ID ( CARD

NUMBER)

CATEGOREY

FirstName

SecondName

FamilyName

Ahmad
Mahinaz
Nour
Maya
Mohammad
Nasir

Mohammad
Mustafa
Ahmad
Ahmad
Ahmad
Akram

Machmouchi
Hamdoun
Machmouchi
Machmouchi
Machmouchi
Khan

Gender

BirthDate

MaritalStatus

Nationality

[Male,Female] *

DD/MM/YYYY *

See the lookup

[Single,Married,D
sheet and enter
ivorcee,Widow] *
Fullname *

[Principle,Spouse,Child
,Parent,Other] *

Male
Female
Female
Female
Male
Male

10/09/1973
09/08/1982
07/02/2005
14/08/2007
11/09/2008
01/01/1966

Married
Married
Single
Single
Single
Married

Principle
spouse
Child
Child
Child
Employee

Lebanese
Lebanese
Lebanese
Lebanese
Lebanese
Pakistan

Relation

RelationTo

EmiratesIDNumber

UIDNumber

PassportNumber

[ID/NAME of the
principal member] *

Eg: 999-9999-9999999-9 * (if

under process please provide
application number )

*(if under
process please
provide
application
number )

[If not available,

the National ID]
*

784-1973-6832875-9

Employee

Employee

784-1982-5724875-1
784-2005-5174872-4
784-2007-4639651-2
784-2008-0680708-5
784-1966-8138542-1

RL
RL
RL
RL
RL

3259477
0067887
3259479
2379284
3259478

ContactNumber

Email

Emirate of visa
issuance

Emirate of
Residence

See the Emirates

in lookup sheet
for possible
values. *

506446938 amachmouchi@saudibuilding.org
Dubai
Sharjah

Residential
Location (within
the emirate)

See the locations

sheet *

Sharjah

EMIRATES OF
WORK

WorkLocation
(within the
emirate)

Salary

See the
SalaryBand in
See the locations
lookup sheet for
sheet *
possible values.
*

Dubai

Dubai

Commission

Inception Date

[Yes,No] *

DD/MM/YYYY *

9600 No

Expiry Date

Gross Premium

Actual Premium

Group/ Individial Policy Holder

DD/MM/YYYY *

[Group,
Individual] *

CURRENTLY
CURRENT VISA
INSURED YES/NO ISSUANCE DATE

Entity Type

Entity ID (Trade
License No)

[Resident,
Citizen,
Establishment,
*
Property Owner]
*

Policy Contact
Number

Policy Email

Policy Number

Policy Name

New/ Renewal

Treaty Type

[New, Renewal] *

[Reinsurance,
TPA] *

Business Type

Top up policy

Product Origin

Product Code

Product ID

[Direct,
Facilitator,
Broker] *

[Top up Policy,
Main Policy] *

Policy ID

DHA Nationalities

Emirates

Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad

Dubai
Abu Dhabi
Ajman
Fujairah
Ras Al Khaimah
Sharjah
Umm Al Quwain
UAE national
Dubai national
GCC national
Diplomat

Channel Islands
Chile
China
China, Hong Kong Special Administrative Region
China, Macao Special Administrative Region
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic People's Republic of Korea
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faeroe Islands
Falkland Islands (Malvinas)
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada

Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See
Honduras
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands

Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Republic of Korea
Republic of Moldova
Reunion
Romania
Russian Federation
Rwanda

Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Sark
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Sudan
Spain
Sri Lanka
State of Palestine
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Tajikistan
Thailand
The former Yugoslav Republic of Macedonia
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan

Turks and Caicos Islands

Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United Republic of Tanzania
United States of America
United States Virgin Islands
Uruguay
Uzbekistan
Vanuatu
Venezuela (Bolivarian Republic of)
Viet Nam
Wallis and Futuna Islands
Western Sahara
Yemen
Zambia
Zimbabwe

SalaryBand
Less than 4000 AED/month
Between 4001 AED and 12000 AED/month
More than 12000 AED/month
No salary

GenderLookup
Male
Female

MaritalStatus

Relation

Commission

Group/
Individial

New/
Renewal

Treaty Type

Single
Married
Divorcee
Widow

Principle

Yes

Group

New

Reinsurance

Spouse
Child
Parent
Other

No

Individual Renewal

TPA

Business
Type

Top up policy

Entity Type

Direct

Top up Policy

Resident

Facilitator
Broker

Main Policy

Citizen
Establishment
Property Owner

Dubai
NAKHLAT DEIRA
AL CORNICHE
AL RAS
AL DAGHAYA
AL BUTEEN
AL SABKHA
AYAL NASIR
AL MURAR
NAIF
AL RIGGA
CORNICHE DEIRA
AL BARAHA
AL MUTEENA
AL MURAQQABAT
RIGGAT AL BUTEEN
ABU HAIL
HOR AL ANZ
AL KHABAISI
PORT SAEED
AL HAMRIYA PORT
AL WUHEIDA
HOR AL ANZ EAST
AL MAMZAR
NADD SHAMMA
AL GARHOUD
UMM RAMOOL
AL RASHIDIYA
DUBAI INT'L AIRPORT
AL TWAR FIRST
AL TWAR SECOND
AL TWAR THIRD
AL NAHDA FIRST
AL QUSAIS FIRST
AL QUSAIS SECOND
AL QUSAIS THIRD
AL NAHDA SECOND
AL QUSAIS IND. FIRST
AL QUSAIS IND. SECOND
MUHAISANAH THIRD
MUHAISANAH FOURTH
AL QUSAIS IND. THIRD
AL QUSAIS IND. FOURTH
AL QUSAIS IND. FIFTH
MIRDIF

Abu Dhabi
ABU AL ABYAD
ABU DHABI
AL AIN
AL KHATIM
AL KHAZNAH
AL MAFRAQ
AL MAFRQ
AL MARFA
AL MUSAFAH
AL RAHBA
AL RUWAIS
BANIYAS
BIDA ZAYED
DELMA
GHIYATHI
LIWA
LIWA OASIS
MUSAFAH
SHAHAMA
SILA
WESTERN

Ajman
AJMAN

MUSHRAIF
MUHAISNAH FIRST
AL MIZHAR FIRST
AL MIZHAR SECOND
MUHAISANAH SECOND
OUD AL MUTEENA FIRST
OUD AL MUTEENA SECOND
MUHAISANAH FIFTH
OUD AL MUTEENA THIRD
WADI ALAMARDI
AL KHWANEEJ FIRST
AL KHWANEEJ SECOND
ALEYAS
AL TTAY
World Island
JUMEIRA ISLAND ONE
AL SHINDAGHA
AL SOUQ AL KABEER
AL HAMRIYA
UMM HURAIR FIRST
UMM HURAIR SECOND
AL RAFFA
MANKHOOL
AL KARAMA
OUD METHA
MADINAT DUBAI AL MELAHEYAH
AL HUDAIBA
AL JAFILIYA
AL KIFAF
ZA'ABEEL FIRST
AL JADAF
JUMEIRA FIRST
AL BADA'A
AL SATWA
TRADE CENTER FIRST
TRADE CENTER SECOND
ZA'ABEEL SECOND
JUMEIRA SECOND
AL WASL
BURJ KHALIFA
BUISNESS BAY
AL MERKADH
JUMEIRA THIRD
AL SAFA FIRST
AL QOUZ FIRST

AL QOUZ SECOND
UMM SUQEIM FIRST
AL SAFA SECOND
AL QOUZ THIRD
AL QOUZ FOURTH
UMM SUQEIM SECOND
AL MANARA
AL QOUZE IND.FIRST
AL QOUZE IND.SECOND
UMM SUQEIM THIRD
UMM AL SHEIF
AL QOUZE IND.THIRD
AL QOUZE IND.FOURTH
AL SAFOUH FIRST
AL BARSHA FIRST
AL BARSHA THIRD
AL BARSHA SECOND
NAKHLAT JUMEIRA
AL SAFOUH SECOND
AL THANYAH FIRST
AL THANYAH SECOND
AL THANYAH THIRD
MARSA DUBAI
AL THANYAH FIFTH
AL THANYAH FOURTH
AL KHEERAN
RAS AL KHOR
AL KHAIRAN FIRST
AL KHAIRAN SECOND
NADD AL HAMAR
AL WARQA'A FIRST
AL WARQA'A SECOND
AL WARQA'A THIRD
AL WARQA'A FOURTH
AL WARQA'A FIFTH
WADI ALSHABAK
NAKHLAT JABAL ALI
AL WAJEHAH AL BHARIYAH
HESSYAN FIRST
HESSYAN SECOND
SAIH SHUAIB 1
JABAL ALI INDUSTRIAL THIRD
JABAL ALI INDUSTRIAL SECOND
MADINAT AL MATAAR
SAIH SHUAIB 2

SAIH SHUAIB 3
SAIH SHUAIB 4
JABAL ALI FIRST
JABAL ALI SECOND
JABAL ALI THIRD
MENA JABAL ALI
DUBAI INVESTMENT PARK SECOND
DUBAI INVESTMENT PARK FIRST
JABAL ALI INDUSTRIAL FIRST
BU KADRA
RAS AL KHOR IND. FIRST
RAS AL KHOR IND. SECOND
RAS AL KHOR IND. THIRD
NADD AL SHIBA SECOND
NADD AL SHIBA THIRD
NADD AL SHIBA FOURTH
NADD AL SHIBA FIRST
WARSAN FIRST
WARSAN SECOND
WARSAN FOURTH
NADD HESSA
HADAEQ SHEIKH MOHAMMED BIN RASHID
WADI AL SAFA 2
WADI AL SAFA 3
WADI AL SAFA 4
WADI AL SAFA 5
WADI AL ASAFA 6
WADI AL ASAFA 7
AL BARSHA SOUTH FIRST
AL BARSHA SOUTH SECOND
AL BARSHA SOUTH THIRD
AL HEBIAH FIRST
AL HEBIAH SECOND
AL HEBIAH THIRD
AL BARSHA SOUTH FOURTH
AL HEBIAH FOURTH
AL HEBIAH FIFTH
AL BARSHA SOUTH FIFTH
ME'AISEM FIRST
ME'AISEM SECOND
AL AWIR FIRST
AL AWIR SECOND
ENKHALI
AL WOHOOSH
LEHBAB FIRST

AL MERYAL
NAZWAH
WARSAN THIRD
AL ROWAIYAH FIRST
AL ROWAIYAH SECOND
AL ROWAIYAH THIRD
MEREIYEEL
UMM AL DAMAN
LE HEMAIRA
LEHBAB SECOND
UMM AL MO'MENEEN
MARGHAM
AL MAHA
UMM ESELAY
REMAH
MARGAB
YARAAH
HATTA
UMM NAHAD FIRST
UMM NAHAD SECOND
UMM NAHAD THIRD
UMM NAHAD FOURTH
AL YUFRAH 1
AL YUFRAH 2
AL MARMOOM
AL YALAYIS 1
AL YALAYIS 2
AL YALAYIS 3
AL YALAYIS 4
AL YALAYIS 5
AL LESAILY
GRAYTEESAH
AL FAGAA'
SAIH AL SALAM
AL HATHMAH
AL SELAL
GHADEER BARASHY
SAIH AL DAHAL
AL O'SHOOSH
SAIH SHUA'ALAH
MUGATRAH
AL LAYAN 1
AL LAYAN 2
HEFAIR

Fujairah
FUJAIRAH

Ras Al Khaimah
RAS AL KHAIMAH

Sharjah
KHAWR FAKKAN
SHARJAH

Umm Al Quwain
UMM AL QUWAIN