‫‪Annexe 3‬‬

‫ﺍﺳﺘﻤﺎﺭﺓ ﻃﻠﺐ ﺑﻴﻊ ﺑﺎﻟﺘﻘﺴﻴﻂ‬

‫ﻣﻌﻠﻮﻣﺎﺕ ﻋﻦ ﻃﺎﻟﺐ ﺍﻟﺸﺮﺍﺀ‬
‫ﺍﻟﺸﺮﻳﻚ ﻓﻲ ﺍﻟﺸﺮﺍﺀ‬ ‫ﺍﻟﻤﺸﺘﺮﻱ‬
‫‪Mansouri‬‬
‫ﺍﻟﻠﻘﺐ‬

‫ﺍﻟﻠﻘﺐ ﻗﺒﻞ ﺍﻟﺰﻭﺍﺝ‬

‫‪Abdelmadjid‬‬ ‫ﺍﻻﺳﻢ‬

‫‪05-10-2017‬‬ ‫ﺗﺎﺭﻳﺦ ﺍﻟﻤﻴﻼﺩ‬

‫‪‬‬
‫‪‬‬
‫‪‬‬ ‫)‪Marié(e‬‬ ‫ﺍﻟﺤﺎﻟﺔ ﺍﻟﻌﺎﺋﻠﻴﺔ‬
‫‪‬‬

‫‪……………………………………………………………………..‬‬

‫…‪…………………………………………………………………..‬‬
‫‪ALger‬‬ ‫ﺍﻟﻌﻨﻮﺍﻥ ﺍﻟﺤﺎﻟﻲ‬
‫‪……………………………………………………………………..‬‬

‫‪2.13555924535E11‬‬ ‫ﺍﻟﻬﺎﺗﻒ ﺍﻟﺜﺎﺑﺖ‬

‫……………………………………………………………………‬

‫……………………………………………………………………‬ ‫‪2.13555924535E11‬‬ ‫ﺍﻟﻬﺎﺗﻒ ﺍﻟﻤﺤﻤﻮﻝ‬

‫ﺍﻟﻌﻨﻮﺍﻥ ﺍﻻﻟﻜﺘﺮﻭﻧﻲ‬

‫‪1‬‬ ‫ﻋﺪﺩ ﺍﻷﺷﺨﺎﺹ ﺍﻟﻤﺘﻜﻔﻞ ﺑﻬﻢ‬

‫……………………………………………………………………‬

‫ﺍﻟﻤﻬﻨﺔ‬

‫ﺍﺳﻢ ﺍﻟﻤﺴﺘﺨﺪﻡ ﺍﻟﺤﺎﻟﻲ‬

‫……………………………………………………………………‬

‫……………………………………………………………………‬ ‫ﻋﻨﻮﺍﻥ ﺍﻟﻤﺴﺘﺨﺪﻡ‬

‫……………………………………………………………………‬

‫ﺍﻟﻬﺎﺗﻒ ﺍﻟﻤﻬﻨﻲ‬

‫ﺃﻗﺪﻣﻴﺘﻜﻢ ﻓﻲ ﻭﻇﻴﻔﺘﻜﻢ ﺍﻟﺤﺎﻟﻴﺔ‬

‫ﻣﺪﺍﺧﻴﻠﻜﻢ ﺍﻟﺸﻬﺮﻳﺔ ﺍﻟﺼﺎﻓﻴﺔ‬

‫ﺍﻟﺒﻨﻚ ﺍﻷﺳﺎﺳﻲ ﺍﻟﺤﺎﻟﻲ‬
‫‪Al Salam bank - Agence Dely Brahim‬‬ ‫ﺍﻟﻤﺘﻌﺎﻣﻞ ﻣﻌﻪ‬
‫ﻓﺮﻉ‬

‫ﻻ ﺗﺘﺮﺩﺩﻭﺍ ﻋﻨﺪ ﺍﻟﺤﺎﺟﺔ ﺇﻟﻰ ﺃﻱ ﻣﻌﻠﻮﻣﺎﺕ ﻓﻲ ﺍﻻﺗﺼﺎﻝ ﺑﻤﺴﺘﺸﺎﺭﻱ ﺍﻟﻤﺘﻌﺎﻣﻠﻴﻦ ﻓﻲ ﻣﺴﺘﻮﻯ ﻣﺨﺘﻠﻒ ﻓﺮﻭﻉ ﻣﺼﺮﻑ ﺍﻟﺴﻼﻡ ﺍﻟﺠﺰﺍﺋﺮ ﻣﻦ ﺃﺟﻞ ﻣﺴﺎﻋﺪﺗﻜﻢ ﻓﻲ ﻣﺨﺘﻠﻒ ﺧﻄﻮﺍﺕ ﺍﻟﺘﻤﻮﻳﻞ ﻭﺍﻟﺠﻮﺍﺏ ﻋﻠﻰ ﻛﺎﻓﺔ ﺍﺳﺘﻔﺴﺎﺭﺍﺗﻜﻢ‪.‬‬
‫ﺑﻤﻠﺌﻜﻢ ﺍﻟﺠﻴﺪ ﻟﻬﺬﻩ ﺍﻻﺳﺘﻤﺎﺭﺓ ﺗﻮﻓﺮﻭﻥ ﻟﻠﻤﺼﺮﻑ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻀﺮﻭﺭﻳﺔ ﻭ ﺍﻟﺪﻗﻴﻘﺔ ﻋﻨﻜﻢ ﻭﻋﻦ ﺣﺎﺟﻴﺎﺗﻜﻢ ﺑﻤﺎ ﻳﻴﺴﺮ ﺍﺗﺨﺎﺫ ﺍﻟﻘﺮﺍﺭ ﺍﻟﻤﻨﺎﺳﺐ ﺑﺸﺄﻥ ﻃﻠﺒﻜﻢ‪.‬‬
‫‪Evaluation only. Created with a Trial Version of Xporter for JIRA.‬‬
 ‫‪Annexe 3‬‬
‫ﺭﻗﻢ ﺍﻟﺤﺴﺎﺏ‬

‫……………………………………………………………………‬

‫……………………………………………………………………‬ ‫ﺗﻮﺿﻴﺤﺎﺕ ﺇﺿﺎﻓﻴﺔ ﺗﺮﻭﻧﻬﺎ‬

‫……………………………………………………………………‬ ‫ﺿﺮﻭﺭﻳﺔ‬
‫……………………………………………………………………‬

‫……………………………………………………………………‬

‫ﻣﻌﻠﻮﻣﺎﺕ ﺑﺸﺄﻥ ﺫﻣﺘﻜﻢ ﺍﻟﻤﺎﻟﻴﺔ‬

‫ﺍﻟﺸﺮﻳﻚ ﻓﻲ ﺍﻟﺸﺮﺍﺀ‬ ‫ﺍﻟﻤﺸﺘﺮﻱ‬

‫ﺩﺝ‬ ‫ﺩﺝ‬ ‫ﺣﺴﺎﺏ ﺍﺩﺧﺎﺭﻱ‬

‫ﺩﺝ‬ ‫ﺩﺝ‬ ‫ﺃﻭ ﻣﻨﻘﻮﻟﺔ‬ ‫ﺃﺻﻮﻝ ﻋﻘﺎﺭﻳﺔ‬

‫……………………………………………………………………‬ ‫……………………………………………………………………………‬

‫……………………………………………………………………‬ ‫……………………………………………………………………………‬ ‫ﺗﻮﺿﻴﺤﺎﺕ ﺇﺿﺎﻓﻴﺔ ﺗﺮﻭﻧﻬﺎ‬

‫……………………………………………………………………‬ ‫……………………………………………………………………………‬ ‫ﺿﺮﻭﺭﻳﺔ‬
‫……………………………………………………………………‬ ‫…‪………………………………………………………………………..‬‬

‫‪………………………………………………………………….....‬‬ ‫…‪………………………………………………………………………..‬‬

‫ﻣﻌﻠﻮﻣﺎﺕ ﺑﺸﺄﻥ ﻧﻔﻘﺎﺗﻜﻢ‬

‫ﺍﻟﺸﺮﻳﻚ ﻓﻲ ﺍﻟﺸﺮﺍﺀ‬ ‫ﺍﻟﻤﺸﺘﺮﻱ‬
‫ﺗﺎﺭﻳﺦ ﺍﻟﻘﺴﻂ ﺍﻟﻨﻬﺎﺋﻲ‬ ‫ﻗﻴﻤﺔ ﺍﻟﻘﺴﻂ ﺍﻟﺸﻬﺮﻱ‬ ‫ﺗﺎﺭﻳﺦ ﺍﻟﻘﺴﻂ ﺍﻟﻨﻬﺎﺋﻲ‬ ‫ﻗﻴﻤﺔ ﺍﻟﻘﺴﻂ ﺍﻟﺸﻬﺮﻱ‬

‫ﺩﺝ‬ ‫ﺩﺝ‬ ‫ﺗﻤﻮﻳﻞ ﻋﻘﺎﺭﻱ‬

‫ﺩﺝ‬ ‫ﺩﺝ‬ ‫ﺗﻤﻮﻳﻞ ﺳﻴﺎﺭﺓ‬
‫ﺩﺝ‬ ‫ﺩﺝ‬ ‫ﻏﻴﺮﻩ‬
‫ﺩﺝ‬ ‫ﺩﺝ‬ ‫ﺇﻳﺠﺎﺭ ﻣﺪﻓﻮﻉ‬
‫ﺩﺝ‬ ‫ﺩﺝ‬ ‫ﻏﻴﺮﻩ‬

‫‪……………………………………………….........................…..‬‬ ‫‪……………………………………………………….............................…..‬‬ ‫ﺗﻮﺿﻴﺤﺎﺕ ﺇﺿﺎﻓﻴﺔ ﺗﺮﻭﻧﻬﺎ‬

‫‪……………………………............……….............................…..‬‬
‫‪……………………………………………….........................…..‬‬
‫‪……………………………............……….............................…..‬‬
‫‪………………………………………………………...................‬‬
‫‪……………………………………………………….............................…..‬‬
‫ﺿﺮﻭﺭﻳﺔ‬
‫‪………………………………………………………..............................….‬‬
‫……‪………………………………………………………...........................‬‬
‫……‪………………………………………………………...........................‬‬

‫ﻻ ﺗﺘﺮﺩﺩﻭﺍ ﻋﻨﺪ ﺍﻟﺤﺎﺟﺔ ﺇﻟﻰ ﺃﻱ ﻣﻌﻠﻮﻣﺎﺕ ﻓﻲ ﺍﻻﺗﺼﺎﻝ ﺑﻤﺴﺘﺸﺎﺭﻱ ﺍﻟﻤﺘﻌﺎﻣﻠﻴﻦ ﻓﻲ ﻣﺴﺘﻮﻯ ﻣﺨﺘﻠﻒ ﻓﺮﻭﻉ ﻣﺼﺮﻑ ﺍﻟﺴﻼﻡ ﺍﻟﺠﺰﺍﺋﺮ ﻣﻦ ﺃﺟﻞ ﻣﺴﺎﻋﺪﺗﻜﻢ ﻓﻲ ﻣﺨﺘﻠﻒ ﺧﻄﻮﺍﺕ ﺍﻟﺘﻤﻮﻳﻞ ﻭﺍﻟﺠﻮﺍﺏ ﻋﻠﻰ ﻛﺎﻓﺔ ﺍﺳﺘﻔﺴﺎﺭﺍﺗﻜﻢ‪.‬‬
‫ﺑﻤﻠﺌﻜﻢ ﺍﻟﺠﻴﺪ ﻟﻬﺬﻩ ﺍﻻﺳﺘﻤﺎﺭﺓ ﺗﻮﻓﺮﻭﻥ ﻟﻠﻤﺼﺮﻑ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻀﺮﻭﺭﻳﺔ ﻭ ﺍﻟﺪﻗﻴﻘﺔ ﻋﻨﻜﻢ ﻭﻋﻦ ﺣﺎﺟﻴﺎﺗﻜﻢ ﺑﻤﺎ ﻳﻴﺴﺮ ﺍﺗﺨﺎﺫ ﺍﻟﻘﺮﺍﺭ ﺍﻟﻤﻨﺎﺳﺐ ﺑﺸﺄﻥ ﻃﻠﺒﻜﻢ‪.‬‬
‫‪Evaluation only. Created with a Trial Version of Xporter for JIRA.‬‬
 ‫‪Annexe 3‬‬

‫ﻣﻮﺿﻮﻉ ﺍﻟﺒﻴﻊ ﺑﺎﻟﺘﻘﺴﻴﻂ‬

‫ﺍﻟﻤﺒﻠﻎ ﺍﻹﺟﻤﺎﻟﻲ‬ ‫ﺍﻟﻜﻤﻴﺔ‬ ‫ﺳﻌﺮ ﺍﻟﻮﺣﺪﺓ‬ ‫ﺍﻟﻤﻮﺭﺩ‬ ‫ﺗﺤﺪﻳﺪ ﺍﻟﻤﺒﻴﻊ‬
‫‪01‬‬
‫‪02‬‬
‫‪03‬‬

‫ﺗﻮﺿﻴﺤﺎﺕ ﺇﺿﺎﻓﻴﺔ ﺗﺮﻭﻧﻬﺎ ﺿﺮﻭﺭﻳﺔ‬

‫………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………‬

‫………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………‬

‫………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………‬

‫………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………‬

‫ﻳﺸﺮﻓﻨﺎ ﺃﻥ ﻧﺘﻘﺪﻡ ﺇﻟﻴﻜﻢ ﺑﻄﻠﺐ ﺍﻻﺳﺘﻔﺎﺩﺓ ﻣﻦ ﺑﻴﻊ ﺑﺎﻟﺘﻘﺴﻴﻂ ﻻﻗﺘﻨﺎﺀ ‪........................................................................‬‬

‫ﺍﻟﻤﻘﺪﺭﺓ ﻗﻴﻤﺘﻬﺎ ﺑـ ‪ ......................................................‬ﻭﺫﻟﻚ ﻟﻤﺪﺓ ‪...............................................................‬‬

‫ﻧﻘﺮ ﻧﺤﻦ ﺍﻟﻤﻮﻗﻌﻮﻥ ﺃﺩﻧﺎﻩ ﺑﺼﺤﺔ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻤﻘﺪﻣﺔ ﺃﻋﻼﻩ‪ ،‬ﻭﻧﻠﺘﺰﻡ ﺑﺘﻘﺪﻳﻢ ﻛﺎﻓﺔ ﺍﻟﻤﺴﺘﻨﺪﺍﺕ ﺍﻟﻀﺮﻭﺭﻳﺔ ﺍﻟﺪﺍﻟﺔ ﻋﻠﻰ ﺫﻟﻚ ﻭﺇﻋﻼﻡ ﻣﺼﺮﻑ ﺍﻟﺴﻼﻡ‬
‫ﺍﻟﺠﺰﺍﺋﺮ ﺑﺄﻱ ﺗﻐﻴﻴﺮﺍﺕ ﺗﻄﺮﺃ ﻋﻠﻴﻬﺎ‪.‬‬

‫ﻛﻤﺎ ﻧﺮﺧﺺ ﻟﻠﻤﺼﺮﻑ ﺍﻻﺳﺘﻌﻼﻡ ﻋﻨﻬﺎ ﻭﺍﻟﺘﺄﻛﺪ ﻣﻨﻬﺎ ﻟﺪﻯ ﺑﻨﻚ ﺍﻟﺠﺰﺍﺋﺮ‪ ،‬ﺃﻭ ﺃﻱ ﻫﻴﺌﺔ ﺃﻭ ﺷﺨﺺ ﻳﺤﻮﺯ ﻣﻌﻠﻮﻣﺎﺕ ﻋﻨﺎ‪ ،‬ﻭﻋﻦ ﻣﻼﺀﺗﻨﺎ ﻭﻭﺿﻌﻴﺘﻨﺎ‬
‫ﺍﻟﻤﺎﻟﻴﺔ‪.‬‬

‫______________________________________‬ ‫______________________________________________‬
‫ﺗﻮﻗﻴﻊ ﺍﻟﺸﺮﻳﻚ ﻓﻲ ﺍﻟﺸﺮﺍﺀ‬ ‫ﺗﻮﻗﻴﻊ ﺍﻟﻤﺸﺘﺮﻱ‬

‫ﺑﺘﺎﺭﻳﺦ‪_________________________________________:‬‬ ‫ﺣﺮﺭ ﻓﻲ‪_______________________________________:‬‬

‫ﻻ ﺗﺘﺮﺩﺩﻭﺍ ﻋﻨﺪ ﺍﻟﺤﺎﺟﺔ ﺇﻟﻰ ﺃﻱ ﻣﻌﻠﻮﻣﺎﺕ ﻓﻲ ﺍﻻﺗﺼﺎﻝ ﺑﻤﺴﺘﺸﺎﺭﻱ ﺍﻟﻤﺘﻌﺎﻣﻠﻴﻦ ﻓﻲ ﻣﺴﺘﻮﻯ ﻣﺨﺘﻠﻒ ﻓﺮﻭﻉ ﻣﺼﺮﻑ ﺍﻟﺴﻼﻡ ﺍﻟﺠﺰﺍﺋﺮ ﻣﻦ ﺃﺟﻞ ﻣﺴﺎﻋﺪﺗﻜﻢ ﻓﻲ ﻣﺨﺘﻠﻒ ﺧﻄﻮﺍﺕ ﺍﻟﺘﻤﻮﻳﻞ ﻭﺍﻟﺠﻮﺍﺏ ﻋﻠﻰ ﻛﺎﻓﺔ ﺍﺳﺘﻔﺴﺎﺭﺍﺗﻜﻢ‪.‬‬
‫ﺑﻤﻠﺌﻜﻢ ﺍﻟﺠﻴﺪ ﻟﻬﺬﻩ ﺍﻻﺳﺘﻤﺎﺭﺓ ﺗﻮﻓﺮﻭﻥ ﻟﻠﻤﺼﺮﻑ ﺍﻟﻤﻌﻠﻮﻣﺎﺕ ﺍﻟﻀﺮﻭﺭﻳﺔ ﻭ ﺍﻟﺪﻗﻴﻘﺔ ﻋﻨﻜﻢ ﻭﻋﻦ ﺣﺎﺟﻴﺎﺗﻜﻢ ﺑﻤﺎ ﻳﻴﺴﺮ ﺍﺗﺨﺎﺫ ﺍﻟﻘﺮﺍﺭ ﺍﻟﻤﻨﺎﺳﺐ ﺑﺸﺄﻥ ﻃﻠﺒﻜﻢ‪.‬‬
‫‪Evaluation only. Created with a Trial Version of Xporter for JIRA.‬‬