Critical infrastructure & Goastal Protection Authority Gi Infrastructure Permt's Department * introduction Form .ijl_s 34 s145 Y aloull dxgsall sLiiall ale jigs yy Aygsall Sbbiall assbai dosh D ecsizies ’ applicant's Details (Ueki ott fuisane [Durga Radad Valet [ets = = Sait ifemm | Vda Eo PredousNaenaity Swans atonatey | “Trdlta Bates] f z = = paeerre Anand) tenner Eiryl peceaial Date OF Entry = [dsSaut Sais [pate orsien | 1515 6|1984 Forel Port of Eoey SES [mere | sate gae fia, [_ vast | caneesponer | jaar acs] | ‘Occupation | ESS wenttomon] [ant ose Bank T [ shu | c=) [Paceotisue | Pessport No. Go [assnttons | Beivoate 14 lostdo: Pate ottsue! (alae lo. Peete Pace Ofeave | a Expiyoae | [Date OF tssue seen [ssn [ta¢Pitien) as tege/Uniery| satiny foraduation ean | Place Oftesue | Fame OLS [Residence No. dat—itt pais] Sintlnseon | a [eet an [ot Stan] ey [sete ase | Smtolse|naonity | Tedig 0 a) [Bet] vate orsires] | eares pe IF] Roma. Vole o Is] Reho. SAnivacantha Verma: 2 17 3 ie A | [ nationatey [Fetelretersname] OS aay Ly | [bate oF pith SHE GG praee ofeie| Tura Nai Spall ose | [exsupation [_ Shacilemptover | 3 ‘Gastighea| | T nationsiiy | deat [Metered Fs ae. Voleti el | [paeorean | [ate pe ora ae |_Oecupation | Kimutlemployer | aes The document should! be hand! written in Arabic for Arabs nationals & English typing for other nationalities.J Relatives at Employer aaltzag [Nationality Zap! I Name ea le) T I Th 7 T rE] ul | A Friends ‘fia’ [ Employer dass TNasonatity Susini ey Tel I fy | cE | 3 J Residence Address Sail tin ) set Déivers Colony | ot ttleaton TRnanat Bak Godavast | +s Bids. No. TAR AQ& [eewioe es ltandiord | sy Ex) ma | [situ |r | zs Mobiene AQ AGO RQ EDDA ARS lotone | aan) rosex | [apt aee Par eos) | J Previous Occupation in UAE agai (slstatnle gull Jiasw ) Weldox fy ig Countries you visited taj All Gu I gall i eat i i E ‘ 2 lel Foust E J Countriesyou workedwith ta, Jaa Al Gua il boat ) Is] Dubai ft t 5] Ro sads Ply | §| Gauct: Ei Car information Bsa Sly [ mace ores. | [esmstaasleartrna | [ sentest | late Color tap os—piateno. | Hapa) Facets (eet ae eepryoae | ([Gsscratas pee ose =r Have you served in the Military Service: O Yes © No 20 Opec uaa Foanaie eS Level Of Service| ask es country Tate Ranke [seat tateofsevier_| 1, Undersigned certify that all the above statement are ‘Bigll obs Saylgll Glad Gh: old aigall Lil aastl Photographs & Passport Copy. correct & complete. waalS9 Zoe cee [13{olaorg | & [Sesto V Dunje Raval S| re [Durgo Raced \ |i ze Include the following with this statement: raagllaalt Sits alt shal Yon yp g Hyon po