CMA Form 3 - EN

(1)

SABB Ca <JLc_tJ

1

ةرامتسا حيشرت

ةيوضعل سلجم

ةرادإ كنبلا يدوعسلا يناطيربلا

) باس (

Membership Nomination Form for SABB Board

ةرامتسا حيشرت ةيوضعل سلجم ةرادإ كنبلا يدوعسلا يناطيربلا

( )باس ةديدجلا هترودل ثلاثل ةدتمملا

تاونس نم ًارابتعا خيرات

رياني 01 23 ىتحو م 20 خيرات ربمسيد 31

م 2025 . Nomination Form for the Saudi British Bank (SABB)

Board Membership for the new term starting on 01 January 2023 and ending on 31 December 2025.

: حيشرتلا طورش صوصنلا اهتنمضت يتلا تاطارتشلاا ةاعارم حشرملا ىلع بجي ،كونبلا ةبقارم ماظن ،تاكرشلا ماظن اهيلع لمتشإ يتلا ةيماظنلا ماقم نع ةرداصلا تاميلعتلاو ةيذيفنتلا حئاوللاو يزكرملا كنبلا

يدوعسلا ةيلاملا قوسلا ةئيهو

:يلاتلا كلذكو ، Conditions of candidates:

Candidates must observe the requirements contained in the statutory provisions contained in the Companies Law, the Banking Control Law, the Executive Regulations and the instructions issued by the Saudi Central Bank and the Capital Market Authority, as well as the following:

. 1 كل قحي ل وأ هسفن حيشرت مهاسم ةيوضعل رثكأ وأ رخآ صخش

لإا سلجم .ةراد

1. Each shareholder has the right to nominate himself or others to the membership of the Board.

. 2 ءافيتسا عيقوتو نم حشرتلل باس ةرامتسا لبق

ةيوضعلل حشرملا

ايصخش ، .قفرملا لودجلا ةئبعتو 2. The nomination forms must be completed and

signed by the candidate personally, and to fill the table attached.

. 3 نأ قفري حشرملا هيطب

ةخسن بلط نم ةحضاو

ةيوهلا

ةيلئاعلاو ةيصخشلا ةصاخلا

و نييدوعسلل نييدوعس ريغلا

،ةينطولا ةيوهلا ةقاطب(

ةقاطب ةماقلإاو رفسلا زاوجو ةلئاعلا

.)يدوعس ريغلل 3. A clear copy of candidate's personal and family

ID for Saudis and non-Saudis (National ID, Family ID, Passport and Iqama for non- Saudis).

. 4 نأ قفري انايب حشرملا هتريسب

تاربخلاو تلاهؤملاو ةيتاذلا

يف لاجم لامعأ ةطشنأو .)تدجو نإ( كونبلا 4. A copy of his CV showing experience and skills

in the Banking business (if any).

. 5 يف لاح قبس حشرملل لغش

ةيوضع سلجم

ىدحإ ةرادإ

تاكرشلا

،ةمهاسملا هيلعف

قافرإ نايب ليصافت نمضتي ءامسأ

تاكرشلا ةمهاسملا

ناك يتلا سلاجمب اوضع

،اهتارادإ

خيراوتو هلغش .ةيوضعلا 5. Candidate must provide a list of Joint-Stock

companies of which he occupied as a Board member and the respective dates.

. 6 ئبعت صاخلا )ةمءلاملا( جذومن ة يزكرملا كنبلل

وعسلا يد

حشرملا لبق نم جذومنلا عيقوتو .

6. Fill in SAMA (Fit & Proper) form, and to be signed by the nominee.

. 7 ةكرش ةرادإ سلجم ةيوضعل حشرملل ةيتاذلا ةريسلا جذومن ةئبعت

قر ةجردم ةمهاسم ( م

3 ةيلاملا قوسلا ةئيهب صاخلا ) 7. Fill in CMA form (3) CV of candidates .

nominated for the membership of the Boards

of Listed Joint-Stock companies.

(2)

SABB 1I

2

. 8 كنبلا ةرادإ سلجم يف اوضع ناك نأ هل قبس يذلا حشرملا

يناطيربلا يدوعسلا (

باس ) هيلعف ، / اهيلع كنبلا نم نايب ميدقت

اهلغش ةرود رخلأ /

اهتلغش يفوتسم ا يلي ام : 8. If the candidate had occupied SABB Board

membership, he/she then has to provide a statement from SABB of the last Board term, including the following information:

- ددع ا هتيوضع ةرتف للاخ تدقع يتلا ةرادلإا سلجم تاعامتج - Number of Board meetings held during .

his\her membership term.

- لاا ددع

،ةلاصأ وضعلا اهرضح يتلا تاعامتج ةبسنو

هروضح

لاا عيمجل تاعامتج

. - Number of meetings he/she attended in

his/her personal capacity and percentage of attendance of all meetings.

- ددعو وضعلا اهيف كراش يتلا ةمئادلا ناجللا ا

لا يتلا تاعامتج

لاا كلتل هروضح ةبسنو ،ةنجل لك اهتدقع تاعامتج

- The permanent committees in which he/she . participated and the number of meetings each of such committees had held and the percentage of attendance.

- للاخ كنبلا اهققح يتلا ةيلاملا جئاتنلل اصخلم تاونس نم ةنس لك

هتيوضع . - Summary of the financial results achieved by

the Bank in each year of his/her Board membership.

. 9 ىلع نم بغري يف حشرتلا ةيوضعل سلجم

ةرادلإا نأ

حصفي حصفت / :حلاصملا ضراعت تلااح نم يأ نع - A person who desires to nominate

himself/herself for the membership of the Board shall disclose any cases of conflicts of interest:

أ) نع حاصفلإا يف ةرشابم ريغ وأ ةرشابم ةحلصم دوجو

باسحل متت يتلا دوقعلاو لامعلأا كنبلا

يذلا حشرتلا يف بغري

هترادإ سلجمل .

- Having direct or indirect interest in the contracts and businesses entered into for the benefit of the Bank in which he desires to be nominated to the Board.

ب ) ةسفانم هنأش نم لمع يأ نع حاصفلإا كنبلا

عورف دحأ يف وأ

يذلا طاشنلا ي

هلواز . - Engaging in business that may compete with

the Company or any of its activities.

مسا حـــشرملا Candidate Name

مقر ةقاطب لاوحلأا / زاوجلا National ID /Passport اهردصم

Issue place اهخيرات

Date of issuing

خيرات دلايملا Date of Birth

لهؤملا يملعلا Qualifications

تاربخلا يف لاجم لامعأ ةطشنأو كنبلا نإ

تدجو Experience in the Bank's business activities, if any

(3)

SABB 1I

3

ا لييييييصافت نايب تايويييييضعل

يف ة بايييييسلاو ةيلاحلا جم

ا ةرادإ سل

:)اهحاضيإ ىجري( ةمهاسملا تاكرشلا Details of current and previous Board membership(s) of

joint stock companies (please specify):

Candidate’s Work Experience: : حشرملا وضعلل ةيلمعلا تاربخلا

مسا ةكرشلا

Company Name خيرات

ءدب ةيوضعلا

Starting of Board membership خيرات

ءاهتنا ةيوضعلا

Ending date of the membership

Candidate’s Academic Qualifications: :حشرملا وضعلل ةيملعلا تلاهؤملا

مسا ةحناملا ةهجلا

Academic Institution Name لهؤملا

Qualification صصختلا

Major لهؤملا ىلع لوصحلا خيرات

Qualification Date

ةرتفلا Duration ةربخلا تلااجم

Area of Expertise

(4)

SABB 1I

4

حيشرتلا بلط ىلع عيقوتلاو طورشلا ىلع علاطلااب رارقإ

Acknowledgment of the conditions and signature of the nomination application

دقل تعلطأ ىلع طورش حيشرتلا نلعملا

يف ةنمضملاو ،اهنع

اهرفاوتلو ،ةيفارشلإا تاهجلا نع ةرداصلا حئاوللا يننإف ،يدل

يدبأ يف يتبغر حيشرتلا

ةيوضعل سلجم

ةرادإ كنبلا يدوعسلا

)باس( يناطيربلا ةرودلل

ةمداقلا يتلا أدبت نم خيرات 01 رياني

2023 م خيرات ىتحو 31

ربمسيد 2025 .م I have read the announced candidates conditions

advised by the regulations issued by the Regulatory authorities. Having met the aforementioned conditions, I wish to be nominated for SABB Board Membership for the new term starting from 01 January 2023 to 31 December 2025.

مسلاا Name

) باس ( ةكولمملا مهسلاا ددع Number of shares held (SABB)

ناونعلا Address

سكافلا/فتاهلا مقر Phone Number/Fax

عيقوتلا Signature

ةيتاذلا ةريسلل ةديؤملا تادنتسملا ةرامتسلإا هذه عم قفرم نإ( كنبلا لامعأ يف تاربخلاو تلاهؤملاو .)تدجو

Attached herewith the supporting documents,

qualifications and experience in the Bank's business (if

any).

(5)

SABB m y

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(S" y. - j 9") A. 13. Ilik "7 1 a sn4

JI:3)

Independence Declaration (Independent — Not Independent)

⃰ Relatives (As per CMA definition): parents, grandparents and their ancestors, children, grandchildren and their descendants, spouses, siblings and maternal and paternal half-siblings.

⃰

ا

براقلأ بسحب(

)ةيلاملا قوسلا ةئيه فيرعت :

دلاولأا ، اولع نإو تادجلاو دادجلأا ، تاهملأاو ءابلآا

ءاقشلأا تاوخلأاو ةوخلإا ، تاجوزلاو جاوزلأا ، اولزن نإو مهدلاوأو .ملأ وأ ،بلأ وأ ،

⃰ ⃰ Relatives (As per SAMA definition): parents, grandparents, children, grandchildren, and spouses.

⃰⃰ ⃰ ⃰ Regulatory Rules and Procedures issued pursuant to the Companies Law relating to Listed Joint Stock Companies - Article Fifty-Eight: Indirect Interest.

⃰⃰

براقلأا بسحب(

يزكرملا كنبلا فيرعت يدوعسلا

) : دلاولأا ، تادجلاو دادجلأا ، تاهملأاو ءابلآا

.تاجوزلاو جاوزلأا ، مهدلاوأو

⃰⃰⃰

ا ةرداصلا ةيميظنتلا تاءارجلإاو طباوضل ةجردملا ةمهاسملا تاك رشب ةصاخلا تاك رشلا ماظنل ً

اذيفنت –

:نوسمخلاو ةنماثلا ةداملا .ة رشابملا ريغ ةحلصملا

لقتسم( ةيللاقتسلإا ةفصب رارقإ –

)لقتسم ريغ

Independence Declaration (Independent – Not Independent)

With reference to the Key Principles of Governance issued by the Saudi Central Bank and Article 20 of the Corporate Governance Regulations issued by the Capital Market Authority the independence of Board Members, we kindly request that you fill out the below form in accordance with the definition provided for independent Member.

لإ ةراشإ ،يدوعسلا يزكرملا كنبلا نع ةرداصلا ةمكوحلل ةسيئرلا ئدابملا ى ةيلاملا قوسلا ةئيه نم ةرداصلا تاكرشلا ةمكوح ةحئلا نم نيرشعلا ةداملاو وجرن ،هنع ةقثبنملا ناجللاو ةرادلإا سلجم ءاضعأ ةيللاقتسا ضراوعب ةقلعتملا هاندأ لقتسملا وضعلا فيرعت قفو جذومنلا ةئبعت مكتداعس نم .

قبطني لا Not Applicable

قبطني Applicable

راوع للاقتسلاا ض اقفو

لا تاذ ةمظنلأل ةقلاع

Measures of Independence Pursuant to Relevant Regulations

لا ةرقف No.

هتبسنام ً

اكلام نوكي نأ 5

ةبارق ةلص هل وأ ،اهتعومجم نم ىرخأ ةك ر ش مهسأ وأ كنبلا مهسأ نم ريكأ وأ %

⃰ نم عم

.ةبسنلا هذه كلمي Owns 5% or more of the shares of the Bank or any other company within its group; or is 1 a relative ⃰ of who owns such percentage.

هتبسن ام كلتمي ةيرابتعا ةفص يذ صخشل ً

لاثمم نوكي نأ 5

ةك ر ش مهسأ وأ كنبلا مهسأ نم ر يكأ وأ % نم ىرخأ

.اهتعومجم Is a representative of a legal person that holds 5% or more of the shares of the Bank or 2 any company within its group.

.اهترادإ سلجم ةيوضعل حشرملا كنبلا ةعومجم نم ىرخأ ةك ر ش ي ف ةرادإ سلجم وضع نوكي نأ Is a Board member of any company within the bank’s group. 3

ةبارق ةلص هل نوكي نأ

⃰ .اهتعومجم نم ىرخأ ةك ر ش ي ف وأ كنبلا ي ف ر ييذيفنتلا رابك نم وأ سلجملا ءاضعأ نم يأ عم

Is a relative ⃰ of any member of the Board of Director or Senior Executive of the Bank, or 4 any other company within the Bank’s group

نم ىرخأ ةك ر ش وأ اهعم لماعتم فرط يأ وأ كنبلا ىدل ر ييضاملا ر يماعلا للاخ ً

افظوم لمعي ناك وأ لمعي نأ للاخ فارطلأا كلت نم يأ ىدل ةرطيس صصحل ً

اكلام نوكي نأ وأ ،نيدروملا رابكو تاباسحلا يعجارمك ،اهتعومجم ر يماعلا . ر ييضاملا

5 Is an employee or used be an employee, within the preceding two years, of the Bank, or for any party dealing with Bank or for any company within its group, such as external auditors and main suppliers; or if you have within the preceding two years, held controlling interests in any such parties.

ة ر شابم ريغ وأ ة ر شابم ةحلصم هل نوكي نأ

⃰ ⃰ ⃰

.كنبلا باسحل متت ي تلا دوقعلاو لامعلأا ي ف

Has a direct or indirect interest⃰ ⃰ ⃰ in the businesses and contracts executed for the benefit 6

of the Bank account.

(6)

SABB

1

⃰ Relatives (As per CMA definition): parents, grandparents and their ancestors, children, grandchildren and their descendants, spouses, siblings and maternal and paternal half-siblings.

⃰

براقلأ

ا

بسحب(

)ةيلاملا قوسلا ةئيه فيرعت :

دلاولأا ، اولع نإو تادجلاو دادجلأا ، تاهملأاو ءابلآا

.ملأ وأ ،بلأ وأ ، ءاقشلأا تاوخلأاو ةوخلإا ، تاجوزلاو جاوزلأا ، اولزن نإو مهدلاوأو

⃰ ⃰ Relatives (As per SAMA definition): parents, grandparents, children, grandchildren, and spouses.

⃰⃰ ⃰ ⃰ Corporate Governance Regulation Issued by the Capital Market Authority – Article Seventy-Four: Definition of Competing Business

⃰ ⃰

براقلأا بسحب(

يزكرملا كنبلا فيرعت يدوعسلا

) : ، تاهملأاو ءابلآا دلاولأا ، تادجلاو دادجلأا

.تاجوزلاو جاوزلأا ، مهدلاوأو

⃰ ⃰

⃰

ةيلاملا قوسلا ةئيه نع ةرداصلا تاك رشلا ةمكوح ةحئلا –

نوعبرلأاو ةعباسلا ةداملا لامعأ موهفم :

ةسفانملا

Acknowledgement رارــقإ

I confirm in case any of the conditions mentioned above become applicable I will inform the Bank Company Secretary immediately.

ي تأ ف هنأ دهع ةيللاقتسلاا ضراوع نم يأ ثودح لاح

هلاعأ ةروكذملا موقأس

غلابإب ةرادإ سلجمل ةماعلا ةناملأا لا

. ً اروف كنب

قبطني لا Not Applicable

راوع للاقتسلاا ض اقفو

لا تاذ ةمظنلأل ةقلاع

Measures of Independence Pursuant to Relevant Regulations

لا ةرقف No.

( نع ديزت ةناجل نم يأ وأ ةرادلإا سلجم ةيوضع ةأفاكم لىع ةولاع ،كنبلا نم ةيلام غلابم ضاقتي 200,000

لاير )

وأ .لقأ امهيأ ؛هناجل نم يأ وأ ةرادلإا سلجم ةيوضع لباقم اهيلع لصحت ي تلا قباسلا ماعلا ي ف هتآفاكم نم % 50

7 Receives financial consideration from the Bank in addition to the remuneration for his/her membership of the Board or any of its Committees exceeding an amount of SAR 200,000 or 50% of his/her remuneration of the last year of membership of the Board or any of its Committees, whichever is less.

ةسفانم هنأش نم لمع ي ف ك يشي نأ

⃰ ⃰ ⃰

هلوازي يذلا طاشنلا عورف دحأ ي ف رجتي نأ وأ ،سيئرلا اهطاشن ي ف كنبلا

.كنبلا Engages in a business where it competes ⃰ ⃰ ⃰ with the main business activity of the Bank, 8 or if it conducts business in any of the activities practiced by the Bank.

.كنبلا ةرادإ سلجم ةيوضع ي ف ةلصفنم وأ ةلصتم تاونس عست لىع ديزي ام ضمأ دق نوكي نأ Has served for more than nine years, consecutive or inconsecutive, as a Board Member of 9 the Bank.

هبراقأ دحأ مساب وأ همساب ةينامتئا ةقلاع هيدل نوكت نأ

⃰ ⃰⃰⃰⃰

( نع ديزت كنبلا عم 1,000,000

.يدوعس لاير )

Has credit relationship either in his/her own name or in the name of any of a relatives ⃰⃰⃰⃰ ⃰ , 10 with the Bank that exceeds SAR 1,000,000.

قبطني لا Not Applicable

ل نيحشرتملل ةعجارملا ةنجل ةيوضع

This section is for Audit Committee Membership nomination

ةينامتئا ةقلاع ةيدل نوكت نأ كنبلا عم

هبراقأ دحأ مساب وأ همساب

⃰⃰⃰⃰ ⃰⃰⃰⃰

، هترادإ سلجم ءاضعأ وأ كنبلا عم ةفص يأب وأ

.نييذيفنتلا اهيفظوم وأ Has a credit relationship in his/her name or in the name of one of your relatives ⃰⃰⃰⃰ ⃰ , or in 11 any capacity with the bank, its board members, or its executive staff.

Name: : مس لا ا

Signature: : عيقوتلا

Date: : خيراتلا

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O O 0

O O

Form (3)

Curriculum Vitae Form of nominated/appointed/representative board member of a legal person for the membership of the board of directors of a listed joint- stock company in the Saudi Stock Exchange (Tadawul)

Instructions for Filling out this Form

1. This Form shall be completed by the nominated/appointed/representative board member of a legal Person (the “Member”) for a membership of a board of directors of a joint stock company that is listed in the Saudi Stock Exchange “Tadawul” (the “Company”).

2. The Member shall send this Form to the Company.

3. The Company shall send this Form along with the electronic Form (3) to the Capital Market Authority (“CMA”) through the electronic connection system immediately after it obtains the approval of the competent authority or at least (3) business days prior to convening the general assembly, provided that the Company shall provide the CMA with the approval of the competent authority once received.

1. Company Information Company’s Name

Company’s Sector

2. Membership Type and Nature

Membership Classification (Mark with 🗸) Executive Member Non-Executive Member Independent Member Membership Nature (Mark with 🗸) Personal Capacity Representative of a Legal Entity

Name of the Legal Person that the Member represents:

Appointment Date: Appointment Date:

/ /

End date of the Board Office Term:

/ /

3. Member’s Personal Information Full name (including father’s name,

grandfather’s name, and family name):

Nationality: Date of Birth: Mailing Address:

Place of Employment: Job Title: Office

Telephone:

Mobile:

Fax:

Identity (ID) Number:

Number of shares that the Member owns in the Company:

Number of shares owned by the Legal Person that the Member represents:

4. Member’s Academic Qualifications

# Degree/qualification Major Degree Awarded Date Name of Awarding Entity

1 2 3 4 5

5. Member’s Work Experience

Period Areas of Experience

(8)

I

❑ ❑

❑ ❑ n

Form (3)

6. Current memberships in the boards and committees in other joint stock companies (listed or closed) or in any other company of any legal form or its committees,

# Company’s name Main activity

Membership Classification (Executive, Non-

Executive, Independent)

Membership nature (Personal Capacity, Representative of a

Legal entity)

Committees Membership

Company’s Legal Form

1 2 3 4

7. Please answer the following questions:

a. Is the Member an owner of five percent (5%) or more of the shares of the Company or any other company within its group? If yes, please provide the full details as follows:

Yes No

# Company’s Name Ownership Percentage

1 2 3

b. Is the Member a representative of a Legal Person that owns five percent (5%) or more of the shares of the Company or any other company within its group?

If yes, please provide the full details of the ownership of the Legal Entity:

Yes No

Not applicable

# Company’s Name Ownership Percentage

1 2 3

c. Was the Member a senior executive of the Company or any other company within its group during the past two years?

If yes, please provide the full details as follows:

Yes No

# Company’s Name Executive Position

1 2 3

d. Does the Member have a first-degree relationship to any other member of the board of directors of the Company or any company within its group?

Yes No

# Full name of the relative of the Member Company’s Name

1 2 3

e. Does the Member have a first-degree relationship to any senior executive of the Company or any company within its group?

Yes No

# Full name of the relative of the Member Company’s Name

1 2 3

(9)

n

0 Form (3)

f. Is the Member a member of a board of directors or board of managers of any company within the group of the Company?

Yes No

# Company’s Name

1 2 3

g. During the past two years, was the Member an employee of any party connected to the Company or any company within its group such as external auditors or main suppliers, or an owner of a controlling interest in any such parties?

Yes No

# Company’s Name Name of the connected party to the company Position Ownership

percentage

1 2 3

h. Is the Member fully dedicated to managing the Company? Yes No

i. Does the Member receive any monthly or annual salary from the

Company? Yes No

j. Does the Member have a direct or indirect interest in the business or contracts that are executed for the Company’s account? If yes, please provide the full details as follows:

Yes No

# Nature of the business and contracts Duration of the business and contracts Value of the business and contracts

1 2 3

k. Does the Legal Person that the Member is representing have a direct or indirect interest in business or contracts that are executed for the Company’s account?

Yes No

Not applicable

# Nature of the business and contracts Duration of the business and contracts Value of the business and contracts

1 2 3

l. Is the Member a member of a board of directors or board of managers of any company that has business or contracts with the Company?

Yes No

# Company’s name Nature of the business and

contracts

Duration of the business and

contracts

Value of the business and contracts

(10)

Iii o m

o o

o o o

o o

o o iii

Form (3)

m. Is the Legal Person that the Member is representing a member of a board of directors or a board of managers of any company that has business or contracts with the Company?

Yes No

Not applicable

# Company’s Name Nature of the business

and contracts

contracts

Value of the business and contracts 1

2 3

n. Does the Member own or participate in the ownership of an entity that has business or contracts with the Company? If

yes, please provide the full details as follows: Yes

No

# Entity’s Name Nature of the business

and contracts

contracts

2 3

o. Does the Legal Person that the Member is representing own or participate in the ownership of an entity that has business or contracts with the Company?

Yes No

Not applicable

and contracts

contracts

2 3

p. Is the Member a senior executive in an entity that has business or contracts with the Company? If yes, please provide the full details as follows:

Yes No

and contracts

contracts

2 3

q. Does the Member participate in any business that would compete with the Company or any company within its group, or do business that competes with the ancillary activities of the Company or any company within its group?

Yes No

# Company’s Name Nature of the competing work or activity

1 2 3

r. Does the Legal Person that the Member is representing participate in any business that would compete with the Company or any company within its group, or do business that competes with the ancillary activities of the Company or any company within its group?

Yes No

Not applicable

1 2 3

(11)

7

0

o o o

0 0

❑ ❑

o

Form (3)

s. Is the Member a member of a board of directors or board of managers of a company where such company or any company within its group participate in any business that would compete with the Company or any company within its group, or do business that competes with the ancillary activities of the Company or any company within its group?

Yes No

1 2 3

t. Is the Legal Person that the Member is representing a member of a board of directors or board of managers of a company where such company or any company within its group participate in any business that would compete with the Company or any company within its group, or do business that competes with the ancillary activities of the Company or any company within its group?

Yes No

Not applicable

1 2 3

u. Does the Member own or participate in the ownership of an entity, where such entity, or any company within its group,

participate in any business that would compete with the Company or any company within its group, or do business that competes with the ancillary activities of the Company or any company within its group?

Yes No

# Entity’s Name Nature of the competing work or activity

1 2 3

v. Does the Legal Person that the Member is representing own or participate in the ownership of an entity, where such entity, or any company within its group, participate in any business that would compete with the Company or any company within its group, or do business that competes with the ancillary activities of the Company or any company within its group?

Yes No

Not applicable

1 2 3

w. Is the Member a senior executive in an entity, where such entity, or any company within its group, participate in any business that would compete with the Company or any company within its group, or do business that competes with the ancillary activities of the Company or any company within its group?

If Yes, please provide the full details as follows:

Yes

No

1 2 3

Note: The Member and the Legal Person that the Member is representing shall be responsible the for the correctness of information provided in this Form (each to the information applicable to him/it).

The Member The Legal Person that the Member represents

Name: Name of the Legal Person that the Member represents:

Signature: Name of the authorized signatory:

Date: Position

* Disclaimer:

This form represents a translation of the Arabic original version, therefore, in case of any misinterpretation, the Arabic version will prevail

(12)

Sa

l ull j9157 at5o,u di Taclawul Group

)3( جذومن Form (3) “ Confidential “ " يّرــــــــــس "

ةعجارملا ةنجلو ةرادإلا سلجم ءاضعأ تامولعم جذومن ردصملل

مهبراقأو نييذيفنتلا رابكو

Issuer’s Board of Directors, Audit Committee, Senior Executives and their associates information From

Filing the form instructions

1. The form shall be updated no more than 10 business days from the date of the change of board of directors, executive team, or audit committee members. Or on any change regarding their relatives or in any information in it during the first 10 days of the start of the issuer’s board of directors’

duration.

2. Unless the contrary intention appears, the words and expressions in this Glossary shall have the meaning herein specified:

Rules and regulation: Exchange rules and regulations, and all its amendment.

The form: the form of Board of Directors, Audit Committee, Senior Executives information.

Issuer: Any company that has is securities listed in the market.

Disclosed: Is one of the board of director member or senior executive or audit committee or their relatives according to this from is considered as an insider person as of Exchange rules.

Senior Executive: any natural person to whom has given responsibility to take strategic actions for the issuer including the CEO and their acting and the financial manager.

Relative: Husband and wife and their minor children.

3. A copy of the family card shall be attached, and the national ID for the GCC members. And a copy of the Iqama for the residents and their relatives if any, or a copy of the passport if they do not have an Iqama as per the definition.

4. If resignation of any of the board members, senior executive, or audit committee the issuer must notifies the Exchange in no longer than 5 business days.

جذومنلا ءلم تاميلعت 1 اهاصقأ ةدم لالخ جذومنلا ثدحُي. 10

خيرات نم لمع مايأ رييغت ثودح

ةرادإلا سلجم يف

وأ يرادإلا زاهجلا وأ وأ ةعجارملا ةنجل ءاضعأ

براقألا تانايب يف ريغتلا دنع نم يأ وأ

اهاصقأ ةدم لالخو هيف ةدراولا تامولعملا 10

ةرادإ سلجم ةرود ةيادب نم لمع مايأ ردصملا

.

2 قي مل ام اهءازإ ةحضوملا يناعملا هاندأ ةدراولا تارابعلاو تاملكلاب دصقُي . صنلا قايس ض

كلذ ريغب :

:حئاوللاو ةمظنألا ماظن

هيلع أرطت دق تاليدعت يأو ،ةيذيفنتلا هحئاولو ةيلاملا قوسلا .م

لا جذومن : ةعجارملا ةنجلو ةرادإلا سلجم ءاضعأ تامولعم جذومن ردصملل

نييذيفنتلا رابكو

.مهبراقأو :ردصملا ةكرش يأ يه اهل عاونأ نم عون يأ قاروألا

ةيلاملا ةجردم يف قوسلا .

:حصفٌملا مهبراقأو ةعجارملا ةنجل ءاضعأ وأ نييذيفنتلا رابك وأ ةرادإلا سلجم ءاضعأ دحأ وه

.عل ّطملا صخشلاب ةيلاملا قوسلا ماظن يف مهيلإ راشملاو جذومنلا اذه قفو نييذيفنتلا رابك تارارقلا ذيفنتو عضو نع ًالوؤسم نوكيو ريدي يعيبط صخش يأ":

ةيجيتارتسالا ردصملل يلاملا ريدملاو هباونو يذيفنتلا سيئرلا كلذ يف امب .

:بيرقلا

“ رصقلا دالوألاو ةجوزلاو جوزلا .

3 لود ينطاومل ةينطولا ةيوهلا ةروصو )ةلئاعلا رتفد( ةرسألا لجس نم ةحضاو ةروص قفرُت .

نم ةروصو ميقملل ةماقإلا ةصخر نم ةروصو ،يبرعلا جيلخلا لودل نواعتلا سلجم ةصخر

بسحب ةماقإ دوجو مدع لاح يف رفسلا زاوج نم ةروص وأ مهدوجو لاح يف براقألل ةماقإلا .فيرعتلا 4 . ىلع بجي ةعجارملا ةنجل وأ ،نييذيفنتلا رابك ،ةرادإلا سلجم ءاضعأ دحأ ةلاقتسا لاح يف

ردصملا لالخ قوسلا راعشإ (

5 ) .لمع مايأ

ةراشإ عض( X امثيح ةمزاللا تاناخلا ىلع )قبطني

(use X as a checkmark to the below blanks) ءارجإلا عون Process type

☐ فيلكت / نييعت Designation / assign

☐ ... ىرخأ ………..………… Other

☐ ةلاقتسا : ( ركذ ببسلا )

Resignation :

(Mention the cause)

مسا ردصملا Issuer name

☐ ةرادإ سلجم وضع Member of the Board of

directors

☐ نييذيفنتلا رابك نم Senior executive

☐ ةعجارملا ةنجل وضع Audit committee

مسالا Name يفيظولا ىمسملا

Position title ةيوهلا مقر

National ID خيرات

داليملا Date of birth

تانايبلا ةيصخشلا Personal Information

ةعيبط ةيوضعلا Membership type

☐ هتفصب ةيصخشلا By himself

☐ يرابتعا صخش نع لثمم

( ركذا مسا صخشلا يرابتعلاا )

A representative of a member (state the name of the member) لجسلا مقر

يراجتلا CR Number

ةيعامتجالا ةلاحلا Social status

☐ جوزتم

Married

☐ بزعأ Single ةيسنجلا

nationality بصنملا يلوت خيرات

/

ريغتلا/ةلاقتسالا Date of designation/

resignation/ change

يديربلا ناونعلا B.O.X address ينورتكلإلا ديربلا

Email address

فتاهلا Telephone سكافلا

FAX لاوجلا

Phone

ءامسأ براقألا

( )لودجلا ةئبعت متي ال ةلاقتسالا لاح يف

(13)

'lila JO at5o,u Saudi Tadawul Group

)3( جذومن Form (3) “ Confidential “ " يّرــــــــــس "

Related names (

if resignation do not complete the table below )

اهيف كلمي ةكرش وأ ،صخشلا كلذ اهيلع رطيسي ةكرش ينوناقلا اهلكش ناك ًايأ رثكأ وأ %30

( )لودجلا ةئبعت متي ال ةلاقتسالا لاح يف A company controlled by that person, or a company controlled by 30% of its shares or more whatever its legal form.

( if resignation do not complete the table below )

ماكحألاو طورشلا 1 ةعجارملا ةنجلو ةرادإلا سلجم ءاضعأ تامولعم جذومن ىلع عيقوتلا ّدَعُي . ردصملل

ًارارقإ مهبراقأو نييذيفنتلا رابكو

.)"ماكحألاو طورشلا"( ماكحألاو طورشلا هذهب 2 . ىلع بجي حصفُملا ردصملاو مدقي نأ ا ىلإ صوصنملا قئاثولاو تادنتسملا عيمج قوسلا اهيلع

يف اذه جذومنلا

،

سلا ماظنو )"حئاوللاو ةمظنألا"( اهيلع أرطت تاليدعت يأو ،قوسلا دعاوقو ،ةيذيفنتلا هحئاولو ةيلاملا قو .

3 دصقُي . ضقي مل ام حئاوللاو ةمظنألا يف اهل ةحضوملا يناعملا ماكحألاو طورشلا يف ةدراولا تارابعلاو تاملكلاب

كلذ ريغب صنلا قايس سلجم ءاضعأ تامولعم جذومن )"جذومنلا"( ةملكب دصقُي ماكحألاو طورشلا هذه ضارغألو،

ةعجارملا ةنجلو ةرادإلا ردـــصملل

ةقفارملا تادنتـــسملاو هيف ةدراولا تانايبلاو قودنـــص مهبراقأو نييذيفنتلا رابكو

رخآل تقو نم لوادت اهددحت يتلا ،هل .

4 . دهعتي حصفُملا ردصملاو عالطالاب نألا ىلع حئاوللاو ةمظ مازتلالاو .اهب

5 . رقي حــــصفملا هملعب ماكحألاب ةــــضورفملا هيلع بجومب ماكحأ ماظن قوــــسلا ةيلاملا ماظنو تاكرــــشلا امهحئاولو

،ةيذيفنتلا دهعتيو مدعب حاص فإلا نع يأ ةمولعم ةيلخاد لص تت لامعأب ردصملا يأل

صخش

،رخآ امك دهعتي مدعب

لوادتلا ءانب ىلع كلت ةمولعملا ةيلخادلا هنأو ىلع ملع نأب ماظن قوـــــسلا ةيلاملا دق بتر ىلع كلذ ةيلوؤـــــسم

ةيئانج .

6 . ال ت لمحت لوادت وأ اهتقد وأ بلطلا اذه يف ةدراولا عيقاوتلاو ماقرألاو تانايبلاو تامولعملا ةحــص مدع ةيلوؤــسم

لمحتيو ،اهلامتكا مدع وأ اهتمالــــس حــــصفُملا

ردــــصملاو هدحو ام راثآ وأ تاعبت يأو كلذ نع ةيلوؤــــسملا لماك

.هنع جتنت ةينوناق تافورــــصملاو رارــــفألاو رئاــــسخلا عيمج نع عاديإ ضيوعتب ردــــصملاو حــــصفُملا مزتلي كلذك

ًايأ جذومنلا يف ةدراولا تاميلعتلل لوادت ذيفنتل ةجيتن ةئـــــشانلا اياـــــضقلاو تاءاعدالاو تايلوؤـــــسملاو فيلاكتلاو لخيو ،اهتعيبط تناك يتلا تاكرــشلاو اهيفظومو اهيريدمو اهترادإ سلجمو لوادت ةيلوؤــسم ردــصملاو حــصفُملا ي

يأ هاجت ةيلوؤــسم وأ ىواعد وأ تاــضيوعت وأ رئاــسخ وأ تابلاطم وأ رارــفأ يأ نع اهل ةعباتلا تاكرــشلا وأ اهعبتت .جذومنلا ذيفنت ةجيتن رشابم ريغ وأ رشابم لكشب أشنت ،ةهج وأ صخش

7 . دهعتي و حصفُملا .لوادت هددحت رخآ دنتسم يأ ميدقتب ردصملا

8 . ُت ال َع ّد لوادت لوؤــسم ًة قلعتت اهريغ وأ ماقرأ وأ عيقاوت وأ تامولعم وأ تانايب وأ تادنتــسم يأ ظفح نع جذومنلاب

،

قحب لالخإلا نود كلذو لوادت

هتدارإل ًاقفو اهب ظافتحالا يف ا

.ةدرفنملا

9 . نأب ردـــصملا دهعتي وـــضعلا

لثمملا ىلع عقوملا ا جذومنل ًاماظن هيلإ ضَّوفم ب

ىلع عيقوتلا جذومنلا ةقداـــصملاو

راطخإب ردصملا دهعتي امك ،هيف ةدراولا تانايبلا ةحص ىلع لوادت

ت يأب رييغ ىلع أرطي وضعلا لثمملا .

10 . مدقي ردصملا نم ةيلصأ ةخسن جذومنلا

ىلإ

،لوادت لابقتسا ةليسو ديدحت لوادتلو جذومنلا

مأ ًايودي تناكأ ءاوس

أ ًاينورتكلإ م ىدل ةلوبقم ىرخأ ةقيرط يأ لوادت

يف ةدراولا تاميلعتلا ذيفنت لامكتسال كلذو جذومنلا

.

11 . نوكي ملست جذومنلا ةيمسرلا لمعلا مايأ لالخ

،لوادتل ماكحألاو طورشلا هذه ضارغألو ّدَعُي

يذلا راعشإلا ت هملست

لوادت مايأ نم قحاللا مويلا يف ملس ت هنأ ىلع لمعلا مايأ ريغ يف وأ يمسرلا لمعلا تقو نم نيتعاس رخآ لالخ

.ةيمسرلا لمعلا 12 . ا نوكي ال جذومنل ًالمتكم ةينفلاو ةيئارجإلا تاميلعتلل ًاقفوو ةحيحص هـــل ةلمكملا قئاثولاو تانايبلا عيمج نكت مل ام

لوادتل رخآل تقو نم ددجتت دق يتلاو

، و لوادتل اهريدقتل ًاقفو- - مدع لوبق جذومنلا يذلا يوتحي ىلع

،بطــــش وأ

تانايب ريغ

،ةءورقم وأ .ةحضاو ريغ

13 َّـسفت . اهل عـضختو ةيراـسلا ةيدوعـسلا ةيبرعلا ةكلمملا نيناوقو ةمظنأل ًاقبط ماكحألاو طورـشلا هذه ر

، و يأ عـضخي

ملا ةيئاضقلا ةهجلل ماكحألاو طورشلا قيبطت ءارج نم أشني عازن اب ةصتخ

ضايرل يف ا ةكلممل ةيبرعلا ةيدوعسلا . Terms and Conditions

1- Signing the Issuer’s Board of Directors, Audit Committee, Senior Executives and their associates information form shall be deemed as an acknowledgment of these Terms and Conditions ("Terms and Conditions").

2- The Disclosed and Issuer shall submit to the Exchange all documents provided in this Form, the Capital Market Law, its implementing regulations, Exchange rules, and any amendments to the aforementioned ("Laws and Regulations").

3- Terms and phrases used in the Terms and Conditions shall have the meanings given thereto in the Laws and Regulations unless the context requires otherwise. For the purposes of these Terms and Conditions, the word ("Form") shall mean of the Issuer’s Board of Directors, Audit Committee, Senior Executives and their associates information form, the information contained therein, and documents attached thereto as Tadawul determines from time to time.

4- The Disclosed and Issuer undertake to review Laws and Regulations and abide thereby.

5- The Disclosed acknowledges that he is aware of the provisions imposed on him by the Capital Market Law, the Companies Law and their implementing regulations. The Disclosed undertakes to not disclose any insider information related to the Issuer’s business to any other party. Also the Disclosed acknowledges to not trade based on insider information. The Disclosed is aware that the Capital Market Law considered this as a criminal liability.

6- Tadawul shall assume no responsibility for the inaccuracy of information, data, numbers, and signatures provided in this Form, nor for the truthfulness, integrity, or completion thereof; the Disclosed and Issuer shall solely be responsible for this in full as well as for any resulting legal consequences. The Disclosed and Issuer shall also undertake to indemnify Tadawul against all losses, damages, expenses, costs, liabilities, claims, and legal actions resulting from the execution by Tadawul of the instructions provided in the Form notwithstanding the nature thereof. The Disclosed and Issuer discharges the Tadawul, its board of directors, directors, officers, mother companies, and subsidiaries thereof from any liability, claims, losses, compensations, actions, or liability towards any person or entity, resulting directly or indirectly from the execution of the Form.

7- The Disclosed and Issuer undertake to provide Tadawul with any documents specified by the Tadawul.

8- Tadawul shall not be responsible for keeping any documents, data, information, signatures, numbers, or other items relevant to the Form, all without prejudice to the right of Tadawul to keep those as per the sole discretion thereof.

9- The Disclosed undertake that the Representative Member signing the Form is duly authorized to sign on such the Form and rectify the information provided therein; the Asset Manager shall also notify Tadawul of any update on the Representative Member.

10- The Issuer shall provide the original copy of the Form, rectified thereby, to Tadawul, and Tadawul shall specify the method of receiving such the Form, whether in hand, electronically or in any other means acceptable to Tadawul in order to complete the execution of the instructions provided in the Form.

11- The Form should be received during official Business Days of Tadawul, and for the purposes of these Terms and Conditions, notice received by Tadawul during the last two hours of official working hours or other than during Business Days shall be considered to have been received in the subsequent official Business Day.

12- The Form may not be deemed complete unless all complementary information and documents are correct as per the procedural and technical instructions of Tadawul, which may be subject to revision from time to time, and Tadawul may, upon its discretion, refuse to accept any Application containing any strike-offs, non- legible, or unclear information.

13- These Terms and Conditions shall be construed and applied in accordance with the laws and regulations of the Kingdom of Saudi Arabia. Any dispute arising out of the Form of these Terms and Conditions shall be referred to the competent judicial authority in Riyadh in Kingdom of Saudi Arabia.

لا لثمملا وضع /

Representative Member

مسالا / Name :

ةفيظولا / Job :

عيقوتلا / Signature :

خيراتلا /

:Date Official stamp/يمسرلا متخلا

/حصفُملا Disclosed

مسالا / Name :

ةفيظولا / Job :

عيقوتلا / Signature :

خيراتلا / :Date

مسالا Name ةقالعلا ةفص

Relationship type ةيوهلا مقر

ID number داليملا خيرات

Date of birth

م s ةكرشلا مسا

Company name ةكرشلل يراجتلا لجسلا مقر

Company’s CR number ةيكلملا ةيبسن

Ownership percentage