[Please print on company letterhead]

To: Manager / Team Leader, Date: DD/MM/YYYY_

Payroll Department, DOZ B1F2,
Mashreqbank psc,
Dubai Outsource Zone, Dubai (“Bank”).

Dear Sir,
Re:- Debit Authority Letter for Salary Payment Services - WPS

We, , [Please insert employer’s name]

(“Customer”) hereby request that the Bank debit the Customer’s account, details of which are given below for the Total File
Amount and transfer the Total File Amount, representing the wages of the Customer’s employees, to the employees’
respective accounts maintained with the financial entities as per the Customer’s instructions (“Request”) through the WPS
system.

The account details are as follows:

Customer Account No Total File Amount

SIF File Name
Value Date (Not before) No of employees Customer MOL ID
In case of any communication / clarification on this Request, please contact the following persons as per their details.

Name
Telephone # Mobile # Mobile #
E-mail Add

I/We, hereby confirm that we have, read the Mashreq Salary Payment Services Banking Services Terms and Conditions
(“Terms and Conditions”) and/or signed the Mashreq Salary Payment Services Banking Services Agreement
(“Agreement”). By our signature on this Debit Authority, we, on behalf of the Customer, hereby confirm our acceptance of
the provisions in the Terms and Conditions and/or Agreement and agree to abide by it.

I / We, the undersigned further confirm that we have been duly authorised by the Customer to issue this Debit Authority and
to confirm our acceptance of the Terms and Conditions and/or Agreement. I/We request the Bank to proceed with the
Request.

Regards,

For and on behalf of

Customer’s name and stamp:

Sign: Sign:
Name: Name:
Designation: Designation:
(Authorised signatures should be as per account operation rights)

Attachments
1. SIF file in non-rewriteable CD
2. Print-out of the SIF File with company stamp and signature.