Total Capital Constant Capital :.. Variable Capital : Authenticated Loans Volume :. Capital Possession :

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1 Application to Benefit from Law on the Encouragement of Investment in Palestine Law No. [1] of 1998 and its Amendments Name of Investor / Company:.. I.D. Card No. Passport No.:.. Date of Application Submission: / / Investor s Nationality : Applicant s Name : Applicant s Capacity :.. Type of Application : New Investment Development For Purposes of Residence and Nationality Company s Data : Company s Registration No. Date of Registration : / / Company s Office / Address: Tel.: Fax: .. Type of Company / Legal Status: Governorate:. Project Sector : Industrial Tourist Building & Constructions Agricultural Educational Health Services Economic Activity:. Project Summary.. Total Manpower : Administration Laborers:. Production Laborers:.. Project Location:. Governorate :. Basin : Parcel No. :. Total Capital Constant Capital :.. Variable Capital : Authenticated Loans Volume :. Capital Possession : Local Self Loans Foreign Self : Value :.. Lending Authority :. Self : Value : Lending Authority :...

2 Expected Schedule for Project Implementation: Date of Starting Implementation: / / Date of Ending Implementation: / / Date of Starting Production: / / Project Current Status :.. Has the Project Activity Stopped? : Yes No Date of Stopping Work : / / Reason of Stopping : Project Production Statement : I. Industrial Projects : Final Product Annual Volume II. Tourist Project : Hotels : Hotel Classification :. Number of Rooms : Tourist Apartments: Number of Apartments :.. Tourist Restaurants: Classification : Entertainment Projects: Nature of Work :. III. Educational Projects : 1. Schools : Number of Classrooms :.. 2. Universities : Number of Faculties : Volume of Students :.. 3. Institutes : Number of Students:.. IV. Hospitals : Number of Beds : Hospital Quality : V. Services, Agricultural and Other Projects : Nature and Quantity of Production :. Attachments: Registration Certificate of Company / Establishment : Passport Photocopy : Feasibility Study Identity Card Copy First Tax Invoice: Date : / / Project Costs Invoices Developmental Projects Implementation Plan Tax liability acquittal from Development Projects

3 Licenses : Licenses : License (1) :.. issued by : Date of issuance : / / License (2) :.. issued by : Date of issuance : / / Acknowledgment : I, the undersigned, the authorized signatory on behalf of Company, do hereby declare and acknowledge that the information mentioned in this application and all attached documents regarding the Project of are correct and legal, and I am responsible for this. Full Name :. I.D. Card No... For Agency Official Use : Investment Window Department : Signature : File No... Missing Documents (if any) : Name and Signature of Application Recipient:... Date of Notifying the Applicant about the Missing Document : / / Serving Missing Documents : 1- Date of Serving : / / Signature of Server : 2- Date of Serving : / / Signature of Server : 3- Date of Serving : / / Signature of Server : 4- Date of Serving : / / Signature of Server : Date of Application Completion : The Agency does hereby declare and acknowledge that the application has been completed on / / regarding. Name : Capacity :.. Signature : The Agency does hereby declare and acknowledge that the application has been completed on / / regarding. Name : Capacity :.. Signature :

4 General Registry Department for Investment : Date of Transfer to General Registry Department for Investment : / / Opinion of Department :. Date of Issuing a Registered Investment Certificate : / / Registered Investment Certificate No. : Signature : Exemption Department 1- Income Tax Exemptions : Date of Transfer to Executive Incentives Committee : / /.. Capital according to Financial Report :. Recommendation of Incentives Committee :.. 2- Customs Exemptions Date of Application Submission : / / Notary Undertaking Deed : Date : / / Deed No. :.. Decision on Exemption :. Date of Decision : / / Residence and Identity Department Date of Transfer to Residence and Identity Department : / / Response of Department :. Date of Response : / / Board of Directors : Date of Presentation to Board of Directors : / / Board s Decision: Date of Issuing Investment Confirmation Certificate : / / Date of Transferring the Decision to the Investment Window: / / Date of Notifying the Investor about the Decision: / /

5 Oppositions Date of Submitting Oppositions : / / Reason of Opposition : (1) (2). Decision on Response to the Opposition :. Special Notes on the Project:..

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