Second Party
Provider Name (English)
*
Provider Name (Arabic)
*
Authorised Signatory (English)
*
Authorised Signatory (Arabic)
*
Located (Emirates)*
Telephone/Mobile No
*
Email ID
*
Regulatory ID
*
Fax Number
Account Details
IBAN *
Bank Name
*
Swift Code
Branch
Address
Notices/Communications
Provider Name
*
Contact Person
*
Provider Address
*
For and on behalf of Provider
Authorized Representative
*
Document Upload
| Document Name | Upload |
|---|---|
| Trade License | |
| Facility License | |
| POA | |
| Emirates ID of POA | |
| Passport copy of the POA |
