Request for Consumer Credit Report for Ministry of Housing Applications

‫طلب التقرير اإلئتماني لألفراد لطلبات وزارة االسكان‬

APPLICANT INFORMATION ‫بيانات مقدم الطلب‬
Applicant Name: : ‫إسٌ ٍقذً اىطيت‬

ID Type: :‫ّىع اىهىٌخ‬ ID Number / CPR: :ً‫اىشقٌ اىشخظ‬

Nationality: :‫اىجْسٍخ‬ Gender: :‫اىجْس‬ D.O.B: :‫ربسٌخ اىٍَالد‬
Road: :‫طشٌق‬ Flat: : ‫شقخ‬ Building: : ‫ٍجْى‬
P.O. Box: :.‫ة‬.‫ص‬ City: :‫اىَذٌْخ‬ Block: :‫ٍجَغ‬
Office Tel.: :‫هبرف ا ىؼَو‬ Home Tel.: :‫هبرف اىَْضه‬ Mobile: :‫اىْقبه‬
: ‫اقرار مقدم الطلب‬
‫ أفىع ٍشمض اىجحشٌِ ىيَؼيىٍبد اإلئزَبٍّخ ث ششمخ ثْفذ ثزحذٌث ثٍبّبرً اىشخظٍخ اىَىضحخ أػالٓ وإدخبىهب فً حبه ػذً رىافشهب فً ّظبً ٍشمض اىجحشٌِ ىيَؼيىٍبد‬،ٓ‫أّب اىَىقغ أ دّب‬
.‫اإلئزَبٍّخ و إطذاس اىزقشٌش اإلئزَبًّ اىزي ٌحزىي ػيى مبفخ اىجٍبّبد اإلئزَبٍّخ اىَزىفشح ىذٌهب ٍِ اىجْىك واىَؤسسبد اىََىىخ واألػضبء‬
‫مَب أفىع ٍشمض اىجحشٌِ ىيَؼيىٍبد اإلئزَبٍّخ ثششمخ ثْفذ ثئسسبه اىزقشٌشي اإلئزَبًّ اىخبص ثشقًَ اىشخظً اىَىضح أػالٓ إلداسٓ اىخذٍب د االسنبٍّخ ثىصاسح اإلسنبُ ورىل خاله‬
.‫ٍذح أقظبهب ش هش ٍِ ربسٌخ هزا اىطيت وأرؼهذ ثبىحضىس السزالً اىزقشٌش إرا ىٌ ٌشسو ىيجهخ اىَزمىسح‬
ً‫ حٍث أُ ششمخ ثْفذ غٍش ٍشخض ىهب ثزغٍٍش أو رؼذٌو اىجٍبّبد اىىاسدح ف‬.‫ ٌجت ٍشاجؼخ اىجْل أو اىَؤسسخ اىََىىخ‬،ًّ‫فً حبه ػذً طحخ اىَؼيىٍبد اىَزمىسح فً اىزقشٌش اإلئزَب‬
.‫ اىجْىك و ٍؤسسبد اىزَىٌو واألػضبء هً اىجهخ اىىحٍذح اىزً رَيل حق رغٍٍش أو رؼذٌو اىجٍبّبد اىخبطئخ‬.‫اىزقشٌش أو اإلطال ع ػيٍهب‬

Notice to the Applicant:

I the undersigned request and authorized BAHRAIN CREDIT REFERENCE BUREAU operated by THE BENEFIT COMPANY to add and update
my personal details as given above and issue my Credit Report to show the information which has been held by them as given by the Banks , the
Financial Institutions and Members. I authorize BAHRAIN CREDIT REFERENCE BUREAU operated by THE BENEFIT COMPANY to issue
my Credit Report as per the ID number given above and deliver it to HOUSING SERVICE DIRECTORATE at MINISTRY OF HOUSING within
a month from the request date, and I confirm receiving my report incase if the report was not sent to the mentioned directo rate.
If the information provided in the Credit Report is believed to be incorrect, you should inform the Bank or the Financial Ins titution directly.
THE BENEFIT COMPANY is not authorized to change any data that has been provided by these organizations. Th e Banks, the Financial
Institutions, or the members are the only organizations who are authorized to correct the data if an error has been found.

DATE: :‫التاريخ‬ SIGNATURE: :‫التوقيع‬

WITNESS INFORMATION ‫بيانات الشاهد‬

(FOR MINISTRY OF HOUSING & ESKAN BANK USE ONLY) ) ‫( إل سزخذاً وصاسح اإلسنبُ وثْل اإلسنبُ فقظ‬
Witness Name: : ‫إسٌ اىشبهذ‬
ID Number (CPR): :ً‫اىشقٌ اىشخظ‬
Witness Signature: :‫رىقٍغ اىشبهذ‬

WITNESS INFORMATION ‫بيانات الشاهد‬ MINISTRY OF HOUSING / ESKAN BANK

(FOR MINISTRY OF HOUSING & ESKAN BANK USE ONLY ) ) ‫( إل سزخذاً وصاسح اإلسنبُ وثْل اإلسنبُ فقظ‬ Stamp
Witness Name: : ‫إسٌ اىشبهذ‬

ID Number (CPR): :ً‫اىشقٌ اىشخظ‬

Witness Signature: :‫رىقٍغ اىشبهذ‬

MINISTRY OF HOUSING / ESKAN BANK REF. NO. :

Benefit Use Only ‫إلستخدام شركة بنفث فقط‬ THE BENEFIT COMPANY Stamp
Date Received: :ً‫ربسٌخ ا إل سزال‬

Approved by: :‫ٍىافق ٍِ قجو‬

Date Sent to Customer: :‫ربسٌخ إسسبه اىزقشٌش‬

Carrier Reference No: :‫سٍض اىجشٌذ‬

FOR MINISTRY OF HOUSING / ESKAN BANK USE ONLY