Local Agent Agreement

SEND TO:*

DO YOU WANT TO SEND A COPY TO A BANKS LEGAL STAFF?*

BANKS LEGAL STAFF*

NAME OF FOREIGN COMPANY*

JURISDICTION OF THE FOREIGN COMPANY*

ADDRESS OF THE FOREIGN COMPANY*

Street Address City Country

AUTHORISED INDIVIDUAL WHO SHOULD RECEIVE NOTICES ON BEHALF OF THE FOREIGN COMPANY*

AUTHORISED SIGNATORY OF THE FOREIGN COMPANY*

DATE OF AUTHORITY DOCUMENT OF FOREIGN COMPANY AUTHORISED SIGNATORY*

REGISTRATION NUMBER OF FOREIGN COMPANY AUTHORISATION DOCUMENT (IF APPLICABLE)

IS THE AGENT AN INDIVIDUAL?*

FORM OF AUTHORITY UNDER WHICH AUTHORISED SIGNATORY OF FOREIGN COMPANY IS SIGNING*

NAME OF AGENT*

ADDRESS OF THE AGENT*

Street Address City Country

JURISDICTION OF THE AGENT*

PASSPORT NUMBER OF THE AGENT*

AUTHORISED INDIVIDUAL WHO SHOULD RECEIVE NOTICES ON BEHALF OF THE AGENT*

LICENCE ACTIVITIES OF THE BRANCH (AS PUBISHED BY THE RELEVANT ECONOMIC DEPARTMENT*

EMIRATE IN WHICH THE BRANCH IS BEING REGISTERED*

AGENT ANNUAL FEE*

AUTHORISED SIGNATORY OF AGENT

FORM OF AUTHORITY UNDER WHICH AUTHORISED SIGNATORY OF AGENT COMPANY IS SIGNING*

DATE OF AUTHORITY DOCUMENT OF AGENT COMPANY AUTHORISED SIGNATORY

REGISTRATION NUMBER OF AGENT COMPANY AUTHORISATION DOCUMENT (IF APPLICABLE)