ADCB A Strong And Well Established Bank In The UAE

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Ö W êPƒ‰á«eÓ SE’G áaÒ ü d QÉéàdG »ÑXƒHCG æH øe IÉ ŸG äÉbÉ ÑdGApplication FormADCB Islamic Banking Covered Cards600 56 2626 - www.adcbislamic.com

IMCá«eÓ SE’G áaÒ ü d QÉéàdG »ÑXƒHCG æH øe IÉ ŸG äÉbÉ ÑdG Ö W êPƒ‰ADCB Islamic Banking Covered Cards Application Form»àdG äÉë«ë üàdG hCG äÓjó àdG «ªL Y bq h . Ñ æJ ’ »àdG äÉfÉÿG ‘ ( Ñ æj ’) ÖàcGh ,ΩÉ ùbC’G «ªL CÓeEG .áHƒ ŸG äÉfÉ«ÑdG áÄÑ J Lôoj.IóYÉ ùe C’ æÑdG »ØXƒe øe CG e çóëàdG Lôj .É¡dÉNOEÉH Ωƒ JPlease fill in the details in CAPITAL LETTERS. Complete all sections and mark N/A for areas notapplicable. Countersign all modifications or corrections you make. Please speak to a bankrepresentative for any assistance with this application.IôFGO) º SÉH § a « ûdG ôjô– Lôoj .áHƒ ŸG äGóæà ùŸG øe Aõéc æÑdG dEG ¿Éª V « T Ëó J IÉ ŸG ábÉ ÑdG »ÑdÉW øe Ö oj ¿CG øµÁ.ábÉ ÑdG QGó UEG Y á aGƒe hCG ܃ ŸG ábÉ ÑdG óq Ék fɪ V πµq ûj ’ « ûdG ƒÑb q¿EG .( QÉéàdG »ÑXƒHCG æH äÉbÉ HApplicants may be required to submit a security cheque to the Bank as part of documentation.Please address the cheque to ‘ADCB Cards’ only. Acceptance of a cheque constitutes neither aguarantee of card limit nor approval of a card.ájQhô V * áeÓY É¡« Y ƒ VƒŸG äÉfÉÿG «ªLAll fields marked with * are mandatory.*IÉ ŸG ábÉ ÑdG ƒf QÉ«àNG LôjoPlease indicate your choice of Covered Card*TouchPoints VisaInfinitePlatinumGoldEtihad �ÑdGâ«æ«ØfEGGõ«a ùàæjƒH ûJÉJá«æ«JÓÑdGô ûàæ « Sâ«æ«ØfEGGõ«a OÉ–’G*á« üî ûdG äÉfÉ«ÑdG † HA few details about yourself*Mrs.Middle NameFirst Nameá ùfB’GMs.Ió«q ùdGá FÉ dG º SGLast NameÜC’G º SG hC’G º S’Gá«eÓ SE’G áaÒ ü d QÉéàdG »ÑXƒHCG æH øe IQOÉ üdG ábÉ ÑdG Y ô¡¶j ¿CG ÖZôJ ɪc ª SGYour name as you would like it on your ADCB Islamic Banking Card.Ék aô M 19 übCG óëH ,Aɪ SC’G ÚH IóMGh áaÉ ùe ôJCGLeave one space between names. Maximum of 19 characters.NationalityDate of Birth d dm my yy yOÓ«ŸG ïjQÉJá« ùæ GPassport NumberExpiry Dated dm my yy yAÉ¡àf’G ïjQÉJôØ ùdG RGƒL ºbQVisa NumberExpiry Dated dm my yy yAÉ¡àf’G ïjQÉJáeÉbE’G IÒ TCÉJ ºbQEmirates ID No.Years in the UAEäGQÉeE’G ádhO ‘ äGƒæ ùdG OóYäGQÉeE’G ájƒg ºbQMarital StatusAnniversary DateSingled dy yEducationiôNCGOtherMarriedm mêhq õàeÜõYCGäGQÉeE’G ádhO ‘in the UAEGraduatePost-GraduateiôNCGOtherÉ« Y äÉ SGQOYes’NoFaxº f?OÉ–’G « V èeÉfôH ‘ ájƒ †Y jód πgOÉ–’G « V ájƒ †Y ºbQ ôcP Lôj ,º f áHÉLE’G âfÉc GPEG(äÉbÉ ÑdG πc » eÉ »eGõdEG ÊhεdE’G ójÈdG) *IóëàŸG á«Hô dG äGQÉeE’G ádhO ‘ H É üJ’G äÉfÉ«HYour contact details in the UAE* (E-mail ID is mandatory)Office Tel. hC’G º S’G(§ a OÉ–’G äÉbÉ Ñd) *OÉ–’G « V ájƒ †Y π« UÉØJEtihad Guest Membership Details* (applicable for Etihad cards only)Residence Tel.» SGQódG πgDƒŸG( àjɪM É¡æe Oƒ ü ŸG á«q æeCG Iõ«e òg) :(êGhõdG πÑb) ΩC’G º SGá FÉ dG º SEGLast NameAre you an existing Etihad Guest member?If yes, provide your Etihad Guest membership number‹ÉªLE’G - ÚdÉ ŸG OóY» eÉLMother’s Maiden Name (this is a security feature for your protection)First Nameá«q YɪàL’G ádÉ G:êGhõdG ïjQÉJy yNo. of Dependants - TotalVer.08/March2020ó«q ùdGá jƒëàdGExtn.MobileE-mailπª dG JÉgøµ ùdG JÉg ôëàŸG JÉ¡dG ùcÉØdGÊhεdE’G ójÈdG( jó U hCG Öjôb) *IóëàŸG á«Hô dG äGQÉeE’G ádhO ‘ «dEG ƒLôdG øµÁ üî TPersonal reference in the UAE* (relative or friend)Company NameNameMobileOffice Tel.Residence Tel. ôëàŸG JÉ¡dGøµ ùdG JÉg(1)ácô ûdG º SGº S’Gπª dG JÉgFRM-Mr.

*øµ ùdG ¿GƒæYResidential address*Building NameFlat/Villa No.Street/AreaNearest LandmarkEmirateP.O. BoxResidence TypeOwnedôLDs ƒeRentedEmployer providedá æŸG/ QÉ ûdGºbQ Ó«a/á TájÉæÑdG º SGójÈdG hóæ UIQÉeE’GIõ«‡ áeÓY ÜôbCGπª dG ÖMÉ U øe øes Dƒeo UÉN eøµ ùdG ƒf( Ñ fG ¿EG) Êɵe ºbQMakani Number (if applicable)ºgQódÉH ƒæ ùdG QÉéjE’G ᪫b ôcPCG Gk ôLCÉà ùe âæc GPEGIf rented, annual rent in AED(§ a øjóaGƒ d) *» UC’G ó ÑdG ‘ ºFGódG ¿Gƒæ dGPermanent address in home country* (for expatriates only)Flat/Villa No.Building NameStreet/AreaPin/ZIP CodeCityCountryá æŸG/ QÉ ûdGájÉæÑdG º SGºbQ Ó«a/á TádhódGáæjóŸG ójÈdG õeôdG(ô TÉÑŸG ‹hódG É üJ’G õeQ e) JÉ¡dG--Tel. (with IDD Codes)*πª dG ¿GƒæYOffice address*ácô ûdG º SGCompany Nameácô ûdG JÉg ºbQCompany Phone NumberBuilding Nameá æŸG/ QÉ ûdGStreet/AreaájÉæÑdG º SGIõ«‡ áeÓY ÜôbCGNearest LandmarkP.O. BoxIQÉeE’GEmirateójÈdG hóæ U*Ék ØXƒe âæc GPEGIf you are a salaried individual*áØ«XƒdG ªq ùeDesignationd dDate of Joiningm my yπª dÉH ÉëàdE’G ïjQÉJy yá«Ø«XƒdG àbÉ H ºbQStaff ID No.Departmentº ù dG HÉ ùdG πª dG ÖMÉ U º SGName of Previous EmployerNo. of Years with Previous EmployerMonthly SalaryMonthly Additional IncomeMonthly Deductions ô¡ ûdG ÖJGôdG HÉ ùdG πª dG ÖMÉ U e äGƒæ ùdG OóYájô¡ ûdG äÉeƒ üÿG ‹ÉªLEG‘É VE’G ô¡ ûdG πNódG* UÉÿG πª dG á SQɇ ádÉM ‘If you are self employed*Organisation NameNature of BusinessYears of Business in the UAEAnnual Gross IncomeAnnual Gross ExpensesAnnual Net Incomeáæ¡ŸG/πª dG á «ÑWá ù SDƒŸG º SG ƒæ ùdG πNódG ‹ÉªLEGäGQÉeE’G ádhO ‘ πª dG äGƒæ S OóY ƒæ ùdG πNódG ‘É Uájq ƒæ ùdG äÉ ØædG ‹ÉªLEGájQÉéàdG á üNôdG ºbQTrade License No.Issuance DateAÉ¡àf’G ïjQÉJExpiry DateQGó UE’G ïjQÉJ* ójÈdG ¿Gƒæ dGMailing address*Which P.O. Box would you like us to send your statement/correspondence to? « Y äÓ SGôŸG/ÜÉ ù G ûc É SQEG ܃ ŸG ójÈdG hóæ U ƒgÉeP.O. Boxº ù dGDepartmentójÈdG hóæ UIQÉeE’GEmirate*? QÉéàdG »ÑXƒHCG æH iód Ék HÉ ùM “ πgAre you an ADCB account holder?*Yes HÉ ùM ºbQ ÖàcG ,º æH áHÉLE’G ádÉM ‘»FÉ àdG aó d áÁóà ùe äɪ« J ôa ‘ ºµaô üe ‘ ÓYCG QƒcòŸG »HÉ ùM øe Ék jô¡ T »FÉ àdG º üÿG ºàjq ¿CG Oq hCGStanding instructions for auto paymentI would like to have my above mentioned account in your bank atbranch automatically debited each month towards my Card payment for the followingpercentage:5%OR% (in multiples of 5%)OR:á«JC’G áÑ ùædÉH »àbÉ H äÉeGõàdG OGó ùd ëà ùŸG ÑŸG ‹ÉªLEGTotal Amount DuehCG(áÄŸÉH 5 äÉØYÉ †e) %hCG%5(Ék jô¡ T) *ÜÉ ù G ûc QGó UEG ïjQÉJ QÉ«àNG LôjoPlease select your preferred billing date* (of each month)5thº f’NoIf yes, provide your Account No.ô TÉ dG10th(2) ùeÉÿG

, ƒÑ e ÜÉ ùM ûc πc øY ºgGQO 5 ÜÉ ùàMG ºà« S) *ÊhεdE’G ÜÉ ù G ûc ‘ GÎ T’G(É¡eÓà SEÉH ÖZôJ »àdG äÉHÉ ù G ƒ ûc GƒfCG óMCG QÉ«àNG LôojE-statement subscription* (paper statements are charged AED 5 per statement.Please select at least one mode)Do you wish to enroll for E-statements?YesNoDo you wish to receive paper statements?YesNo’’º fº f?ÊhεdE’G ÜÉ ù G ûc ‘ GÎ T’ÉH ÖZôJ πg? ƒÑ e »bQh ÜÉ ùM ûc ΩÓà SÉH ÖZôJ πgiôNC’G ¿ÉªàF’G äÉbÉ H äÉfÉ«HDetails of other credit cardsName of Issuing BankCredit Card NumberCredit LimitábÓ dG ïjQÉJ æÑdG eMember Since¿ÉªàF’G óq M¿ÉªàF’G ábÉ H ºbQQó üŸG æÑdG º SG1.-12.-23.-3iôNCG ƒæH e äÉbÓ dG/ábÓ dG äÉfÉ«HDetails of relationship(s) with other banksBank Loan/Finance Type ëà ùŸG ó« UôdG(ºgQódÉH)ájq ô¡ T É ùbCG(ºgQódÉH)πjƒªàdG/ Vô dG ƒf æÑdG º SG1.-12.-23.-3á«aÉ VE’G äÉbÉ ÑdG/ábÉ ÑdG äÉfÉ«HSupplementary applicant(s) card detailsMr.Mrs.á ùfB’GMs.Ió« isterOthersFirst NameMiddle NameáæHEGDaughterÜC’G¿hôNCGá FÉ dG º SGLast NameÜC’G º SGd dNationalityDate of BirthPassport NumberCredit Limit (in AED)Marriedm my yOÓ«ŸG ïjQÉJá« ùæ G(ºgQódÉH) ¿ÉªàF’G óMôØ ùdG RGƒL ºbQy yiôNCGOtherêhõàeÜõYCGá«YɪàL’G ádÉ G( àjɪM É¡æe Oƒ ü ŸG á«æeCG Iõ«e òg) (êGhõdG πÑb) ΩC’G º SGMother’s Maiden Name (This is a security feature for your protection)First Name hC’G º S’G.á«æ«J’ Ék aôM 19 übCG óëH .Aɪ SC’G ÚH IóMGh áaÉ ùe ôJCGLeave one space between names. Maximum of 19 characters.SingleêhõdGñCGá«eÓ SE’G áaÒ ü d QÉéàdG »ÑXƒHCG æH øe IQOÉ üdG á«aÉ VE’G ábÉ ÑdG ‘ ô¡¶j ¿CG ÖZôJ ɪc º S’GName as you would like it on your ADCB Islamic Banking CardMarital StatusΩC’GâNCGó« ùdGáHGô dG á UáLhõdGøHEGLast Nameá FÉ dG º SG(3) hC’G º S’G

Card fees» ùæ « ùcEGè« ØjôH OÉfôjÉÑ SCGºgQO 525Å T’Å T’ºgQO 1312 50Å T’Å T’Å T’ºgQO 1050ºgQO 630Å T’ºgQO 2625ºgQO 1050ºgQO 525Å T’3.25%ºgQO 1050ºgQO 315Å T’ºgQO 2625ºgQO 525ºgQO 262 50Å T’%3 25Up to 1.50%%1 50 àMLate Payment FeeAED 241.50Cash Advance Fee3.15% or AED 52.50 (whichever is higher)Islamic Credit Shield (Takaful)0.9345% of the total outstanding balanceºgQO 241 50(ÌcCG ɪ¡jCG) ºgQO 52 50 hCG %3 15 ëà ùŸG ó« UôdG ‹ÉªLEG øe %0 9345á eÉ ŸG Ñe ‹ÉªLEG øe %2 99(á eÉ e πc øY) ºgQO 5 25Annual Membership FeeAspirePrivilege ClubExcellencyTouchPoints Infinite CardAED 1,050AED 1,050AED 525AED 630AED 315NilTouchPoints Platinum Card (free for the first year)NilNilNilEtihad Infinite CardAED 2,625AED 2,625AED 1,312.50Etihad Signature CardAED 1,050AED 525NilEtihad Platinum CardAED 525AED 262.50NilSupplementary CardsNilNilNilTouchPoints Gold CardMonthly Profit RateBalance Transfer/Pay Order Facility/Instalment PlansForeign Currency Transaction MarginExchange House Payment Charge2.99% of the total transaction amountAED 5.25 (per transaction) àbÉ Ñd ájq ƒæ ùdG Ωƒ SôdGájƒæ ùdG ájƒ † dG Ωƒ SQâ«æ«ØfG ùàæjƒH ûJÉJ ábÉ H( dhC’G áæ ù d Ék fÉ›) á«æ«JÓÑdG ùàæjƒH ûJÉJ ábÉ Há«ÑgòdG ùàæjƒH ûJÉJ ábÉ Hâ«æ«ØfG OÉ–’G ábÉ Hô ûàæ « S OÉ–’G ábÉ Há«æ«JÓÑdG OÉ–’G ábÉ Há«aÉ VE’G äÉbÉ ÑdGáÑ ùàëŸG ájô¡ ûdG ìÉHQC’G/ aódG ôeGhCG äÓ«¡ ùJ/ó« UôdG πjƒ– É ùbCG Y aódG á NôNCÉàŸG aódG Ωƒ SQájó ædG áØ ùdG Ωƒ SQ» aɵàdG ÊɪàF’G QódG Ωƒ SQá«ÑæLC’G äÓª dÉH äÓeÉ ŸG ûeÉgáaGô üdG äÉcô T iód aódG Ωƒ SQ᪫ dG áÑjô V ÚfGƒ d Ék ÑW ôNB’ âbh øe Ò« à d á VÉÿG áÑ ùædG gh %5 áÑ ùæH áaÉ †ŸG ᪫ dG áÑjô V øª †àJ Ö dG Gòg ‘ IQƒcòŸG Ωƒ SôdG «ªLÊhεd’G bƒŸG Y QÉéàdG »ÑXƒHCG æH øe OGôaCÓd á«aô üŸG äÉeóÿG hô Th ΩɵMCG Y ÓW’G øµÁ .IóëàŸG á«Hô dG äGQÉeE’G ádhO ‘ áaÉ †ŸGAll Charges stated herein are inclusive of 5% VAT, which may be amended from time to time inaccordance with UAE VAT Law and ADCB Consumer Banking Terms and Conditions available onadcb.comadcb.com» ù«FôdG Ö dG Ωó e QGôbEGDeclaration by principal card applicantIn consideration of my application for the Abu Dhabi Commercial Bank Islamic Banking (referred to asADCB in this form) Covered Card(s), I hereby declare that all statements made by me in this applicationare true and correct to the best of my knowledge and authorise ADCB to make any and all creditinvestigations that are deemed appropriate. « Y jh) á«eÓ SE’G áaÒ üdG IôFGO -. .Ω. T QÉéàdG »ÑXƒHCG æH øe IÉ e äÉbÉ H/ábÉ H Y ƒ üë d Ö W Ëó àd Gk ô¶f æÑdG VƒaCG h »ª Y π †aCG Ö ùM á« « Mh áë«ë U Ö dG Gòg ‘ » Ñb øe áeó ŸG äÉfÉ«ÑdG áaÉc ¿CÉH ÑLƒÃ ó«aCG ,(” æÑdG” » j ɪ«a.áÑ SÉæe ÉgÈà j »àdG á«fɪàF’G äGQÉ ùØà S’G áaÉch øe CG πª HI understand that ADCB can decline this application without assigning any reason whatsoever and thatthe application and its supporting documents will become a part of ADCB’s records and will not bereturned to me. I authorise ADCB to issue Supplementary Card(s) for use on my account to theperson(s) named, who I undertake, is/are over 18 years of age and agree that the Bank may provideinformation to him/her about the account. I hereby agree to indemnify the Bank against any loss,damage, liability or costs incurred by the Bank on account of any breach by me or the SupplementaryCardholder(s) of the aforesaid condition or the Covered Card Terms and Conditions or the IslamicBanking Consumer Terms and Conditions or by any reason of any legal disability or incapacity of theSupplementary Cardholder(s).øe Gk AõL íÑ üJ ƒ S d áªYóŸG äGóæà ùŸGh Ö dG ¿CGh âfÉc ɪ¡e ÜÉÑ SCG CG AGóHEG ¿hO Ö dG Gòg †aQ æÑ d øµÁ fCG QOCG ÊEG UÉî TC’G/ ª SG QƒcòŸG üî ûdG dEG »HÉ ùM Y á«aÉ VEG äÉbÉ H/ábÉ H QGó UEÉH æÑdG VƒaCGh .‹ É¡JOÉYEG ºàj ødh æÑdG äÓé SA’Dƒg dEG »HÉ ùM øY äÉeƒ e Ëó J æÑ d Rƒéj fCG Y aGhCGh .ô ûY áæeÉãdG ø S Ghó J ób º¡fCÉH ó¡ JCG øjòdGh º¡Fɪ SCG IQƒcòŸG CG ÖÑ ùH æÑdG Égóѵàj «dɵJ hCG äÉeGõàdG hCG QGô VCG hCG ôFÉ ùN CG øY æÑdG †jƒ J Y ÑLƒÃ aGhCGh .º¡æe CG hCG UÉî TC’GábÉ ÑdG hô Th ΩɵMC’ hCG ôcòdG fB’G ô û d á«aÉ VE’G äÉbÉ ÑdG á ªM/á«aÉ VE’ G ábÉ ÑdG πeÉM ÖfÉL øe hCG »ÑfÉL øe áØdÉflá« gCG ΩóY hCG õéY CG øY œÉf ÖÑ S C’ hCG á«eÓ SE’G áaÒ üdG e 𫪠dG äÓeÉ Jh ábÓY ºµ– »àdG hô ûdGh ΩɵMC’G hCG IÉ ŸG.á«aÉ VE’ G äÉbÉ ÑdG á ªM/á«aÉ VE’G ábÉ ÑdG πeÉ á«fƒfÉbThe Covered Card Terms and Conditions and the Islamic Banking Consumer Terms and Conditionsand the Service and Price Guide will be made available to me in any form including but not limited toin either printed or digital form along with the Covered Card(s) and my activation of the card(s)confirms that I have received, read and agreed to the conditions mentioned therein. I further agree thatthe contents of the Covered Card Terms and Conditions, the Islamic Banking Consumer Terms andConditions and the Service and Price Guide including amendments, which ADCB may make from timeto time, will be binding upon me. I also understand that ADCB can change the fees and chargeswithout giving me any notice.äÉeóÿG hóLh á«eÓ SE’G áaÒ üdG e 𫪠dG äÓeÉ Jh ábÓY ºµ– »àdG hô ûdGh ΩɵMC’Gh IÉ ŸG ábÉ ÑdG hô Th ΩɵMCGá « üH hCG á«bQh áî ùf ‘ ÉeEG ,ô ü G ’ ÉãŸG π«Ñ S Y , dP ‘ ÉÃ á « U hCG πµ T CÉH É¡« Y ÓWEÓd ‹ áMÉàe ¿ƒµJ ƒ S Ωƒ SôdGh J ‘ IQƒcòŸG hô ûdG Y â aGhh â WGh ⪠à SG ób »æfCG äÉbÉ ÑdG/ábÉ Ñ d » « ØJ ócDƒjh .IÉ ŸG äÉbÉ ÑdG/ábÉ ÑdG e ᫪bQ𫪠dG äÓeÉ Jh ábÓY ºµ– »àdG hô ûdGh ΩɵMC’G ,IÉ ŸG ábÉ ÑdG hô Th ΩɵMCG äÉjƒàfi ¿CG Y aGhCG ɪc . hô ûdGh ΩɵMC’G.‹ áeõ e ¿ƒµJ ƒ S ôNBG dEG âbh øe æÑdG É¡ Nój ób »àdG äÓjó àdG dP ‘ Éà Ωƒ SôdGh äÉeóÿG hóLh á«eÓ SE’G áaÒ üdG e.‹ QÉ TEG CG «LƒJ ¿hO QƒLC’Gh Ωƒ SôdG Ò« J æÑ d Rƒéj fCG Ék †jCG QOCGhΩɵMC’ G dEG †îj ÜÉ ù G Gòg ¿CGh »ª SEÉH QÉL ÜÉ ùM íàØj ƒ S ,Ö dG Gòg Y á aGƒŸG óæY , æÑdG ¿CG ÑLƒÃ ôbCGh aGhCG.á«aô üŸG äÉHÉ ù G π« ûJh íàa Uƒ üîH æÑdG πÑb øe IQô ŸG hô ûdGhI hereby agree and acknowledge that ADCB will open a current account on approval of thisapplication. Such current account shall be governed by the terms and conditions prescribed by ADCBin relation to opening and operations of bank accounts.OóëŸG ÊɪàF’G ó G hÉ ùj Ñà ÓYCG «dEG QÉ ûŸG ÜÉ ù G Y ܃ë ùe ñQDƒe ÒZ « ûH æÑdG IÉaGƒÃ ó¡ JCG ɪc dÉÑŸG äÉ aO OGó S ‘ »ÑfÉL øe ÉØNEG hCG ÓNEG CG OƒLh ádÉM ‘h .»H á UÉÿG QÉéàdG »ÑXƒHCG æH øe IÉ ŸG äÉbÉ ÑdÉH/ábÉ Ñ døµj ¿EG ,QƒcòŸG « ûdG ïjQCÉàH æÑdG ÑLƒÃ VƒaCG ,(á«aÉ VE’G äÉbÉ ÑdG áaÉc dP ‘ ÉÃ) »H UÉÿG ábÉ ÑdG ÜÉ ùM ‘ á ëà ùŸG. aó d Áó Jh ó H îjQCÉJ ” óbI further undertake to provide ADCB an undated cheque drawn on the above referred current account,for an amount equivalent to the limit assigned on my ADCB Covered Card(s). In the event of a defaultor failure by me to effect payments of the outstanding amount under my Card Account (including allSupplementary Cards), I hereby authorise ADCB to insert the date on the said cheque, if undated andpresent it for payment.áãdÉãdG GôWC’G øe äÉeóN Ohõe øY áHÉ«ædÉH äÉ †«ØîàdGh ÉjGõŸGh ƒ G † H Vô H ôNBG dEG âbh øe Ωƒ j ƒ S æÑdG ¿CÉH ôbCGΩGóîà S’G hô Th ΩɵMCÉH ΩGõàd’G Ö àj æÑdG ÓN øe á Vhô ŸG äÉ †«ØîàdGh ÉjGõŸGh ƒ G ΩGóîà SG ¿CG Y ÑLƒÃ aGhCGh.iôNC’G dÉÑŸGh Ωƒ SôdGh QƒLC’G aO dP ‘ Éà æÑdG hCG/h áãdÉãdG GôWC’G øe áeóÿG Ohõe πÑb øe IOóëŸGCardholder acknowledges that the Bank shall from time to time offer to the Cardholder certain rights,benefits and discounts on behalf of third party service providers. Cardholder hereby agrees that use ofthe rights, benefits and discounts offered via the Bank shall require compliance with the terms of usespecified by the third party service provider and/or the Bank, including payment of fees, charges andother amounts.ä’Éch/ádÉch hCG ¿ÉªàFG Öàµe CG dEG áHƒ e á« üî T äÉfÉ«H CG hCG/h »ª SG ádÉMEG æÑ d Rƒéj fCG aGhCGh ôbCGh ⪡ah äCGôb ó d.Ék Ñ SÉæe æÑdG Èà j ÉªÑ ùM äGQÉ ùØà S’G J πªY hCG/h á« LôeI have read, understood, acknowledge and agree that the Bank may refer my name and/or anypersonal data required to any credit bureau or reference agency/agencies and/or make suchreferences and enquiries as the Bank may consider necessary.Gòg Ö dG êPƒ‰ ‘ É¡ « UÉØJ IQƒcòŸG áëHGôŸG SÉ SCG Y æÑdG øe ùdG AGô ûH óæà ùŸG Gòg ÖLƒÃ 𫪠dG ó jThe customer hereby promises to purchase the Commodities from the Bank on a Murabaha basis asper the details mentioned in this application form.SignatureDate d dm my yïjQÉàdGy y§ a æÑdG ΩGóîà SE’For Bank Use OnlyCIF No.𫪠dG «bƒJ e ºbQ𫪠dG äÉeƒ e ôØdG õeQBranch CodePromo Code11»éjhÎdG õeôdGPromo Code33»éjhÎdG õeôdG(4)CIDSource CodePromo Code2𫪠dG jô J ºbQQó üŸG õeQ2»éjhÎdG õeôdG

Card feesAnnual Membership FeeAspireOn-Sale Agency AgreementAED 1,050TouchPoints Infinite CardTouchPoints Platinum Card (free for the first year)AED 630Privilege ClubExcellencyAED 1,050AED 525AED 315Nil» ùæ « ùcEGNil its sellingNilagent inhereby appointsNilthe Bank asAED 1,312.50AED 2,6252,625Etihad connectionInfinite Cardwith the sale ofAEDRelevantCommoditiesthat theNilAED525AED 1,050Etihad CustomerSignature Card may have purchasedfrom the Bank on a MurabahaNilAED 262.50AED 525Etihad Platinum Cardbasis under a Murabaha Contractsubjectto the rightsandNilNilNilSupplementary Cardsobligations set out in the Bank’s Covered Card Terms and3.25%Monthly Profit RateConditions and the Islamic Banking Consumer Terms andBalance Transfer/Pay Order Facility/Up to 1.50%Conditionsare available at ereby accepts its appointment asAgent.AEDInvestment241.50Late Payment3.15% or AED 52.50 (whichever is higher)Islamic Credit Shield (Takaful)0.9345% of the total outstanding balanceForeign Currency Transaction MarginExchange House Payment ChargeôjÉÑ SCG àbÉ Ñd ájq ƒæ ùdG Ωƒ SôdGájƒæ ùdG ájƒ † dG Ωƒ SQ عقد وكالة بيع â«æ«ØfG ùàæjƒH ûJÉJ ábÉ HºgQO 1050ºgQO 525ºgQO 1050( dhC’G áæ ù d Ék fÉ›) á«æ«JÓÑdG ùàæjƒH ûJÉJ ábÉ HºgQO 630Å T’ºgQO 315 ùàæjƒH ûJÉJ ábÉ HÅ T’ البنك ب صفة وكيل بيع له ل á«ÑgòdGÅ T’ التي قد يكون Å T’ العميل أغرا ض بيع ال سلع املعنية مبوجبه العميل يعني â«æ«ØfG OÉ–’G2625 ب شرائها من البنك على أ سا س املرابحة ºgQO 1312 50 احلقوق ºgQO2625 مرابحة ºgQO وااللتزامات مبوجب بعقد قام ábÉ H قد ô ûàæ « SábÉ HºgQO لدى 1050 أحكام وال شروط للبطاقة املغطاة 525 البنك وال حتكم Å T’ وال شروط التي ºgQO أحكام يف ال OÉ–’G املذكورة á«æ«JÓÑdG OÉ–’G ábÉ HºgQO 525Å T’ºgQO 262 50 وميكن االطالع على الأحكام وال شروط على ، عالقة وتعامالت العميل مع ال صريفة الإ سالمية á«aÉ VE’G äÉbÉ ÑdGÅ T’Å T’. ب صفة وكيل بيع مبوجبه تعيينه Å T’ ويقبل البنك .adcbislamic.com/covered%3 25áÑ ùàëŸG ájô¡ ûdG ìÉHQC’G/ aódG ôeGhCG äÓ«¡ ùJ/ó« UôdG πjƒ–%1 50 àM É ùbCG Y aódG á NºgQO 241 50ôNCÉàŸG aódG Ωƒ SQ(ÌcCG ɪ¡jCG) ºgQO 52 50 hCG %3 15ájó ædG áØ ùdG Ωƒ SQ ëà ùŸG ó« UôdG ‹ÉªLEG øe %0 9345» aɵàdG ÊɪàF’G QódG Ωƒ SQá eÉ ŸG Ñe ‹ÉªLEG øe %2 99á«ÑæLC’G äÓª dÉH äÓeÉ ŸG ûeÉg(á eÉ e πc øY) ºgQO 5 25áaGô üdG äÉcô T iód aódG Ωƒ SQTouchPointsCardTheGoldCustomerCash Advance Feeè« ØjôH OÉf2.99% of the total transaction amountAED 5.25 (per transaction).᪫ dG áÑjô V ÚfGƒ d Ék ÑW ôNB’ âbh øe Ò« à d á VÉÿG áÑ ùædG gh %5 áÑ ùæH áaÉ †ŸG ᪫ dG áÑjô V øª †àJ Ö dG Gòg ‘ IQƒcòŸG Ωƒ SôdG «ªLÊhεd’G bƒŸG Y QÉéàdG »ÑXƒHCG æH øe OGôaCÓd á«aô üŸG äÉeóÿG hô Th ΩɵMCG Y ÓW’G øµÁ .IóëàŸG á«Hô dG äGQÉeE’G ádhO ‘ áaÉ †ŸGAll Charges stated herein are inclusive of 5% VAT, which may be amended from time to time inaccordance with UAE VAT Law and ADCB Consumer Banking Terms and Conditions available onadcb.com العميل adcb.comCustomer» ù«FôdG Ö dG Ωó e QGôbEGDeclaration by principal card applicantIn consideration of my application for the Abu Dhabi Commercial Bank Islamic Banking (referred to asADCB in this form) Covered Card(s), I hereby declare that all statements made by me in this applicationare true and correct to the best of my knowledge and authorise ADCB to make any and all creditinvestigationsthat are deemed appropriate. « Y

ADCB in this form) Covered Card(s), I hereby declare that all statements made by me in this application are true and correct to the best of my knowledge and authorise ADCB to make any and all credit investigations that are deemed appropriate. I understand that ADCB can decline this app