APPLICATION FORM DETAILS OF THE APPLICANT of parent company (If any) Permanent Address P.O. Box City Country Mobile Tel. Fax Website Relationship with proposed company Investor Partner Consultant Manager Other (Please specify) Activities (Services or products sold/ manufactured by 1. parent company, if any) 4. 5. PROPOSED TRADE NAME 1. COMPANY STATUS Free Zone Non Free Zone Establishment (Single owner) Limited Liability Company (Partnership) Branch LICENCE CATEGORY Industrial Trading General Trading Consulting/Service Professional Commercial ACTIVITIES/ PRODUCTS OF THE PROPOSED COMPANY 1. Automotive Chemicals Construction related Food processing Glass 4. Household products 5. Packaging PLEASE CLASSIFY YOUR BUSINESS Industrial equipment Metals/metal products Plastic Electricity/related equipment Others (Please specify) APPLICATION FORM INDUSTRIAL LICENCE 1/6
DETAILS OF THE PARTNER(S) PARTNER 1 % of Equity Nationality Address in Home Country Local Address Tel (Home Country) Mobile (Home Country) Tel (Local) Mobile (Local) Authorized Signatory Yes No If yes Jointly Severally PARTNER 2 % of Equity Nationality Address in Home Country Local Address Tel (Home Country) Mobile (Home Country) Tel (Local) Mobile (Local) Authorized Signatory Yes No If yes Jointly Severally PARTNER 3 % of Equity Nationality Address in Home Country Local Address Tel (Home Country) Mobile (Home Country) Tel (Local) Mobile (Local) Authorized Signatory Yes No If yes Jointly Severally APPLICATION FORM INDUSTRIAL LICENCE 2/6
INVESTMENT (AED/ USD) Initial Capital BANK REFERENCE (For all partners) of the Partner of the Bank Branch Tel 1. DETAILS OF THE MANAGER Address Tel Mobile FACILITIES Land / Location O Al Hamra O Al Ghail Area (m 2 ) Warehouse (Area in m 2 ) Office Space (Area in m 2 ) Flexi Facilities Executive Accommodation Business Lounge Labour Accommodation VISA/MENPOWER REQUIREMENTS Visa required No Yes (Please specify the number of Investor/Partner Visas) Manpower Skilled Semi skilled Unskilled APPLICATION FORM INDUSTRIAL LICENCE 3/6
WHERE DID YOU HEAR ABOUT RAK INVESTMENT AUTHORITY? CONFERENCE/ EXHIBITION Gulfood Big 5 Automechanika ME Others (Please specify) MAGAZINE OR NEWSPAPER Gulf News Khaleej Times The National Others (Please specify) INTERNET Search Engine Banner/ Link (Please specify) RAKIA Website Social Media: O Linkedin O Facebook O Twitter REFERRAL (PLEASE SPECIFY) Lawyer/ Consultant Embassy/ Business Council/ Trade Commission Existing RAKIA Client Other DIRECT CONTACT (Please specify name of person/rakia employee who contacted you) Do you allow RAKIA to use your company details such as name, logo etc. in its website and promotional activities? Yes No APPLICATION FORM INDUSTRIAL LICENCE 4/6
ADDITIONAL INFORMATION FOR INDUSTRIAL COMPANIES OUTPUT PRODUCED Product 1 2 3 4 5 Production (Capacity per annum) % Exported User Industries EXPORT MARKETS UAE Rest of GCC MENA Region South Asia (India/ Pakistan) Rest of Asia Africa Europe North America Others (Please specify) RAW MATERIALS Feedstock Estimated Annual Consumption % Imported Mode of Transport 1 2 3 4 5 UTILITIES (Kindly state your estimated monthly requirements in terms of utilities) Power - KW/month Water - Gallons/month Industrial Gases ( of the gas) - MMBTU/month APPLICATION FORM INDUSTRIAL LICENCE 5/6
DISCLAIMER 1. The issuance of the licence shall not waive the need of the applicant to obtain any other required permits from RAK Government and / or the Federal Authorities. Visa(s) to be applied / procured by virtue of the licence issued to the company / establishment is always subject to the immigration laws as well as to the rules and regulations of the Immigration Department. DECLARATION I / We hereby declare that to the best of my / our knowledge and belief, all the particulars furnished in this application are true and accurate in all respects. I/ We hereby irrevocably undertake and agree to comply with all rules, regulations & other conditions issued from time to time by RAK Investment Authority. I/We hereby allow RAK Investment Authority to publish the company name and contact details in its client directory. of Applicant Designation Signature (As per the passport) Date Please fill the form and submit to: Sales Manager - RAK Investment Authority, Government of Ras Al Khaimah, P.O. Box: 31291, Ras Al Khaimah, UAE, Tel: +971 (0)7 206 8666, Fax: +971 (0)7 243 4464, E-mail: info@rakinvestmentauthority.com, www.rak-ia.com Note: Incomplete applications will be rejected FOR OFFICE USE ONLY Approved by Signature Date APPLICATION FORM INDUSTRIAL LICENCE 6/6