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 LUOFRIENDS
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 :..
msaati 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