Enrollment Form

Title of Participant:
Employee No (as per company Record): Employee Category/Plan:

Date of Joining The Company: D D - M M - Y Y Y Y Date of Confirmation: D D - M M - Y Y Y Y

Name of Employee:
Date of Birth: D D - M M - Y Y Y Y Sex: Male Female Marital Status: Married Single

CNIC Designation
Residential Address
Residential Tel No: Office No Mobile No

Name of Spouse:
Date of Birth: D D - M M - Y Y Y Y CNIC Number: Occupation:
Title of Organization: Designation:

Exact Daily Duties:

Residential Tel No: Office No Mobil`e No

Name of Children Sex` Date of Birth CNIC Occupation

Date of Statement: Employee’s Signature Employer Signature

Version: August 2020

PAK-QATAR FAMILY TAKAFUL LIMITED

102-105, Business Arcade, Block-6, P.E.C.H.S, Shahra-e-Faisal, Karachi 75400, Phone: (92-21) 34311747-56 (Ext 120, 135 & 187)
Fax: (9221) 34386451, UAN: 021-111-TAKAFUL (825238), Email: Iftakaful@pakqatar.com.pk, www.pakqatar.com.pk