Registration & Licensing Application form

Form No.: BR/1

1/ . :
( )
License No.

Legal Form

Invested Capital (in Dhs.)

Registration Cancellation

Registration Amendment

New Registration

Changing Activity

Assignment of License

Changing Trade/Co. Name

Withdrawal of Partner

Adding Partner

Changing Legal Form

Changing/ Appointment Agent

Changing Bus Site

Adding Activity

Canceling Activity

Merging companies

/
Devolution of License Reduce/increase the capital

Death/Inc.of Heirs

/
Changing/Appoint. Mgr

Others

Stoping activity/ establishment/ company

Mortgage of shares/ establishment/company

Add activity in the log

Required Activity:

/
Signature

/
File No. Nationality Name Sr. 1 2 3 4 5 6 7 8

/ / / / / / / / / / @ *Owner/Partner/Agent/Manager/Transferor/Seller/Buyer/Heirs' Representative/Mortagager/Mortagagee. . /

I / We, the undersigned acknowledge and undertake that all the information contained herein and all the documents submitted are true and correct. Ofcial Use

Fax:

Tel:

Mob:

Details E-mail:
Area No: Street No: Flat No: Plot No: Annual Rent:

of Business Site Location (State Plot. No.) P.O.Box:

Area: Street: Building No: Landlord: Contract expiry Date:

Type of Site:

Kiosk

Ofce

Shop\Exhibition

Warehouse

E-mail:

Fax: P.O.Box:

Tel:

Mob:

We undertake to strictly comply with the conditions and requirements of the Civil Defence attached to the activity to be carried on. In case of noncompliance by us, the Civil Defence shall have the right to take all legal actions required. We declare that we possess on warehouse for this license. In case of Leasing one, we shall inform the Civil Defence in order to take necessary actions. A minimum ne of DHS. 500 will be charged for any false information submitted.

500

Ofcial Use
Planning Dept.: Compliance Dept.: Others:

Remarks:
Applicant is required to obtain the approval of the planning Dept. before leasing ofce/shop Applicant is required to complete all procedures before carrying on the activities. Validity of initial approval is 6 months.

PRO information:
PRO Name: License No.: Signature: Stamp: