Registration and Credit Application Form

FMH, in keeping with best industry practices, kindly requests the following information as part of our registration’ program. FMH, in keeping with best industry practices, kindly requests the following information as part of our registration’ program.

Please Note: Please Note:

The information provided hereunder is asked for on a confidential basis and will not be shared with any third parties except as required by law, our auditors, and/or any regulatory authority. The information provided hereunder is asked for on a confidential basis and will not be shared with any third parties except as required by law, our auditors, and/or any regulatory authority.

Any request for registration is considered on receipt of all required data and All the fields are mandatory and must be filled to complete the registration. Any request for registration is considered on receipt of all required data and All the fields are mandatory and must be filled to complete the registration.

Credit limit will be agreed from both side after submitting this form. Credit limit will be agreed from both side after submitting this form.

Please complete the below questionnaire and submit it together with documentation requested, if any, to the sender. Please complete the below questionnaire and submit it together with documentation requested, if any, to the sender.

1. COMPANY INFORMATION 1. COMPANY INFORMATION

Company Name

CR Number

TAX REG NO

Company Address

City/PO Box

Country

Company Website

Company Email Address

Did your company have a name change in the past 12 months? Did your company have a name change in the past 12 months? Yes No

If yes, previous Company Name:

1: Please do not use special characters as not supported 1: Please do not use special characters as not supported

2: If you had a name change, please provide a Name Change Letter on Company’s Letterhead 2: If you had a name change, please provide a Name Change Letter on Company’s Letterhead

2. BANKING DETAILS 2. BANKING DETAILS

Beneficiary Full Name

Beneficiary Bank Name

Bank Branch/Address/Country

Bank Account Number / IBAN

Swift Code/Bank Routing Number

Bank Account Currency (Multi-currency/Euro/Dollar/Yen or Local currency)

Corresponding Bank Details

Additional Information

Payment Terms (30 Days from Invoice Receipts)

_ _

3: If you are already registered and you want to change the banking details, please provide the Bank’s Letter from Beneficiary’s Bank and/or the Bank Statement 3: If you are already registered and you want to change the banking details, please provide the Bank’s Letter from Beneficiary’s Bank and/or the Bank Statement

4: If Beneficiary Name is different from Company Name, please provide a Relationship Letter on Company’s Letterhead 4: If Beneficiary Name is different from Company Name, please provide a Relationship Letter on Company’s Letterhead

5: Additional Bank Accounts can be added using a slash (/) 5: Additional Bank Accounts can be added using a slash (/)

6: If Swift Code/Bank Routing Number is not available, please insert NA 6: If Swift Code/Bank Routing Number is not available, please insert NA

3. CONTACT DETAILS 3. CONTACT DETAILS

Company Phone Number

Company Fax Number

Contact Name

Email Address

Contact Details

Accounting Manager Name

Accounting Email Address

Accounting Phone Number

4. DETAILS OF THE CREDIT FACILITY 4. DETAILS OF THE CREDIT FACILITY

Client Section Client Section

CREDIT LIMIT (SAR/USD)

CREDIT PERIOD (Days)

5. REQUIRED_DOCUMENTS 5. REQUIRED_DOCUMENTS

1.) Copy of your Commercial Register (CR) – [ Foreign Client not applicable] 1.) Copy of your Commercial Register (CR) – [ Foreign Client not applicable]

2.) Copy of your Chamber of Commerce Certificate (CR) – [ Foreign Client not applicable] 2.) Copy of your Chamber of Commerce Certificate (CR) – [ Foreign Client not applicable]

3.) Copy of your VAT Group Registration Certificate – [ Foreign Client not applicable] 3.) Copy of your VAT Group Registration Certificate – [ Foreign Client not applicable]

4.) Bank Account Details 4.) Bank Account Details

- Copies should be shared to (finance1@faisal-higgi.com) - Copies should be shared to (finance1@faisal-higgi.com)

6. DECLARATION 6. DECLARATION

☐ We hereby declare that the above details provided herein is true, accurate, correct and complete, and that I am authorized by the entity which I represent (duly mentioned in this form) to fill-in all the information and provide answers to the questions herein. ☐ We hereby declare that the above details provided herein is true, accurate, correct and complete, and that I am authorized by the entity which I represent (duly mentioned in this form) to fill-in all the information and provide answers to the questions herein.

Full Name of the person providing the info

Job Title of the person providing the info

Message