P.O.Box 282228 Dubai, United Arab Emirates Tel: +971 4 8141111 Fax +971 4 8141366

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P.O.Box 282228 Dubai, United Arab Emirates Tel: +971 4 8141111 Fax +971 4 8141366

CONTRACTOR PASS APPLICATION

New Renewal Date: 4/4/2018 1:20:41 上午

DURATION 1 month 3 months 6 months 1 year

APPLICANT DETAILS

Applicant Name (Mr./ Ms. / Mrs.)

Nationality Passport No.

Mobile No.

SPONSOR’S DETAILS

Company Name Tel.

Email

Sponsor’s Signature and Stamp

HOST COMPANY DETAILS

Company Name License No. Tel. Fax Mobile

Company Authorized Signature And Stamp

Government of Dubai – Dubai Aviation City Corporation P.O.Box 282228 Dubai, United Arab Emirates Tel: +971 4 8141111 Fax +971 4 8141366 www.dubaisouth.ae

RACR-FZA-F-014, Rev 0, Oct 2012 Page 1 of 1

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