Social INSURANCE

Bismillahir Rahmanir Rahim

KINGDOM OF SAUDI ARABIA                             Form No. 5- Insurance

GENERAL ORGANIZATION FOR SOCIAL INSURANCE

1. Insurance Office : Tabuk

Information regarding joining of the worker (Labour) previously his registration with the Organization of Insurance.

2.	Another name of origin under the Insurance the worker worked with it	: Saudi Catering & Contracting Est. at City : Tabuk
3.	No. of another participation under the Insurance the worker worked with it	: 010000343
4.	Name of the Origin (or the Branch) in which at present he is working	: Saudi Catering & Contracting Est. at City : Tabuk
5.	Participation  No. of the Origin (or of the Branch)	: 010000343
6.	Name of the worker insured on him	: MOH'D. ABDUL AZIZ
7.	Insurance No. of the worker	: 140393088
8.	Identity No. of the Saudia or Passport No. of the Foreigners	: 154935, Place of Issue : Dhaka
9.	Date of joining in the work	: Day  1 Month 3 Year 1982
10.	The work in which he is doing	:         -
11.	Monthly salary under the Co.	:  940/- SR.
12.	Monthly Participation  (Part of the worker)	:  123/-  SR.
13.	System of paying the salary	: Monthly
Declaration : The In charge on behalf of the origin and the worker hereby declare that the above mentioned particulars are correct  and under their responsibilities.
Signature of the worker : Sd/- Moh'd. Abdul Aziz			Sd/- Illegible In Charge on behalf of the Origin (Official Seal)