UNITED ARAB EMIRATES INTRODUCTORY STATEMENT ‘Statement No. "I FullNeme : .OMEMA... VERGE Place of Birth : Previous Nationality : Religion =... AQ. ov Seat Date of Entry to U.AE Port ot Entry : ‘Sponsor Upon Entry Present Sponsor... areas Place of Employment : .. Profession - Olfice Tel. No: Salary PASSPORT AND RESIDENCE DETAILS Passpory Document No =.248:22.277.. Date of issue =... 27.00. Residence V. No Date of Issue : QUALIFICATION : - Place of tesue :.... QF4... MIAMGAS, . Date ot Expiry : 9... aed. Date of Graduation : Mk W7 Country PUPAE, Languages LULU LAR. on MARITAL STATUS Name of spouse =... Place of Birth Employer .. Nationality : A, .. Date of Birth ... Profession : Place of Birth FORMS IF, Employer. CAEEMED., RELATIVES Name ‘Nationality Employer heb. MOBIELLLA . LOH NMOL LUOFRIENDS Employer WESTMEAD... LUE. Tonys gepeek RLY Pubek T8. day: Cathet. House/Building No Flat No Mobile Tel. No «... VEHICLE DETAILS = Type HORE. 2 _ Place of Registration Plate No Colour of Pate D. License No :.. Date of Issue -. HAD YOU EVER BEEN IN THE MILITARY SERVICE ? YES (NO a-Country . b-Type of Service RANK 2 Duration « |, the undersigned, undertake that details contained in this statement are correct and complete. Enclosure : 4 Personal photos, One photo copy of passport. Date of employment :.. msaati AFAin Farms for Livestock Production | Al-Ain Dairy Integrated Management System (ISO 900.2008 & ISO 22000-2008) wan Laval IV Document ~ Systems Format bron Employment Application Form 2 1. Name (Block Letter) _£oWEVA _vercae _wobeereauca cs 2 Address: (Conespondenee) Blt 17 fo 6 Raed Bart by Sorntoa Tose elengait - Exmail RI wacynercor 3. Address: (Permanent)_ARo® 7-6 Potergay) Calan Za wha He 4, Nationality: 22222. 5. Passport No. 224222. 6. 7. Telephone No. (Contact, Mobile_oove 7756672 Telephone No. (Permanent); 8. Date of Birth: azmy-a¢ Age 23 (yrs), Place of Birth: caver, Camedonea 9.Sex: semnte Weight: 50 kg, Height: f__inches. 10. Marital Status:_swg1E 11. Are you an expatriate living in UAE: Yes /| tyes, No. & Type of vise—~ Date of Entry Date of Expiry. ~ esidence No. 12, Medical History: (Allergy, Prolonged illness, major surgery ete.) ula 13. Any of your relatives working in our company, if yes give detail 14, Present Salary Basi: 20.000 Montily Allowance: ~£-L.202.. Total hse Benefits: 07h payment. beaivin,Phiealih, Oth worth Fee 15. Salary Expected: 2 Nove, 16, How soon can you join us if selected: ai_asible, 17. Whether you ready to shift residence anywhere in UAE : Yes We.) hereby declare that all the information above provided by me are true and 1 will be providing proof on any of the above when asked to. If any ofthe information found to bbe untrue, will be subject to the penalties in accordance with the UAE Labor Laws. ‘OFFICE USE ONLY - Present Salary: Experience in our requirement: Post Applied: - Total Experience: Shortlisted for position. 1 ‘Doe No: FRIHRANDE-B, OOK: 05/12/2012, Rev. Ne 01