CREDIT CARD
YOU MUST KNOW

Credit Card Issuance: aafaq Islamic Finance reserves the right to retrieve, examine and review your Bank Account Statement
and credit report to determine the eligibility and assign a suitable credit limit on the Card to be issued.

Receipt and use of the Card: By acknowledging the receipt of the Card you give your irrevocable consent that you as a
Cardholder have read, understood, accepted, and agreed with the Terms and Conditions published on www.aafaq.ae.

Lost/Stolen Card and Unauthorized transactions: If your Card is lost or stolen, you are required to immediately block your
Card and have it replaced by calling us at 600502006.

WARNING: Transactions on the lost/stolen Card until blocked is full liability of the Cardholder.

COOLING OFF PERIOD: Khiyar Al-Shart (Cooling off Period) is defined as a period after a contract is agreed during which the
buyer can cancel the contract without incurring a penalty.

aafaq provides a ‘Cooling Off Period’ of 5 complete business days from the date of signing this KFS for you to decide in
continuing to proceed with your Card application. Customers may waive cooling-off period of complete 5 business days by
signing a written waiver provided by aafaq Islamic Finance.

WARNING: In the event of a customer’s failure to meet the aafaq’s terms and conditions before and during the Consumer’s
relationships with aafaq, aafaq may initiate appropriate action as deemed necessary as a consequence for non-repayment or
non-fulfillment of terms and conditions.

The actions taken may include the following:

• Negative rating in the AECB bureau or Central Bank.

• Legal Proceedings via Court.
• Collection measures including presenting security cheques for clearing and claim on guarantees.

In case if additional securities in terms of pledge collaterals, post-dated cheques etc. are obtained, these securities can be
utilized or be enforced in case of any default in payment or non-fulfillment of any terms and conditions or any other signed
contract.

COMPLAINTS AND SUGGESTIONS

For complaints and suggestions, you may visit any of our Branches/Outlets and submit in writing or verbally to our customer
service representative. You can also call us 600502006 and we will be happy to assist. Alternatively, you may also visit our
website www.aafaq.ae.

IMPORTANT NOTE FOR THE CUSTOMER AND AAFAQ

This Key Facts Statement must be duly signed by the aafaq’s representative and the customer, prior to availing the financial
product and/or service. A duplicate copy of the signed document must be provided by aafaq for your information and records
at any point of time during the relationship tenure and/or based on your request. In an instance of joint relationship, the Key
Facts Statement copy need to be agreed and signed by the joint party as well and the same has to be physically handed over to
all the account holders.

4|Page
 KEY FACTS STATEMENT (KFS) - CREDIT CARD
If you wish to "Opt in" / "Opt out" of receiving marketing and promotional communications, you may call us anytime at
600502006.

I agree to receive promotional/marketing/product communication from aafaq. Yes No

Preferred mode of communication (if Yes) Email SMS

Acknowledgment and Signature:

I hereby acknowledge that I have read, understood, and agree to the content of this Key Facts Statement.

Customer Name:

Product Chosen:

Email Address:

Customer Signature:

RM/SSO Name

Date:

Single/Joint

Mobile Number:

Signature Verified:

RM/SSO Name: Aafaq Islamic Finance P.S.C. hereby declares that it has been licensed and authorized to carry out financial
products and services in UAE. All our products and services are Shari’ah complaint and approved by our Internal Shari’ah
Committee. For details on approval, kindly visit www.aafaq.ae.

5|Page
 Undertaking and Approval to Obtain and Disclose Information

Date
14/10/2021 ‫اﻟﺘﺎرﻳﺦ‬

CIF Number ‫رﻗﻢ ﺗﻌﺮﻳﻒ ﻣﻠﻒ اﻟﻌﻤﻴﻞ‬

Account Number (s)

1015781919501 /‫أرﻗﺎم اﻟﺤﺴﺎب‬/‫رﻗﻢ‬
‫اﻟﺤﺴﺎﺑﺎت‬
‫اﻟﻤﺴﺘﻨﺪات‬
ID Doc.
Emirates ID No.
784199241647900 ‫رﻗﻢ اﻟﻬﻮﻳﺔ‬
Individual :
Passport No. U23874629 ‫رﻗﻢ ﺟﻮاز اﻟﺴﻔﺮ‬
Company/Legal Entity : Trade License/Reg. ‫رﻗﻢ اﻟﺮﺧﺼﺔ اﻟﺘﺠﺎرﻳﺔ‬
Issued Date ‫ﺗﺎرﻳﺦ اﻻﺻﺪار‬
ENGIN CEYLAN
Name of the Customer/Account Holder ‫إﺳﻢ اﻟﻌﻤﻴﻞ أو ﺻﺎﺣﺐ اﻟﺤﺴﺎب‬

1. (Hereinafter referred to as the Account Holder or Customer)
Through this Undertaking, the above Account Holder (who may be a Customer
and/ or obligor as applicable), hereby entitles and authorizes aafaq Islamic
PJSC (the “Company”), without the need to obtain any additional written or oral
permits, to obtain, request, verify, transfer, disclose and communicate in
general, any such Information (as defined herein), as the Company deems fits
in its absolute discretion with:
(a) any credit information bureau or any such other person or entity,
whether inside the United Arab Emirates or abroad, which maintains
or is supposed to maintain any of the information contained in this
Undertaking relating to the Account Holder and/or the Customer and/
or his authorised signatory(ies).
(b) any governmental or semi-governmental authorities, body,
organization, company or service provider (such as electricity, water
and telecommunication companies.
(c) any branches, subsidiaries, affiliates, representative offices, agents of
the Company, including any appointed third parties, wherever situated.
2. The Company shall be entitled to use any or all of the Information for any
such purpose where the Information may be required, including:
(a) granting or commencing to grant any finance, banking facilities or any
other banking services offered by the Company,
(b) assessing the Account Holder’s/Customer credit position,
(‫)ﻳﺸﺎر إﻟﻴﻪ ﻓﻴﻤﺎ ﺑﻌﺪ ﺑﺼﺎﺣﺐ اﻟﺤﺴﺎب أو اﻟﻌﻤﻴﻞ‬ .1
‫ﺑﻤﻮﺟــﺐ ﻫــﺬا اﻟﺘﻌﻬــﺪ ﻳﺨــﻮل وﻳﻔــﻮض ﺻﺎﺣــﺐ اﻟﺤﺴــﺎب أﻋــﻼه )واﻟــﺬي ﻗــﺪ ﻳﻜــﻮن اﻟﻌﻤﻴــﻞ‬
(‫أو اﻟﻤﻠﺘــﺰم اﻟــﺬي ﻳﺤﺼــﻞ أو ﻳﺮﻏــﺐ ﻓــﻲ اﻟﺤﺼــﻮل ﻋﻠــﻰ ﺗﻤﻮﻳــﻞ ﺣﺴــﺐ ﻣﻘﺘﻀــﻰ اﻟﺤــﺎل‬/ ‫و‬
‫خ" )آﻓــﺎق اﻹﺳــﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳــﻞ( دون اﻟﺤﺎﺟــﻪ‬.‫م‬.‫ﺷــﺮﻛﺔ آﻓــﺎق اﻹﺳــﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳــﻞ "ش‬
‫ﻟﻠﺤﺼــﻮل ﻋﻠــﻰ ﺗﺼﺮﻳﺤــﺎت ﻣﻜﺘﻮﺑــﺔ أ ﺷــﻔﻮﻳﺔ إﺿﺎﻓﻴــﺔ ﺑﺎﻟﺤﺼــﻮل ﻋﻠــﻰ وﻃﻠــﺐ واﻟﺘﺤﻘــﻖ ﻣــﻦ‬
‫ ﺗﺒــﺎدل أي ﻣﻌﻠﻮﻣــﺎت )ﻛﻤــﺎ ﻳﺘــﻢ ﺗﺤﺪﻳﺪﻫــﺎ ﻓــﻲ ﻫــﺬا‬،‫وﺑﻮﺟــﻪ ﻋــﺎم‬، ‫وﺗﺤﻮﻳــﻞ واﻹﻓﺼــﺎح ﻋــﻦ‬
‫اﻟﺘﻌﻬــﺪ( وﻓﻘــﺎ ﻟﻤــﺎ ﺗــﺮاه أﻓــﺎق اﻹﺳــﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳــﻞ ﻣﻨﺎﺳــﺒﺎ ﺣﺴــﺐ اﻟﻤﻄﻠــﻖ ﻣــﻦ‬
: ‫وﻣﻊ‬
‫ ﺳــﻮاء ﻳﺘﻮاﺟــﺪ داﺧــﻞ‬،‫)أ( أي ﻣﻜﺘــﺐ إﺳــﺘﻌﻼم إﺋﺘﻤﺎﻧــﻲ أو أي ﺷــﺨﺺ أو ﻛﻴــﺎن أﺧــﺮ‬
‫واﻟــﺬي ﻳﺤﺘﻔــﻆ أو ﻣــﻦ اﻟﻤﺤﺘﻤــﻞ أن‬،‫دوﻟــﺔ اﻹﻣــﺎرات اﻟﻌﺮﺑﻴــﺔ اﻟﻤﺘﺤــﺪة أو ﺧﺎرﺟﻬﺎ‬
‫ﻳﺤﺘﻔــﻆ ﺑــﺄي ﻣــﻦ اﻟﻤﻌﻠﻮﻣــﺎت اﻟﻤﺘﻀﻤﻨــﺔ ﻓــﻲ ﻫــﺬا اﻟﺘﻌﻬــﺪ واﻟﺘــﻲ ﻟﻬــﺎ ﺻﻠــﺔ‬
‫اﻟﻤﺨﻮﻟﻴﻦ ﺑﺎﻟﺘﻮﻗﻴﻊ ﻋﻨﻪ‬/‫أو اﻟﻤﺨﻮل‬/‫أو اﻟﻌﻤﻴﻞ و‬/‫ﺑﺼﺎﺣﺐ اﻟﺤﺴﺎب و‬
‫)ب( أي ﺟﻬــﺔ ﺣﻜﻮﻣﻴــﺔ أو ﺷــﺒﻪ ﺣﻜﻮﻣﻴــﺔ أو ﻫﻴﺌــﺔ أو ﻣﺆﺳﺴــﺔ أو ﺷــﺮﻛﺔ أو ﻣــﺰود‬
‫ﻣﺜﻞ )ﺷﺮﻛﺎت اﻟﻜﻬﺮﺑﺎء واﻟﻤﻴﺎه واﻹﺗﺼﺎﻻت(؛‬
(‫)ت( أي ﻓــﺮوع أو ﺷــﺮﻛﺎت ﺗﺎﺑﻌــﺔ أو ﺷــﺮﻛﺎت زﻣﻴﻠــﺔ أو ﻣﻜﺎﺗــﺐ ﺗﻤﺜﻴﻠﻴــﺔ أو وﻛﻼء‬
‫ ﺣﻴﺜﻤــﺎ‬،‫ﻷﻓــﺎق اﻹﺳــﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳــﻞ ﺑﻤــﺎ ﻓــﻲ ذﻟــﻚ أي أﻃــﺮاف ﺛﺎﻟﺜــﺔ ﻣﺨﺘــﺎره‬
‫ﻳﻜﻮن ﻣﻮﻗﻌﻬﺎ‬
‫ﻳﺤــﻖ ﻷﻓــﺎق اﻹﺳــﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳــﻞ إﺳــﺘﺨﺪام أي وﻛﺎﻓــﺔ اﻟﻤﻌﻠﻮﻣــﺎت ﻷي ﻏــﺮض ﻳﺴــﺘﺪﻋﻲ‬ .2
: ‫ ﺑﻤﺎ ﻓﻲ ذﻟﻚ‬،‫ﺗﻘﺪﻳﻢ ﻣﺜﻞ ﻫﺬه اﻟﻤﻌﻠﻮﻣﺎت‬
‫ﺗﻘﺪﻳــﻢ أو اﻟﺸــﺮوع ﻓــﻲ ﺗﻘﺪﻳــﻢ أي ﺗﻤﻮﻳــﻞ أو ﺗﺴــﻬﻴﻼت أو أي ﺧﺪﻣــﺎت أﺧــﺮى‬ (‫)أ‬
‫ﻣﺘﺎﺣﺔ ﻣﻦ ﻗﺒﻞ أﻓﺎق اﻹﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬

(c) collecting any amounts or finance and/or any amounts due and ‫ اﻟﻌﻤﻴﻞ‬/ ‫)ب( ﺗﻘﻴﻴﻢ اﻟﻤﺮﻛﺰ اﻹﺋﺘﻤﺎﻧﻲ ﻟﺼﺎﺣﺐ اﻟﺤﺴﺎب‬
payable to the Company, ‫)ت( ﺗﺤﺼﻴــﻞ أي ﻣﺒﺎﻟــﻎ ﻣﺴــﺘﺤﻘﻪ ﻋــﻦ أي ﺗﻤﻮﻳــﻞ أة أي ﻣﺴــﺘﺤﻘﺎت ﻣﺎﻟﻴــﺔ أﺧــﺮى‬
(d) internal use (including for use in connection with the provision of any ‫ﻷﻓﺎق اﻹﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬
products or services to the Account Holder/Customer),
‫)ث( اﻹﺳــﺘﺨﺪام اﻟﺪاﺧﻠــﻲ )ﺑﻤــﺎ ﻓــﻲ ذﻟــﻚ اﻹﺳــﺘﺨﺪام اﻟﻤﺘﻌﻠــﻖ ﺑﺘﻘﺪﻳــﻢ أي ﻣﻨﺘﺠــﺎت‬
(e) data processing, ‫ اﻟﻌﻤﻴﻞ‬/‫)أو ﺧﺪﻣﺎت إﻟﻰ ﺻﺎﺣﺐ اﻟﺤﺴﺎب‬
(f) statistical and risk analysis purposes, ‫)ج( ﻣﻌﺎﻟﺠﺔ اﻟﺒﻴﺎﻧﺎت‬
(g) global cash services, and
‫)ح( ﻷﻏﺮاض إﺣﺼﺎﺋﻴﺔ وﺗﺤﻠﻴﻞ اﻟﻤﺨﺎﻃﺮ‬
(h)
‫ و‬،‫)خ( ﺧﺪﻣﺎت اﻟﻨﻘﺪ اﻟﻌﻤﺎﻟﻴﺔ‬
dealings in securities on any exchange securities market(s) and any
other relevant authorities and agencies pertaining there to.
‫ أﺳــﻮاق ﻣﺎﻟﻴــﺔ ﻟــﻸوراق اﻟﻤﺎﻟﻴــﺔ‬/ ‫)د( اﻟﺘﻌﺎﻣــﻞ ﻓــﺐ اﻷوراق اﻟﻤﺎﻟﻴــﺔ ﻓــﻲ أي ﺳــﻮق‬
3. For the purposes of this Undertaking, “Information” shall mean any personal, ‫وأي ﻫﻴﺌﺎت ووﻛﺎﻻت ذات ﻋﻼﻗﺔ ﺑﺬﻟﻚ‬
financial, legal or credit information relating to the Account Holder/Customer
whether the Account Holder/Customer is an individual or a legal or corporate ‫ إن ﺗﻌﺒﻴــﺮ "اﻟﻤﻌﻠﻮﻣــﺎت" ﻳﻌﻨــﻲ أي ﻣﻌﻠﻮﻣــﺎت ﺷــﺨﺼﻴﺔ أو ﻣﺎﻟﻴــﺔ أو‬،‫ﻷﻏــﺮاض ﻫــﺬا اﻟﺘﻌﻬــﺪ‬ .3
entity, including any information lawfully obtained from any third parties, such ‫اﻟﻌﻤﻴﻞ ﺳــﻮاء ﻛﺎن ﺻﺎﺣــﺐ اﻟﺤﺴــﺎب ﺷــﺨﺼﺎ‬/‫ﻗﺎﻧﻮﻧﻴــﺔ أو إﺋﺘﻤﺎﻧﻴــﺔ ﺗﺘﻌﻠــﻖ ﺑﺼﺎﺣــﺐ اﻟﺤﺴــﺎب‬
‫ ﺑﻤــﺎ ﻓــﻲ ذﻟــﻚ أي ﻣﻌﻠﻮﻣــﺎت ﺗــﻢ اﻟﺤﺼــﻮل ﻋﻠﻴﻬــﺎ ﻗﺎﻧﻮﻧــﺎ ﻣــﻦ‬،‫أو ﻛﻴــﺎن ﻗﺎﻧﻮﻧــﻲ أو إﻋﺘﺒــﺎري‬
as any local or international credit bureaus.

4. This undertaking shall remain full force and effect against the Account Holder/
Customer and may not be terminated or amended without the Company’s prior
written consent.
5. This Undertaking shall be subject to and interpreted in accordance with
the Federal Credit Information Law No. 6 of 2010, as may be amended from
time to time, and any other applicable laws of the United Arab Emirates. Any
disputes arising between the Company and the Account Holder with regards
to this Undertaking shall be referred to the exclusive jurisdiction of the courts
of the United Arab Emirates.
. ‫ ﻣﺜﻞ أي ﻣﻜﺘﺐ إﺋﺘﻤﺎن ﻣﺤﺎي أو دوﻟﻲ‬،‫أي أﻃﺮاف ﺛﺎﻟﺜﺔ‬
‫ اﻟﻌﻤﻴــﻞ وﻻ ﻳﺤــﻖ ﻟــﻪ‬/‫ﻳﻈــﻞ ﻫــﺬا اﻟﺘﻌﻬــﺪ ﺳــﺎرﻳﺎ وﻧﺎﻓــﺬا ﻓــﻲ ﻣﻮاﺟﻬــﺔ ﺻﺎﺣــﺐ اﻟﺤﺴــﺎب‬ .4
‫إﻟﻐــﺎؤه أو ﺗﻌﺪﻳﻠــﺔ دون اﻟﺤﺼــﻮل ﻋﻠــﻰ ﻣﻮاﻓﻘــﻪ ﺧﻄﻴــﺔ ﻣﺴــﺒﻘﺔ ﻣــﻦ ﺷــﺮﻛﺔ أﻓــﺎق‬
.‫اﻹﺳﻼﻣﻴﺔ ﻟﻠﺘﻤﻮﻳﻞ‬
‫ ﺑﺸــﺄن‬2010 ‫ ﻟﺴــﻨﻪ‬6 ‫ﻳﺨﻀــﻊ ﻫــﺬا اﻟﺘﻌﻬــﺪ ﻓــﻲ ﺗﻔﺴــﻴﺮه وﺗﺄوﻳﻠــﻪ إﻟــﻰ أﺣــﻜﺎم اﻟﻘﺎﻧــﻮن رﻗــﻢ‬ .5
‫ وﻷي ﻗﻮاﻧﻴــﻦ أﺧــﺮى ﻣﻄﺒﻘــﺔ‬،‫ ﻛﻤــﺎ ﻳﺘــﻢ ﺗﻌﺪﻳﻠــﺔ ﻣــﻦ وﻗــﺖ ﻷﺧــﺮ‬، ‫اﻟﻤﻌﻠﻮﻣــﺎت ﺗﺎإﺋﺘﻤﺎﻧﻴــﺔ‬
‫ وﻳﺤــﺎل أي ﻧــﺰاع ﻳﻨﺸــﺄ ﺑﻴــﻦ ﺷــﺮﻛﺔ أﻓــﺎق اﻹﺳــﻼﻣﻴﺔ‬،‫داﺧــﻞ دوﻟــﺔ اﻹﻣــﺎرات اﻟﻌﺮﺑﻴــﺔ اﻟﻤﺘﺤــﺪة‬
‫ﻟﻠﺘﻤﻮﻳــﻞ وﺻﺎﺣــﺐ اﻟﺤﺴــﺎب ﺑﺨﺼــﻮص ﻫــﺬا اﻟﺘﻌﻬــﺪ ﻟﻺﺧﺘﺼــﺎص اﻟﻘﻀﺎﺋــﻲ اﻟﺤﺼــﺮي‬
.‫ﻟﻤﺤﺎﻛﻢ دوﻟﺔ اﻹﻣﺎرات اﻟﻌﺮﺑﻴﺔ اﻟﻤﺘﺤﺪة‬

Account Holder/Customer Signature ‫اﻟﻌﻤﻴﻞ‬/ ‫ﺗﻮﻗﻴﻊ ﺻﺎﺣﺐ اﻟﺤﺴﺎب‬