á«fɪàF’G ôjQÉ≤àdG ≈∏Y á≤aGƒŸG êPƒ‰

Credit Report Consent Form

Customer Name: :𫪩dG º°SG

(”Customer”) ("𫪩dG")
Customer’s Nationality: :𫪩dG á«°ùæL

Date: / / / / :ïjQÉàdG

To: Abu Dhabi Commercial Bank - Islamic Banking (the “Bank”).
1. The Customer irrevocably and unconditionally authorize and
permit the Bank to:
(a) Make inquiries with, obtain information from, or supply
information to, any credit bureau or credit reporting
agency (in any jurisdiction) including Al Etihad Credit
Bureau (any such entity being a “Credit Bureau”). Such
inquiries or information may relate to his/her financial
situation, credit reference, credit report (including but
not limited to his/her credit history);
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:»∏j Éà ΩÉ«≤dÉH
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‘ Éà (»FÉ°†b ¢UÉ°üàNG á≤£æe …CG ‘) á«fɪàFG ôjQÉ≤J ádÉch hCG ¿ÉªàFG Öàµe
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∞«æ°üàdGh ‹ÉŸG ∞bƒŸÉH äÉeƒ∏©ŸGh äGQÉ°ùØà°S’G ≥∏©àJ ¿CG Rƒéjh .("¿ÉªàF’G
πé°S ô°ü◊G ’ ∫ÉãŸG π«Ñ°S ≈∏Y ∂dP ‘ ÉÃ) 𫪩∏d ÊɪàF’G ôjô≤àdGh ÊɪàF’G
;(𫪩dÉH ¢UÉÿG á«fɪàF’G äÓeÉ©ŸG

(b) Record all telephone conversations with any such Credit äÉeƒ∏©ŸÉH ®ÉØàM’Gh ¿ÉªàFG Öàµe …CG ™e á«ØJÉ¡dG äÉKOÉëŸG áaÉc π«é°ùJ (Ü)
Bureau and retain and share the information received äÉcô°ûdG ™e äÉeƒ∏©ŸG ∂∏J ácQÉ°ûeh ¿ÉªàF’G Öàµe øe É¡eÓà°SG ” »àdG
from the Credit Bureau with the Bank’s affiliates or ;∂æÑ∏d á©HÉàdG á«YôØdG äÉcô°ûdGh áØ«∏◊G
subsidiaries;

2. The Customer undertakes that the Bank or its directors,
officers or employees shall not be liable for any incorrect,
incomplete or inaccurate information obtained from any
Credit Bureau or for any loss or damage suffered by the
Customer in connection with the supply of information to
any Credit Bureau, including, without limitation, as a result of
any information proving inaccurate, incorrect or incomplete
or any opinion based on such information proving
unfounded.
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∫ƒ°ü◊G ºàj á≤«bO ÒZ hCG á∏eÉc ÒZ hCG áë«ë°U ÒZ äÉeƒ∏©e …CG øY á«dhDƒ°ùŸG
Ëó≤àH ≥∏©àj ɪ«a 𫪩dÉH ≥ë∏j Qô°V hCG IQÉ°ùN …CG øY hCG ¿ÉªàF’G Öàµe øe É¡«∏Y
äƒÑK áé«àf ô°ü◊G ’ ∫ÉãŸG π«Ñ°S ≈∏Y ∂dP ‘ Éà ¿ÉªàFG Öàµe …CG ≈dEG äÉeƒ∏©ŸG
ºàj QGôb …CG áë°U ΩóY hCG á∏eÉc ÒZ hCG áë«ë°U ÒZ hCG á≤«bO ÒZ äÉeƒ∏©e …CG ¿CG
.äÉeƒ∏©ŸG ∂∏J ≈∏Y AÉæH √PÉîJG

The Customer agrees to provide following details and copy of the :∂æÑdG ≈dEG √ÉfOCG IQƒcòŸG äGóæà°ùŸG øe áî°ùfh á«dÉàdG äÉfÉ«ÑdG Ëó≤J ≈∏Y 𫪩dG ≥aGƒj
documents stated below to the Bank:

• Full Name as per passport: :ôØ°ùdG RGƒL Ö°ùM πeɵdG º°S’G •

• Mobile Number: :∑ôëàŸG ∞JÉ¡dG ºbQ •

• EID No.: :äGQÉeE’G ájƒg ábÉ£H ºbQ •
• Passport No.: :ôØ°ùdG RGƒL ºbQ •
• Old Passport No. (optional): :(…QÉ«àNG) Ëó≤dG ôØ°ùdG RGƒL ºbQ •
• Date of Birth (DD/MM/YYYY): / / / / :OÓ«ŸG ïjQÉJ •
Oct-2018

The Customer irrevocably undertakes that the information áë«ë°U êPƒªædG Gòg ‘ IQƒcòŸG äÉeƒ∏©ŸG ¿CÉH É¡æY á©LQ ’ á«FÉ¡f áØ°üH 𫪩dG ó¡©àj
provided in this letter are true and accurate. This letter is governed IQÉeEG ‘ ≥Ñ£ŸG Qó≤dÉHh ,»ÑXƒHCG IQÉeEG ÚfGƒb ≈dEG êPƒªædG Gòg ™°†îjh .á≤«bOh á«≤«≤Mh
by the laws of Abu Dhabi, and to the extent applicable in .IóëàŸG á«Hô©dG äGQÉeE’G ádhód ájOÉ–’G ÚfGƒ≤dG ,»ÑXƒHCG
V.1.0

Abu Dhabi, the federal laws of the United Arab Emirates.

FRM-IBD-000-0.7
Ver.01/October2018

Customer Name 𫪩dG º°SG

Signature of Customer 𫪩dG ™«bƒJ