A) Applicant Details

AMENDMENT OF COMPANY/ LICENSE A) APPLICANT DETAILS Applicant’s Name Applicant’s Position Operating Name Tel.# E-mail

B) AMENDMENT TYPES ( Please fill in the appropriate)

B.1)Change In License (Please tick below) B.2) Change In Company Type (Please tick below)  Existing License  Existing Company Type Commercial Free Zone Establishment Industrial Free Zone Company Consulting and / or Service Branch Commercial / General Trading  Requested license  Requested Company Type Commercial Free Zone Establishment Industrial Free Zone Company Consulting and / or Service Branch Commercial / General Trading

B.3) Change in Operating Name

Existing Company Name :

1. Requested Company Name: 2. 3.

B.4) Change in Licensee (FZE) Existing Licensee Name : New Licensee Name :

Permanent Address in Home Country (New Licensee) :

Issue No: 01 1 Issue Date: 28th December 2014 AMENDMENT OF COMPANY/ LICENSE B.5) Change Of Manager:

Existing Manager Name : Requested Manager Name :

B.6) Change of Activity

Existing Activity : Requested Activity :

B.7) Change in Shareholders: New Shareholder & Number of shares

B. 8) Other Changes:

Date | | 2 Signature

For UAQ FTZ Approval 1. Administration Section Comments

2. Finance & Accounts Department Comments

3. General Manager

UAQ FTZ reserves the right to require for additional documents. Attach additional sheets for any additional informations.

Issue No: 01 2 Issue Date: 28th December 2014