Insider Identity Form

Disclosure Department
Insider Identity Form
– Date:………/………/……………
– Issuing Company Name:……………………………………………………………………..
– Insider Name:…………………………………..National or SDCNo. ……………….
– Date of Electing or Appointing an Insider: …………./………/………………..
– Insider Job Title:…………………………………………………………………………………
– Insider Address: Tel:……………………..Fax………….P.O. Box…………………
– Legal Person Name:…………………………………… National No. or SDC………
– Wife/Husband Name:…………………………………National No. or SDC……….
Underaged Children Names:
1- ……………………………………………………National or SDCNo. .…………………..
2- ……………………………………………………National or SDCNo. ……………………
3- ……………………………………………………National or SDCNo. …………………..
4- ……………………………………………………National or SDCNo. ……………………
5- ……………………………………………………National or SDCNo. ……………………
*By virtue of Article (2) of the Instructions of Disclosure, the Insider is defined as: a person who possesses Inside Information by virtue of his position or job.
Article (23):
A- The following persons of the issuing company shall be considered not exclusive Insiders ex-officio:
1. The Chairman of the Board of Directors of the issuing company.
2. The members of the Board of Directors.
3. The General Manager.
4. The Financial Manager.
5. The Internal Auditor.
6. Relatives of the above-mentioned persons.
B- The natural person representing any juristic person occupying such a position shall be considered an Insider.
Notes:-
– Shall there be more than one SDC number for the Insider, it must be mentioned.
– Insiders names must be stated in full i.e. in four parts.
– In case Insiders are elected or appointed in a company, a detailed résumé must be attached for each Insider. The résumé must include exclusively Insiders ex-officio the following: date of birth, qualifications, year of graduation for each degree and experiences that cover (place of work and duration since graduation until date of appointment at the company). If available his/her membership in other companies.

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