Application Form – ‫ﺑﻴﺎﻧﺎﺕ ﺍﻟﻄﻠﺐ‬

Over the Counter Service ‫ﺧﺪﻣﺔ ﺗﻘﺪﻳﻢ ﻃﻠﺒﺎﺕ ﺍﻟﻜﺎﻭﻧﺘﺮ‬

Application No.: 224169797676 :‫ﺭﻗﻢ ﺍﻟﻄﻠﺐ‬

Application Status: Ready to Pay ‫ﺟﺎﻫﺰ ﻟﻠﺪﻓﻊ‬ :‫ﻭﺿﻌﻴﺔ ﺍﻟﻄﻠﺐ‬
Created Date: 2024-04-01T05:11:58 :‫ﺗﺎﺭﻳﺦ ﺍﻟﻄﻠﺐ‬ Print Date: 2024-04-01 :‫ﺗﺎﺭﻳﺦ ﺍﻟﻄﺒﺎﻋﺔ‬

Service Information
Service Category Application Submission Issue ‫ﺧﻠﻞ ﻓﻲ ﺗﻘﺪﻳﻢ ﻃﻠﺐ‬ ‫ﻧﻮﻉ ﺍﻟﺨﺪﻣﺔ‬
Submitter Information
Full Name in English Jahangir alam ‫ﺍﻻﺳﻢ ﺍﻟﻜﺎﻣﻞ ﺑﺎﻹﻧﺠﻠﻴﺰﻳﺔ‬
Full Name in Arabic ‫ﺟﻬﺎﻧﻐﻴﺮ ﻋﺎﻟﻢ‬ ‫ﺍﻻﺳﻢ ﺍﻟﻜﺎﻣﻞ ﺑﺎﻟﻌﺮﺑﻴﺔ‬
UDB Number 64720169 ‫ﺍﻟﺮﻗﻢ ﺍﻟﻤﻮﺣﺪ‬
Request Details

Details I need change ‫ﺍﻟﺘﻔﺎﺻﻴﻞ‬

Contact Details
Email Jahangiralamkhandxb1122@gmail.com ‫ﺍﻟﺒﺮﻳﺪ ﺍﻹﻟﻜﺘﺮﻭﻧﻲ‬
Mobile No 0521298369 ‫ﺭﻗﻢ ﺍﻟﻬﺎﺗﻒ ﺍﻟﻤﺘﺤﺮﻙ‬

Fees – ‫ﺍﻟﺮﺳﻮﻡ‬

‫ﻗﻴﻤﺔ ﺍﻟﻮﺣﺪﺓ‬ ‫ﺍﻟﻜﻤﻴﺔ‬

Fee Type ‫ﻣﺴﻤﻰ ﺍﻟﺮﺳﻢ‬ Value – ‫ﺍﻟﻘﻴﻤﺔ‬
Unit Amount Quantity
Free Service ‫ﺧﺪﻣﺔ ﻣﺠﺎﻧﻴﺔ‬ 0 0 0

Grand Total 0

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Documents – ‫ﺍﻟﻤﺮﻓﻘﺎﺕ‬

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