:(

:(

:(

Employment Information (You can select more than one item ):

Income Information (You can select more than one item*):

Investment & Indicators Information (You can select more than one item ):

Please Initial Here

(.

Name Relation Nature

* If any, please provide us with a copy of the valid documents that determine the

X

Know Your Customer KYC form (Individuals)

:

:

:

10,000 25,000

100,000 250,000 500,000

50,000 75,000100,000Up to 10,000KDUp to 25,000KD

Up to 100,000KDUp to 250,000KDUp to 500,000KDNone

Up to 50,000KDUp to 75,000KD100,000KD & Above

Profession :

Employer :

Years of Work :

Jop Title :

Employer Phone No.:

Sources of Income :

AverageAnnualIncome:

ApproximateWealth:

InvestmentObjectives&Strategy:

Expected Activity to Account :

Do you trade for your own account or on behalf of other parties?

Others (Pls. Specify)

Others (Pls. Specify)

Inheritance Salaries/Pension/Social Sec.Financing/LoansBusiness Pro t/ Inv. Income

Private Business Student Retired Unemployed Employed

InvestmentExperience :

Appetite ofRisk:

Invested Amount:

Entity Name:

InvestmentAwareness:

Up to 100% of Wealth

Low Volume

For the following bene ciary/ies :

Medium Volume High Volume

Up to 80% of Wealth Up to 60% of Wealth

Low Medium High

Long term InvestmentShort term InvestmentAcquisitionSpeculation

Basic (Less than 2 years)

SharesBonds & Instruments Investment FundsReal EstateOthers (pls. Specify)

Desired investment

Declaration Information:

trends : SharesBonds & Instruments Investment FundsOthers (pls. Specify)

Up to 40% of Wealth Up to 20% of Wealth 20% 40% 60% 80% 100%

:

11 million KD&Above

Others (pls. Specify)

Exchange Market:Position:

If you have a membership of the board of directors or have an access to the financial statements and inside information of any of KSE listed copanies and any other stock exchange markets, please list them below.

(AP/20050094/Licensed by Kuwait Capital Markets Authority ( Register Number AP/20050094/ )

New Account / حساب جديد Information Update / حتديث بياناتDate: / / :.Trading Noالتاريخ: رقم التداول:

مبتدئ (أقل من عامني)Basic (Less than 2 years)

جيد (من 2 إلى 5 أعوام)Expert (More than 5 years)

محترف (أكثر من 5 أعوام)

درجة قبولاملخاطر:

ــن ــي أي م ــة ف ــات الداخلي ــة واملعلوم ــات املالي ــى البيان ــع عل ــس إدارة أو مطل ــة مجل ــك عضوي إذا لدياملاليــة وأي أســواق ماليــة أخــرى, الرجــاء كتابــة لــألوراق الشــركات املدرجــة بأســواق الكويــت

أسمائها أدناه.

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:

:

Political Position Information (if any) :

Additional Information:

EVALUATION OF THE DEGREE OF CUSTOMER RISKS:

For MIC Use Only:

Name:

Signature:

Date :

:

:

/ /

X

•

Royal Families

S. Executives in state ownedinstitution

Yes – Company / Broker Name No

Yes – Market / Broker NameNo

High risk politically exposed person “PEP’s” is any person, who has or had, or seeks tohave, or is nominated for, public position in a foreign country (this applies to non resident persons in kuwait).

Member of Parliament

None

Member of Parliament

None

rtner, Advisor, Agent…) is holding a political position, please specify his/her position:

If you are holding political position, please specify position :

Do you trade in KSE market through another Company / Broker?

Do you trade in other Stock Markets?

• OVERALL CUSTOMER SUMMARY AND OTHER RELEVANT INFORMATION:

ALL REQUIRED AVILABLE DOCUMENTATION HAS BEEN RECEIVED ARE COMPLETE.

LowMediumHigh

Approved Reviewed Prepared

/ /

Name Relation Nature

:For KFHB Use Onlyإلستخدام شركة بيتك للوساطة فقط:

S. Political or Gov Officer or Judicial ormilitary

Royal Families

S. Executives in state ownedinstitution

S. Political or Gov Officer or Judicial ormilitary

XXX

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