mmm Subscription Form oe SEC — Contract Number:ioo7s475s4_________:aiail a8) Type of Subscription: seal eg) Phone Number: 50426056 ald _POST PATA . DD, MM, YYW Date: Cy fs) eo anuun Number Types. ‘edsllesi Customer Data sos Ul p> MM WW. First Name: MOHAMMAD, Jp ttewsll— Datwof Birt: Lis} Loz) Lzaoi! saul yt Middle Name: _ABDULRAZZAO _ Mau] Nationality: KUWAIT aul Surname: ALAHMAD vallal aud Gender tl 1D Number: 3o1021s00038 —__ ‘aillaul 8, Other Contact Number:_51037736__:Jyaal 806) {D Type:_Gy 1D = = sail gg} Ematl ‘gS ay Address: _ ‘wate KD18Package wa Jad Package Details: 66 Data Share Package with 107S A8tl Uuolas aandilduolas youl uit glashuatladyh | tal selon Service Detais Ei |comiment Period) “SaratNa” | Penalty Foes aed phone XS MAX Gold 25668 4 FRUTMASKHE nd MiB 24Month ° a 336 SWAPTO| —__Lfnd SG 18KD (Une 1) 18 Ae ‘SIM CARD 01 0 f=) 0123076853 \ - ado | 13 | the undersigned, read and accept the terms and conditions mentioned in. form, que Addlgallg Lush 2590) 8 oyeShal oly bgp le gulbuly, ols! gBgal Ll 6 Employee Name [SAAD AL-BARAZT ‘Aba au Base 3/7/2019 aul Customer Signature Agent Signature 2 eel “Please only sign inside the box HN SL-FO7