يشرتلا بلط ةرامتسا دلابلا كنب ةرادإ سلجم ةيوضعل ح
ةرودلل ةمداقلا نم أدبت يتلاو
تا خير 17 / 04 / 22 20 م لا ى 16 / 4 0 / 25 20 م
Nomination Form for Board of Directors Membership for the upcoming Term starting from 17/4/2022 to 16/4/2025
عيقوتلا Signature ...
...
ةحفص 1 نم 3
حشرملا مسا Candidate's name
مقر ةماقلإا / رفسلا زاوج / ةينطولا ةيوهلا National ID/Passport/Residence Number
دلايملا خيرات
Date of Birth
يملعلا لهؤملا
Scientific Qualification -
- - -
تاربخلا ا ةيلمعل ةطشنأو لامعأ لاجم يف
كونبلا دجو نإ(
ت )
Practical Experiences in Banking Business and Activities (if any)
- - - - - - يلاح لغشي حشرملا ناك اذإ• سلجم ةيوضع هل قبس وأ ًا
ةرادلإا سلجملل ةعباتلا ناجللا ىدحا يف وضع وأ ىدحلأ ،
تاكرشلا ةجردملا ريغو ةجردملا ،
ىجري(
)اهحاضيإ ، رضح يتلا تاسلجلا روضح لجسو ةلاصأ اه
.
• If the candidate currently or has previously served on the Board of Directors or is a member of one of the board's committees, for one of the listed and unlisted companies, (details list required), and the record of attending the meetings that have been attended in Person.
ةكرشلا Company خيرات
ةيوضعلا ءدب
Start Date of Membership وضعلا ءاهتنا خيرات
ةي
End Date of Membership
1 .
2 .
3 .
4 .
5 . فرأ• ا ق ةيتاذلا ةريسلل ةديؤملا تادنتسملا و
كنبلا لامعأ يف تاربخلاو تلاهؤملا .
• Attach documents supporting the cv, qualifications and expertise in the banking business and activities.
يشرتلا بلط ةرامتسا دلابلا كنب ةرادإ سلجم ةيوضعل ح
ةرودلل ةمداقلا نم أدبت يتلاو
تا خير 17 / 04 / 22 20 م لا ى 16 / 4 0 / 25 20 م
Nomination Form for Board of Directors Membership for the upcoming Term starting from 17/4/2022 to 16/4/2025
عيقوتلا Signature ...
...
ةحفص 2 نم 3
حيشرتلا طورش • :
1 كي نأ نو حشرملا ىلع لصاح ةيملع تلاهؤم
ىلع هدعاست تايلوؤسمو هماهم ءادا
ه .سلجملاب
2 أ بجي أ حشرملل نوكي لا ي
صم وأ ةحل وا ةيوضع .يسيئرلا هطاشن يف كنبلا ةسفانم هنأش نم لمع يأ يف كرتشي
3 تاكرش سمخ نم رثكأ ةرادإ سلجم ةيوضع حشرملا لغشي لاأ بجي ةجردم
.دحاو نآ يف
4 مزتلي نأ رملا حش ةيوضعلا هاجت هتابجاوو هصاصتخاب مايقلل بسانمو فاك تقو صيصختب ةيوضعلا بلطل
5 أ نادإ قبس دق نوكي لا ت
ه ب هسلافإ راهشإب مكح ردص وأ ةناملأاو فرشلاب ةلخم ةميرج
6 .حيشرتلا ةرامتسا عيقوتو ءافيتسا
7 ةئبعت ( جذومن ةمئلاملا ) صاخلا يدوعسلا يزكرملا كنبلاب .
8 ةئبعت ( مقر جذومن 3
) ةئيهب صاخلاو .ةيلاملا قوسلا
9 حشرملل ةبسنلاب إ ةرادإ سلجم ةيوضع لغشي لازيام وأ لغش نأ هل قبس يذلا
ح د ى نايب قافرإ هيلعف ،ةمهاسملا تاكرشلا تاكرشلا ءامسأب
.ةلاصأ اهرضح يتلا تاسلجلا روضح لجسو ةيوضعلا هلغش خيراوتو ،اهتارادإ سلاجمب َاوضع ناك يتلا ةمهاسملا 10 ميدقت وص ةر ةينطولا ةيوهلا ةقاطب نم ةحضاو رفسلا زاوجو
فلأل ةبسنلاب يلئاعلا لجسلاو لوعفملا ةيراس ل يراجتلا لجسلاو دار
كرشل تا
حشرملاب ةصاخلا لاصتلاا ماقرأو تاسسؤملاو .
11 اهتيكلم وأ اهترادإ يف حشرملا كرتشي يتلا تاسسؤملا وأ تاكرشلاب نايب اهترادإ سلاجم ةيوضع وأ
ًلاامعأ سرامتو امعأب ةهيبش
وأ كنبلا ل
.كنبلا عم ةكرتشم حلاصم وأ دوقع اهل 12 اختنا ةلاح يف حشرملا مازتلا ةرادلإا سلجم ةيوضعل هب
ت ةسايسل ًاقفو ةبولطملا تاحاصفلإا ميدقتب ضراع
ةرادلإا سلجم ءاضعأ حلاصم
سلجملا نع ةقثبنملا ناجللا ءاضعأو .
• Nomination terms:
1 The candidate must have scientific qualifications to assist perform his duties and responsibilities in the Board.
2 The candidate must not have any interest, membership or participation in any work that would compete with the bank in its main activity.
3 The candidate must not serve on the board of directors of more than five listed companies simultaneously.
4 The candidate must commit to the application for membership by allocating sufficient and appropriate time to carry out his competence and duties towards membership.
5 Has not previously been convicted of a crime against honour or has been sentenced to bankruptcy 6 Complete and sign the nomination form.
7 Fill in (Fit & Proper form) issued by the Central Bank.
8 Fill in Form 3 - CMA.
9 For a candidate who has previously served or continues to serve on the Board of Directors of a joint stock company, he or she must attach a statement of the names of the joint stock companies that he was a member of the boards of directors, his or her membership dates and the record of attendance at the sessions attended in person..
10 Provide a clear copy of the national identity card, valid passport, family ID for individuals, commercial certificates of companies and institutions and the candidate's contact numbers.
يشرتلا بلط ةرامتسا دلابلا كنب ةرادإ سلجم ةيوضعل ح
ةرودلل ةمداقلا نم أدبت يتلاو
تا خير 17 / 04 / 22 20 م لا ى 16 / 4 0 / 25 20 م
Nomination Form for Board of Directors Membership for the upcoming Term starting from 17/4/2022 to 16/4/2025
عيقوتلا Signature ...
...
ةحفص 3 نم 3
11 A list of companies or institutions that the candidate co-manages, owns or membership of their boards of directors and engages in business similar to the bank's business or has joint contracts or interests with the bank.
12 The candidate's obligation if elected to the Board of Directors to provide the required disclosures in accordance with a policy conflict of interest of board members and members of sub-committees.
رارقإ• علاطلااب حيشرتلا بلط ىلع عيقوتلاو طورشلا ىلع :
لطأ دقل اهنع نلعملا حيشرتلا طورش ىلع تع ،
اضلإاب ام ىلا ةف
درو يف ميماعت ةرازو ةراجتلا و ،ةلصلا تاذ ملا
كونبلا يف ةمكوحلل ةسيئرلا ئداب
ةيدوعسلا ةيبرعلا ةكلمملاب ةلماعلا نم ةرداصلا
يدوعسلا يزكرملا كنبلا ،
تاكرشلا ماظنو
هحئاولو ، و جاردلإاو ليجستلا دعاوق
و ةمكوح ةحئلا
ةيلاملا قوسلا ةئيه نم ةرداصلا تاكرشلا
، و فوتل يتبغر يدبأ يننأف يدل اهر لا يف
ةرادإ سلجم ةيوضعل حيشرت ةمداقلا ةرودلل دلابلا كنب
سلجملل
و يتلا أدبت خيراتب 17 / 4 / 22 20 م .تاونس ثلاث ةدملو
• Acknowledgement of Reviewing the Conditions for Nomination:
I hereby acknowledge that I have read all the nomination conditions including all mentioned in Ministry of Commerce circulars related, the principles of governance in the financial institutions operating in Saudi Arabia issued by the Central Bank, the Companies' Law and its regulations, Listing Rules and the Regulations of Corporate Governance issued by Capital Market Authority, therefore, I would like to apply for the membership for Board of Directors of Bank Albilad for the upcoming term that started from 17/4/2022 for 3 years.
مسلاا Name ينطولا ناونعلا National address
لصاوتلا ماقرا Contact numbers
ينورتكللإا ديربلا E-mail
عيقوتلا Signature ...
...
ًاريرحت يف Date In
:ةظحلام ع لاح يف ةباجلإل ةصصخملا ةحاسملا ةيافك مد
ىلع يأ مم قبس ا اهقافراو اهيلع عيقوتلا متيو ةيجراخ ةقرو يف ةباجلإا قافرإ يغبنيف
.هذه حيشرتلا ةرامتساب Note: If extra space is required to answer any question, the answer shall be written on another paper attached to the Form and signed by the Candidate
CV Template
Candidate’s Information:
Full Name
Nationality Date of Birth
Candidate’s Qualifications:
# Academic Qualification Field of Specialization Graduation Date Name of Issuing Entity 1
2 3 Expertise:
Period Fields of Expertise
Current Membership in the Board of Directors of other Joint Stock Companies (listed or unlisted), or any other company, regardless of its legal form or committees:
# Company Name Major Activity
Membership Type (Executive, Nonexecutive,
Independent)
Membership Nature (Personal, Representative of a Legal Entity)
Committee
Membership Legal Form
1 2 3 4 5 6 7 8
