Investor Identification on the Securities Depository Center’s Database Form

Date

For Natural & Judicial Persons

Name

Nationality

Investor Type

Natural Person

Judicial person

ID Type

Passport

Identity Card

Family Book

Registration Certificate

Other

ID No

ID Place of Issue

ID Issue Date

ID Expiry Date

Address

City

Country

P. O. Box

Zip Code

Phone

Fax

Mobile

E-mail

Name of Authorized Signatory for Judicial Entities

Signature

Official Stamp for Judicial Entities

Other Nationality (If Applicable)

Name

SDC No.

Nationality

For Natural Persons

National No. (If Applicable)

Gender

Male

Female

Mother’s Name

Date of Birth

Agency Information

Agency Type

Caretaker

Custodian

Agent

Trustee

Receiver

Guardian

Liquidator

Agent’s Name

SDC No.:

Nationality

Signature

I, the signatory above, acknowledge that the data and information stated above are correct, complete and accurate and I assume the full responsibility arising therefrom without holding the Securities Depository Center responsible for the invalidity, inaccuracy and/or incompleteness of the said data and information.

For Securities Depository Center’s Use

Operation	Name	Signature	Date
Entry	Name	Signature	Date
Audit	Name	Signature	Date
Approval	Name	Signature	Signature

Important Notice:

All information and data should be filled accurately and clearly.
In cases where there is an agent, the power of attorney issued by the competent authorities shall be attached, and if it is issued outside the Kingdom, it shall be duly certified.
The following valid identification documents must be attached to this form:

Natural Persons:

- For Jordanians: Passport, Family Book, or Identity Card issued by the Civil Status and Passport Department, provided that it contains the National Number.

- For Non-Jordanians: Passport.

Judicial Entities:

- For Jordanians: Registration Certificate at the official competent authorities.

- For non-Jordanians: Certificate of registration, duly certified.

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