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Undertaking and Approval to obtain and disclose information

Customer Name:

Customer ID with ADCB (if any):

Date:

I _________________________________________________irrevocably and unconditionally authorize


and permit Abu Dhabi Commercial Bank PJSC (the Bank) to make inquiries in relation to the financial
situation with Al Etihad Credit Bureau. I hereby agree that such enquiries may relate to any information
relating to my financial position (Including but not limited to its credit history)

Full Name as per passport: ________________________________

EID No: ________________________________

Passport No: ______________________________

Date of Birth (DD/MM/YY): ____________________

Nationality: ____________________________

Gender:_________________________

Mobile Number : _____________________________

_____________________________________

Customer Signature