‫إﺳﺘﻤﺎرة ﻃﻠﺐ ﺧﺪﻣﺔ ﻟﻠﻌﺎﻣﻞ اﻟﻤﺮن‬

Flexible Permit Service Application Form

Required Service ‫اﻟﺨﺪﻣﺔ اﻟﻤﻄﻠﻮﺑﺔ‬

‫ﺳﻨﺘﺎن‬ ‫ﺳﻨﺔ‬ ‫اﻟﺘﻘﺪﻳﻢ ﻋﻠﻰ اﻟﺘﺼﺮﻳﺢ اﻟﻤﺮن‬
Two Years One Year Apply for flexi permit

‫إﻟﻐﺎء ﻣﻌﺎﻣﻠﺔ ﻗﻴﺪ ا§ﺟﺮاء‬ ‫ﺗﺤﺪﻳﺚ ﺑﻴﺎﻧﺎت اﻟﻌﺎﻣﻞ‬ ‫إﻟﻐﺎء‬ ‫ﺗﻐﻴﻴﺮ ﻣﻬﻨﺔ‬
In progress transaction cancellation Update Expatriate Details Cancellation Change Occupation

‫أﺳﺒﺎب إﻟﻐﺎء اﻟﻄﻠﺐ‬

Application Cancellation Reason

Update Expatriate Details ‫ﺗﺤﺪﻳﺚ ﺑﻴﺎﻧﺎت اﻟﻌﺎﻣﻞ‬

Address in Bahrain (Expatriate Employee address in the Kingdom of Bahrain) (‫اﻟﻌﻨﻮان ﻓﻲ ﻣﻤﻠﻜﺔ اﻟﺒﺤﺮﻳﻦ )ﻋﻨﻮان ﺳﻜﻦ اﻟﻌﺎﻣﻞ اﺟﻨﺒﻲ ﻓﻲ ﻣﻤﻠﻜﺔ اﻟﺒﺤﺮﻳﻦ‬
‫اﻟﻤﻨﻄﻘﺔ‬ ‫ﻣﺠﻤﻊ رﻗﻢ‬ ‫ﻃﺮﻳﻖ رﻗﻢ‬ ‫ﻣﺒﻨﻰ رﻗﻢ‬ ‫ﺷﻘﺔ رﻗﻢ‬
Area Block No. Road No. Building No. Flat No.

E-mail ‫اﻟﺒﺮﻳﺪ ا€ﻟﻜﺘﺮوﻧﻲ‬ Phone No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ‬

Expatriate Employee Details ‫ﺑﻴﺎﻧﺎت اﻟﻌﺎﻣﻞ اﺟﻨﺒﻲ‬

Current Passport No. ‫رﻗﻢ ﺟﻮاز اﻟﺴﻔﺮ اﻟﺤﺎﻟﻲ‬ Old Passport No. ‫رﻗﻢ ﺟﻮاز اﻟﺴﻔﺮ اﻟﻘﺪﻳﻢ‬ Personal No. ‫اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ‬

Name (in English / Arabic) First Name - Second Name - Third Name - Family Name ‫ اﻟﻌﺎﺋﻠﺔ أو اﻟﻠﻘﺐ‬- ‫ اﻻﺳﻢ اﻟﺜﺎﻟﺚ‬-‫ اﻻﺳﻢ اﻟﺜﺎﻧﻲ‬- ‫ ا€ﻧﺠﻠﻴﺰﻳﺔ( اﻻﺳﻢ اول‬/‫اﻻﺳﻢ )ﺑﺎﻟﻠﻐﺔ اﻟﻌﺮﺑﻴﺔ‬

Occupation Title ‫اﻟﻤﺴﻤﻰ اﻟﻮﻇﻴﻔﻲ‬ Job Code ‫رﻣﺰ اﻟﻮﻇﻴﻔﺔ‬

‫ﻋﺎﻣﻞ ﺿﻴﺎﻓﺔ ﻣﺮن‬ ‫ﻋﺎﻣﻞ ﻣﺮن‬
Flexi Hospitality Worker Flexi Worker

Declaration ‫إﻗﺮار‬

‫أﻗﺮ أﻧﺎ اﻟﻤﻮﻗﻊ أدﻧﺎه ﺑﺈﻃﻼﻋﻲ ﻋﻠﻰ ﻛﺎﻓﺔ اﻟﺸﺮوط واﺣﻜﺎم اﻟﻤﺘﻌﻠﻘﺔ ﺑﺎﻟﺨﺪﻣﺔ اﻟﻤﻄﻠﻮﺑﺔ وﺑﻤﻮاﻓﻘﺘﻲ ﻋﻠﻴﻬﺎ ﻛﻤﺎ أﻗﺮ ﺑﺼﺤﺔ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻮاردة ﻓﻲ اﻻﺳﺘﻤﺎرة وﻋﺪم‬
.‫اﻟﻌﻤﻞ ﺑﺄي ﻣﻬﻨﺔ ﺗﺨﺼﺼﻴﺔ دون اﻟﺤﺼﻮل ﻋﻠﻰ اﻟﺘﺮﺧﻴﺺ واﻟﻤﻮاﻓﻘﺔ ﻣﻦ اﻟﺠﻬﺎت اﻟﺮﺳﻤﻴﺔ اﻟﻤﻌﻨﻴﺔ ﺑﺬﻟﻚ‬
I declare that I have read and agreed on all the rules and regulations for the required service procedures, and not practice any specialize profession without
obtaining the necessary license and approval from the relevant official authorities.

Signature ‫ اﻟﺘﻮﻗﻴﻊ‬Personal No. ‫ اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ‬Name ‫اﻻﺳﻢ‬

Date ‫اﻟﺘﺎرﻳﺦ‬ Mobile No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬ Phone No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ‬

For Official Use Only ‫ﻟﻼﺳﺘﻌﻤﺎل اﻟﺮﺳﻤﻲ ﻓﻘﻂ‬

Version 2 - 2021

Date ‫اﻟﺘﺎرﻳﺦ‬ Signature ‫اﻟﺘﻮﻗﻴﻊ‬ Employee ID ‫ اﻟﺮﻗﻢ اﻟﻮﻇﻴﻔﻲ‬Received By ‫ﺗﻢ ﺗﺴﻠﻢ اﻟﻄﻠﺐ ﻣﻦ ﻗﺒﻞ‬

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