Form for updating a shareholder data and requesting cash dividends disbursement

Please update your personal information in accordance with the table below in order to be adopted in the shareholder Department's records at Al Mashreq Insurance Company.

All the following are obligatory clauses.

If you want to transfer the value of cash profits, please fill out the following bank information in the table for approval:

I would like to transfer the amount of cash profits to my account shown below.

I don’t want to transfer

The shareholder declares and agrees to the following:

The information contained in this form is correct and Al Mashreq Insurance Company assumes no current and/or future liability in this regard.
Authorizing Al Mashreq Insurance Company to adopt the information provided above until it is notified in writing of any amendments or updates. Furthermore, Al Mashreq Insurance Company takes no responsibility in this regard.
The shareholder is responsible for any expenses incurred by the transfer of cash dividend amounts and/or currency differences resulting from the difference between the account currency and the company's profit currency.
Releasing Al Mashreq Insurance Company in case of fault and/or problem resulting from a mistake in the aforementioned information.
5. Agreeing to pay cash dividends in accordance with the above-mentioned method and releasing Al Mashreq Insurance Company from any future responsibility because of dividend payments using this method.

Note:

For common shareholders (individuals), please attach a copy of the identification document (ID Card/Passport).
The bank must verify the authenticity of the legal representative's signature and the company's seal for preferred shareholders (companies). A copy of the company's registration certificate and the certificate of authorized signatories issued by the Companies Controller's Office must be attached.