Application Form to Enforce Cheque Settlement

(1)

ﺬﻴﻔﻨﺘﻟا ﺐﻟﺎﻃ تﺎﻧﺎﻴﺑ Applicant details

ﻚﻴﺸﻟا ﻪﻨﻣ ردﺎﺼﻟا بﺎﺴﺤﻟا ﺐﺣﺎﺻ Account holder details

1

2

ﻚﻴﺷ ﺬﻴﻔﻨﺗ ﺐﻠﻃ Application Form to Enforce Cheque Settlement

ﺔﻴﺗارﺎﻣا ﺔﻳﻮﻬﻟا ﻢﻗر

ﺔﻴﺗارﺎﻣا ﺔﻳﻮﻬﻟا ﻢﻗر ID Number

ID Number

ﻲﻟوﺪﻟا بﺎﺴﺤﻟا ﻢﻗر

ﻲﻟوﺪﻟا بﺎﺴﺤﻟا ﻢﻗر IBAN Number

IBAN Number

Other applicants (if any)

ﻒﺗﺎﻬﻟا

ﻒﺗﺎﻬﻟا Phone

Phone ﻲﻧوﺮﺘﻜﻟا ﺪﻳﺮﺒﻟا

ﻲﻧوﺮﺘﻜﻟا ﺪﻳﺮﺒﻟا E-mail

E-mail

ﻞﻣﺎﻜﻟا ﻢﺳﻻا

ﻞﻣﺎﻜﻟا ﻢﺳﻻا Name

Name

ﺔﻴﺴﻨﺠﻟا

ﺔﻴﺴﻨﺠﻟا Nationality

Nationality

نوﺮﺧآ ﺬﻴﻔﻨﺗ ﻲﺒﻟﺎﻃ دﻮﺟو لﺎﺣ ﻲﻓ Lawyer Address (if any)

Lawyer Address (if any)

Address

ناﻮﻨﻌﻟا

ناﻮﻨﻌﻟا (ﺪﺟو نإ) ﻲﻣﺎﺤﻤﻟا ﺔﻟﺎﻛﻮﺑ

(ﺪﺟو نإ) ﻲﻣﺎﺤﻤﻟا ﺔﻟﺎﻛﻮﺑ

(2)

ﻚﻴﺸﻟا ﻰﻠﻋ ﻊﻗﻮﻤﻟا Cheque signatory 3

ﻲﻟوﺪﻟا بﺎﺴﺤﻟا ﻢﻗر IBAN Number

Other cheque signatories (if any)

ﺮﺧآ ﻊﻗﻮﻣ دﻮﺟو لﺎﺣ ﻲﻓ

Lawyer Address (if any) (ﺪﺟو نإ) ﻲﻣﺎﺤﻤﻟا ﺔﻟﺎﻛﻮﺑ Address ناﻮﻨﻌﻟا

ﻢﻫﺪﺿ ﺬﻴﻔﻨﺘﻟا بﻮﻠﻄﻣ نوﺮﺧآ Other Respondents 4

Lawyer Address (if any)

Address ناﻮﻨﻌﻟا

(ﺪﺟو نإ) ﻲﻣﺎﺤﻤﻟا ﺔﻟﺎﻛﻮﺑ

Indicate your reasons for making a claim هﺪﺿ ﺔﺒﻟﺎﻄﻤﻟا ﺐﺒﺳ نﺎﻴﺑ

(3)

(ﺐﺒﺴﻟا رﺎﻴﺘﺧا ﻰﺟﺮﻳ) ﻚﻴﺸﻟا عﺎﺠﺗرا ﺐﺒﺳ

Reasons for cheque rejection (please choose any of the following): 6

ﻊﻓﺪﻠﻟ ﻞﺑﺎﻗو ﻢﺋﺎﻗ ﺪﻴﺻر دﻮﺟو مﺪﻋ Lack of outstanding and payable funds تﺎﻤﻠﻜﻟاو مﺎﻗر¤ﺎﺑ ﻎﻠﺒﻤﻟا ﻦﻴﺑ فﻼﺘﺧا

The amount in number is different from the amount in words

ﺪﻴﺻﺮﻟا ﺔﻳﺎﻔﻛ مﺪﻋ Non-sufficient funds ﻢﻫرﺪﻟﺎﺑ تﺎﺒﻴﺗﺮﺘﻟا وأ ﻪﺑ حﻮﻤﺴﻤﻟا ﺪﺤﻟا زوﺎﺠﺘﻳ ﺪﻨﺒﻟا

The cheque amount exceeds the permissible limit or arrangement in dirhams

ﻊﻓﺪﻟا فﺎﻘﻳﺈﺑ ﺮﻣأ روﺪﺻ A stop payment order is issued تارﺎﻣا ﻢﻫرد ﺮﻴﻏ ﺔﻠﻤﻌﺑ ﻚﻴﺷ

Different currency (not in dirhams)

(فﻮﻗﻮﻣ بﺎﺴﺣ) ﺪﻤﺠﻣ بﺎﺴﺣ Frozen account (suspended) (مدﺎﻘﺘﻟا / ﺔﻴﺣﻼﺼﻟا ءﺎﻬﺘﻧﻻ) ﺔﻴﻧﻮﻧﺎﻘﻟا ةﺮﺘﻔﻟا زوﺎﺠﺘﻣ ﻚﻴﺷ

Out of time limit cheque (expired / prescribed)

(ﻖﻠﻐﻣ بﺎﺴﺣ) بﺎﺴﺤﻟا لﺎﻔﻗإ Closed account ﺢﻟﺎﺻ ﺮﻴﻏ ﺦﻳرﺎﺘﺑ ﻚﻴﺷ

Invalid date cheque

ﻊﻴﻗﻮﺗ ﺪﺟﻮﻳ ﻻ Cheque bears no signature ﺦﻳرﺎﺗ نوﺪﺑ ﻚﻴﺷ

Undated cheque

(ﻊﻴﻗﻮﺘﻟﺎﺑ ضﻮﻔﻣ ﺮﻴﻏ ﻊﻗﻮﻤﻟا) جذﻮﻤﻨﻠﻟ ﻖﺑﺎﻄﻣ ﺮﻴﻏ ﻊﻴﻗﻮﺘﻟا Signature does not match the sample (signed by other than

the authorized signatory) ﻊﻓﺪﻟا ﻞﺟﺆﻣ ﻚﻴﺷ

Postdated cheque

(ﻲﻧﺎﺛ ﻊﻴﻗﻮﺗ بﻮﻠﻄﻣ) ﻞﻣﺎﻛ ﺮﻴﻏ وأ ﺺﻗﺎﻧ ﻊﻴﻗﻮﺘﻟا Incomplete signature (other signature is required) ﺮﻴﻬﻈﺗ ﺪﺟﻮﻳ ﻻ

No back endorsement

روﺰﻣ وأ ﻒﻳﺰﻣ ﻚﻴﺷ Fake or forged cheque Other reasons ىﺮﺧأ

Please specify ﺐﺒﺴﻟا تﺎﺒﺛا ﻢﺘﻳ

ﻚﻴﺸﻟا تﺎﻧﺎﻴﺑ Cheques details

ﻪﻴﻠﻋ بﻮﺤﺴﻤﻟا ﻚﻨﺒﻟا

Drawee bank Cheque number ﻚﻴﺸﻟا ﻢﻗر

ﻚﻴﺸﻟا ﻰﻠﻋ ﻚﻨﺒﻟا ةﺮﻴﺷﺄﺗ ﺦﻳرﺎﺗ

Date of bank signature on the cheque Cheque due date (TBC) ﻚﻴﺸﻟا قﺎﻘﺤﺘﺳا ﺦﻳرﺎﺗ

5

ﻚﻴﺸﻟا ﺔﻤﻴﻗ ﻞﻣﺎﻛ Cheque full amount

ﻚﻴﺸﻟا ﺔﻤﻴﻗ ﻦﻣ ءﺰﺟ (هﺪﻳﺪﺤﺗ ﻰﺟﺮﻳ ) Part of the cheque amount

(please specify)

(4)

ﺔﻓﺎﻛ ﻞﻤﺤﺗأو ،ﻚﻴﺸﻟا ﺬﻴﻔﻨﺗ ﺐﻠﻃ ﻲﻓ تﺎﻣﻮﻠﻌﻣو تﺎﻧﺎﻴﺑ ﻦﻣ درو ﺎﻣ ﺔﺤﺼﺑ ﺮﻗأ .ﻚﻟذ فﻼﺧ تﻮﺒﺛ ﻦﻋ ﺔﻴﻧﻮﻧﺎﻘﻟا ﺔﻴﻟوﺆﺴﻤﻟا ﻚﻨﺒﻟا ﻦﻣ ﻢﻠﺘﺴﻤﻟا ﻎﻠﺒﻤﻟا

هﺬﻴﻔﻨﺗ بﻮﻠﻄﻤﻟا ﻎﻠﺒﻤﻟا

تﺎﻜﻴﺸﻟا ﻎﻠﺒﻣ عﻮﻤﺠﻣ Cheques total amount

ﺔﻤﻜﺤﻤﻟا جرﺎﺧ ﻦﻣ ﻢﻠﺘﺴﻤﻟا ﻎﻠﺒﻤﻟا Amount received outside the court

I declare that the facts and information contained within this application are true and accurate, and I accept to be legally accountable for anything to the contrary.

ﻊﻴﻗﻮﺘﻟا Signature

ﺎﻫﺬﻴﻔﻨﺗ بﻮﻠﻄﻤﻟا تﺎﻜﻴﺸﻟا ﻲﻟﺎﻤﺟا

Total value of cheques to be settled 7

؟ﺔﻤﻜﺤﻤﻟا ﻦﻣ ﻚـﺗﺎﺒﻠﻃ ﻲﻫ ﺎﻣ رﺎـﻴﺘﺧا ﻰﺟﺮﻳ What are you seeking from the court? 8

ﺔﻴﻓﺮﺼﻤﻟا تﺎﺑﺎﺴﺤﻟا ﻰﻠﻋ ﺰﺠﺤﻟا Attachment of bank accounts

تادﻮﺟﻮﻤﻟا ﻰﻠﻋ ﺰﺠﺤﻟا Attachment of assets

تاﺪﻨﺴﻟاو ﻢﻬﺳ¤ا ﻰﻠﻋ ﺰﺠﺤﻟا Attachment of shares and bonds ﺔﻴﻜﻨﺒﻟا ﺔﻌﻳدﻮﻟا ﻰﻠﻋ ﺰﺠﺤﻟا

Attachment of bank deposits

ﺔﻳرﺎﺠﺘﻟا ﺔﺼﺧﺮﻟا ﻰﻠﻋ ﺰﺠﺤﻟا Attachment of commercial licenses ﺮﻔﺴﻟا ﻦﻣ ﻊﻨﻤﻟا

Travel ban order

تارﺎﻴﺴﻟا ﻰﻠﻋ ﺰﺠﺤﻟا Attachment of vehicles Other ىﺮﺧأ

تارﺎﻘﻌﻟا ﻰﻠﻋ ﺰﺠﺤﻟا Attachment of real estates Amount recieved from the bank

Claimed amount

(5)

Please give details

ﺔﻴﻓﺎﺿإ تﺎﻧﺎﻴﺑ Additional details

تﺎﺒﻠﻄﻟا ﻰﻠﻋ ﺔﻘﻓاﻮﻤﻟا نﺄﺑ ﻢﻠﻌﻟا ﻰﺟﺮﻳ ﺬﻴﻔﻨﺘﻟا ﻲﺿﺎﻗ ﺔﻄﻠﺴﻟ ﻊﻀﺨﻳ ﺮﻣأ Please note the granting applications is subject

to the approval of enforcement judge.

؟ﺎﻬﻨﻋ دﺎﺷرا ﺪﻳﺮﺗ تﺎﻜﻠﺘﻤﻣ وأ تارﺎﻘﻋ يأ هﺪﺿ ﺬﻔﻨﻤﻠﻟ ﺪﺟﻮﻳ ﻞﻫ

؟ ﺔﻄﺒﺗﺮﻣ ىﺮﺧأ تﺎﻔﻠﻣ يأ وأ ﺮﻔﺴﻟا ﻦﻣ ﻊﻨﻣ وأ ﺔﻴﻈﻔﺤﺗ ﺰﺠﺣ ﺮﻣاوآ يأ ﺪﺟﻮﻳ ﻞﻫ Is there any related enforcement file, previous protective attachment

order, a travel ban order?

Does the debtor have any properties, assets, or real estates you want to give guidance to?

ﻢﻌﻧ No

No ^ﻢﻌﻧ

ﻞﻴﺻﺎﻔﺗ ﺮﻛذ ءﺎﺟﺮﻟا

ﻞﻴﺻﺎﻔﺗ ﺮﻛذ ءﺎﺟﺮﻟا Yes ﻻ

Yes ^ﻻ

9

لﺎﺼﻳﺎﺑ ﺔﻴﻟﺎﺘﻟا ﻒﻳرﺎﺼﻤﻟاو مﻮﺳﺮﻟا داﺪﺳ ﻢﺗ

ﻒﻇﻮﻤﻟا ﺪﻨﻋ By: (name of employee)

1 2 3

The following fees and expenses are paid مﻮﺳﺮﻟا ةﺮﺒﺨﻟا ﺔﻧﺎﻣأ تﺎﻧﻼﻋا مﻮﺳر Court fees Expert fees Notification fees

ﻲﺒﻇﻮﺑأ - ءﺎﻀﻘﻟا ةﺮﺋاد ﻲﻔﻇﻮﻣ ﻞﺒﻗ ﻦﻣ ﻲﻤﺳﺮﻟا ماﺪﺨﺘﺳﻼﻟ For official use only by ADJD officers

Via receipt

10

Please give details

(6)

تاﺪﻨﺘﺴﻤﻟا ﺔﻈﻓﺎﺣ

Supporting documents 11

ﻊـﻴﻗﻮﺘﻟا

Signature Dated ﺦﻳرﺎﺘﻟا Relationship ﺔﻠﺼﻟا

ﺐﻠﻄﻟا مﺪﻘﻣ Applicant

ﻢﻳﺪﻘﺘﻟا راﺮﻜﺗ وأ ﺬﻴﻔﻨﺘﻟا ﺔﻠﺣﺮﻣ ﻲﻓ تاﺪﻨﺘﺴﻣ ﻢﻳﺪﻘﺗ لﺎﺣ ﻲﻓ ﻪﻧﺄﺑ Åﻤﻠﻋ ﺔﺑﻮﻠﻄﻤﻟا تاﺪﻨﺘﺴﻤﻟا ﻊﻴﻤﺟ ﻖﻓرأ ﻪﻧﺄﺑ ﺐﻟﺎﻄﻟا ﺮﻘﻳ : ﺔﻈﺣﻼﻣ .ﺔﻠﺋﺎﺴﻤﻠﻟ ﺐﻟﺎﻄﻟا ضﺮﻌﻳ ﺪﻗ

Note: The applicant hereby declares that he submitted all required documents. Should he file documents during the enforcement process or make re-submissions, the applicant may be held accountable.

ﺔﻳﺬﻴﻔﻨﺘﻟا تاﺪﻨﺴﻟا Enforceable documents

:ﺔﻴﺋﺎﻀﻘﻟا ﻒﻳرﺎﺼﻤﻟاو مﻮﺳﺮﻟا ﻊﻴﻤﺟ تﻻﺎﺼﻳإ (ﺾﻘﻨﻟاو فﺎﻨﺌﺘﺳﻻاو ﻲﺋاﺪﺘﺑﻻا) Receipts of all legal costs and court fees paid at the courts of first instance, appeal and cassation

ﺬﻴﻔﻨﺘﻟا ﺐﻟﺎﻄﺑ صﺎﺨﻟا نﺎﺒﻳÉا Applicant’s IBAN

ﺪﺟو نإ هﺪﺿ ﺬﻔﻨﻤﻟﺎﺑ صﺎﺨﻟا نﺎﺒﻳÉا (Respondent’s IBAN (if any

ﺬﻴﻔﻨﺘﻟا ﺐﻟﺎﻃ ﺔﻳﻮﻫ Applicant’s ID

ﺔﻟﺎﻛﻮﻟا ﺪﻨﺳو ﺬﻴﻔﻨﺘﻟا ﺐﻟﺎﻃ ﻞﻴﻛو ﺔﻳﻮﻫ Applicant’s attorney ID and power of attorney ﺎﻬﻌﻴﻤﺟ تﺎﻜﻴﺸﻟا / ﻚﻴﺸﻟا ةرﻮﺻ ﻪﺘﻤﺟﺮﺗو ﻚﻨﺒﻟا ةدﺎﻓإو Copy of cheque(s) and the bank letter with translation