RESET FORM PRINT

RETAIL SERVICES ‫ﺧﺪﻣﺎت اﻷﻓـ ـﺮاد‬

CUSTOMER REQUEST FOR CARD SERVICES ‫ﻃﻠﺐ ﺧﺪﻣﺎت ﻟﻠﺒﻄﺎﻗﺔ‬
CUSTOMER DETAILS ‫ﺑﻴﺎﻧﺎت اﻟﻌﻤﻴﻞ‬
Customer Name ‫اﺳﻢ اﻟﻌﻤﻴﻞ‬

Account # ‫رﻗﻢ اﻟﺤﺴﺎب‬

Card # ‫رﻗﻢ اﻟﺒﻄﺎﻗﺔ‬

Contact # ‫رﻗﻢ اﻹﺗﺼﺎل‬

REQUIRED SERVICE ‫اﻟﺨﺪﻣﺔ اﻟﻤﻄﻠﻮﺑــــﺔ‬

Card Type ‫ﻧﻮع اﻟﺒﻄﺎﻗﺔ‬
‫إﻟﻐﺎء اﻟﺒﻄﺎﻗﺔ‬ ‫إﺻﺪار ﺑﻄﺎﻗﺔ ﺻﺮاف آﻟﻲ ﺟﺪﻳﺪة ﺑﺎﻹﺳﻢ اﻟﺘﺎﻟﻲ‬
Card Cancellation Issue New Debit Card with the following name
Reason
‫ﺗﺠﺪﻳﺪ اﻟﺒﻄﺎﻗﺔ ﺑﺎﻹﺳﻢ اﻟﺘﺎﻟﻲ‬ ‫إﺳﺘﺒﺪال اﻟﺒﻄﺎﻗﺔ ﺑﺎﻹﺳﻢ اﻟﺘﺎﻟﻲ‬
Card Renew with the following name Card Replacement with the following name

‫اﻟﺴﻤﺎح ﺑﺎﺳﺘﺨﺪام اﻟﺮﻗﻢ اﻟﺴﺮي ﻣﺮه أﺧﺮى‬ ‫إﺻﺪار رﻗﻢ ﺳﺮي ﺟﺪﻳﺪ ﻟﻠﺒﻄﺎﻗﺔ‬
PIN Reset PIN Reissue
‫رﺑﻂ ﺑﻄﺎﻗﺔ اﻟﺼﺮاف اﻵﻟﻲ ﺑﺎﻟﺤﺴﺎﺑﺎت‬ ‫ﺗﻐﻴﻴﺮ ﺣﺴﺎب اﻟﺴﺪاد ﻟﺒﻄﺎﻗﺔ اﻹﺋﺘﻤﺎن‬
Link the Debit card with Suffixes Change Settlement Account
Primary Suffix Secondary Suffix From To
‫ﺗﺮﻗﻴﺔ ﻧﻮع ﺑﻄﺎﻗﺔ اﻹﺋﺘﻤﺎن‬ ‫زﻳﺎدة داﺋﻤﺔ ﻟﻠﺤﺪ اﻹﺋﺘﻤﺎﻧﻲ ﻟ ﺒﻄﺎﻗﺔ اﻹﺋﺘﻤﺎن‬
Upgrade Credit Card Type Increase Credit Card Limit
From To From To
‫زﻳﺎدة ﻣﺆﻗﺘﺔ ﻟﻠﺤﺪ اﻹﺋﺘﻤﺎﻧﻲ ﻟﺒﻄﺎﻗﺔ اﻹﺋﺘﻤﺎن‬ ‫ﺗﻘﻠﻴﺺ اﻟ ﺤﺪ اﻹﺋﺘﻤﺎﻧﻲ ﻟﺒﻄﺎﻗﺔ اﻹﺋﺘﻤﺎن‬
Temporary Limit Increase for Credit Card Decrease Credit Card Limit
From To Duration From To
‫ﺗﻐﻴﻴﺮ ﻧﺴﺒﺔ اﻟﺴﺪاد اﻟﺸﻬﺮي ﻟﺒﻄﺎﻗﺔ اﻹﺋﺘﻤﺎن‬ ‫إﺿﺎﻓﺔ رﻗﻢ ﻋﻀﻮﻳﺔ اﻟﻘﻄﺮﻳﺔ ﻟﺒﻄﺎﻗﺔ اﻹﺋﺘﻤﺎن‬
Change Repayment Option of the Credit Card Add Qatar Airways Membership Number
From % To %
CUSTOMER DATA UPDATE ‫ﺗﺤﺪﻳﺚ ﺑﻴﺎﻧﺎت اﻟﻌﻤﻴﻞ‬

REMARKS OR OTHER SERVICES ‫ﻣﻼﺣﻈــــــﺎت أو ﺧﺪﻣــــــﺎت أﺧـــﺮى‬

Deliver to ‫ﻳﺴﻠﻢ إﻟﻰ‬

CLIENT AGREEMENT ‫ﻣﻮاﻓﻘﺔ اﻟﻌﻤﻴﻞ‬

‫اﻟﺮﺳﻮم‬ ‫ﺗﺎرﻳﺦ اﻟﻄﻠﺐ‬ ‫ﻣﺼﺎدﻗﺔ اﻟﺘﻮﻗﻴﻊ‬ ‫ﺗﻮﻗﻴﻊ اﻟﻌﻤﻴﻞ‬
‫أﻓﻮض ﻣﺼﺮف اﻟﺮﻳﺎن ﺑﺨﺼﻢ رﺳﻮم‬
Fees Request Date S.V Customer Signature
‫اﻟﺨﺪﻣﺔ ﻣﻦ ﺣﺴﺎﺑﻲ إن وﺟﺪ‬
I authorize MASRAF AL RAYAN to Debit
from my Account the Service Fees if any

FOR MASRAF USE ONLY ‫ﻹﺳﺘﺨﺪام اﻟﻤﺼﺮف‬

Staff ID # Signature ‫ﻣﺪﻳﺮ اﻟﻔﺮع أو ﻧﺎﺋﺒﻪ‬ Staff ID # Signature ‫ﻣﻮﻇﻒ ﺧﺪﻣﺔ اﻟﻌﻤﻼء‬
Branch Mgr / Asst Mgr CSR
Staff ID # Signature ‫دﹸﻗــﻖ اﻟﻄﻠــــﺐ‬ Staff ID # Signature ‫ﻗﺴﻢ اﻟﺒﻄﺎﻗﺎت‬
Application Checked Card Centre
P O BOX: 28888 DOHA, QATAR TEL: +974 4425 3333 FAX: +974 4423 5819 www.alrayan.com