‫إﺳﺘﻤﺎرة ﻃﻠﺐ ﺗﺴﺠﻴﻞ ﻣﻨﺸﺄة ﺟﺪﻳﺪة‬

New Establishment Registration Form

‫ﺗﻌﺪﻳﻞ اﻟﺒﻴﺎﻧﺎت‬ ‫ﺗﺴﺠﻴﻞ ﺟﺪﻳﺪ‬
Amendments New Registration

Establishment Details ‫ﺑﻴﺎﻧﺎت اﻟﻤﻨﺸﺄة‬

Establishment Type ‫ﻧﻮع اﻟﻤﻨﺸﺄة‬ CR No. ‫رﻗﻢ اﻟﺴﺠﻞ اﻟﺘﺠﺎري‬
‫ﻏﻴﺮ ﺗﺠﺎرﻳﺔ ﻏﻴﺮ ﺣﻜﻮﻣﻴﺔ‬ ‫ﺣﻜﻮﻣﻴﺔ‬ ‫ﺗﺠﺎرﻳﺔ‬
Non-Commercial Non-Governmental (NCNG) Government Commercial
Establishment Name (In English or Arabic) (‫اﺳﻢ اﻟﻤﻨﺸﺄة )ﺑﺎﻟﻠﻐﺔ اﻟﻌﺮﺑﻴﺔ أو اﻧﺠﻠﻴﺰﻳﺔ‬

‫ اﻟﺸﺨﺺ اﻟﻤﺴﺆول‬/ ‫اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ ﻟﺼﺎﺣﺐ اﻟﻌﻤﻞ‬

Name (In English or Arabic) (‫ اﻻﺳﻢ )ﺑﺎﻟﻠﻐﺔ اﻟﻌﺮﺑﻴﺔ أو اﻧﺠﻠﻴﺰﻳﺔ‬Employer / Responsible Person Personal No.

Correspondents Address of the Establishment ‫ﻋﻨﻮان اﻟﻤﺮاﺳﻼت ﻟﻠﻤﻨﺸﺄة‬

‫اﻟﻤﻨﻄﻘﺔ‬ ‫ﻣﺠﻤﻊ رﻗﻢ‬ ‫ﻃﺮﻳﻖ رﻗﻢ‬ ‫ﻣﺒﻨﻰ رﻗﻢ‬ ‫ﺷﻘﺔ رﻗﻢ‬
Area Block No. Road No. Building No. * Flat No.
*‫ اﻟﺸﺨﺺ اﻟﻤﺴﺆول‬/ ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل ﻟﺼﺎﺣﺐ اﻟﻌﻤﻞ‬
E-mail * *‫اﻟﺒﺮﻳﺪ اﻟﻜﺘﺮوﻧﻲ‬ Employer / Responsible Person Personal No. * Fax No. ‫ رﻗﻢ اﻟﻔﺎﻛﺲ‬Office Telephone No.* *‫ﻫﺎﺗﻒ اﻟﻌﻤﻞ‬

P.O. Box .‫ب‬.‫ص‬ Electricity Account No.* (Non-Governmental Entities) (‫رﻗﻢ ﺣﺴﺎب اﻟﻜﻬﺮﺑﺎء* )ﻟﻠﺠﻬﺎت ﻏﻴﺮ اﻟﺤﻜﻮﻣﻴﺔ‬ Website ‫اﻟﻤﻮﻗﻊ اﻟﻜﺘﺮوﻧﻲ‬

Corresponding Methods * * ‫ﻃﺮﻳﻘﺔ اﻟﻤﺮاﺳﻼت‬ Corresponding Language * * ‫ﻟﻐﺔ اﻟﻤﺮاﺳﻼت‬

‫رﺳﺎﺋﻞ ﻣﻄﺒﻮﻋﺔ‬ ‫ﻓﺎﻛﺲ‬ ‫رﺳﺎﺋﻞ ﻧﺼﻴﺔ ﻗﺼﻴﺮة‬ ‫ﺑﺮﻳﺪ إﻟﻜﺘﺮوﻧﻲ‬ ‫اﻧﺠﻠﻴﺰﻳﺔ‬ ‫اﻟﻌﺮﺑﻴﺔ‬
Letter Fax SMS E-mail English Arabic

Authorised Persons Details ‫ﺑﻴﺎﻧﺎت اﺷﺨﺎص اﻟﻤﺨﻮﻟﻴﻦ ﺑﺘﻘﺪﻳﻢ اﻟﻄﻠﺒﺎت‬

Personal No. ‫اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ‬ Name ‫اﻻﺳﻢ‬
‫ﺗﻨﺸﻴﻂ‬ ‫ﺣﺬف‬ ‫إﺿﺎﻓﺔ‬
Activate Delete Add
E-mail ‫اﻟﺒﺮﻳﺪ اŒﻟﻜﺘﺮوﻧﻲ‬ Office Telephone No. ‫رﻗﻢ ﻫﺎﺗﻒ اﻟﻌﻤﻞ‬ Mobile No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬

Level of Authority ‫ﻛﻼﻫﻤﺎ‬ ‫دﻓﻊ اﻟﻔﻮاﺗﻴﺮ وﻃﺒﺎﻋﺔ ﺗﺼﺎرﻳﺢ اﻟﻌﻤﻞ‬ ‫إدﺧﺎل اﻟﺒﻴﺎﻧﺎت وﺗﻘﺪﻳﻢ اﻟﻄﻠﺒﺎت‬ ‫اﻟﺼﻼﺣﻴﺎت‬
Both Bill Payments/Work Permit Printing Data Entry and Submission

Personal No. ‫اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ‬ Name ‫اﻻﺳﻢ‬

‫ﺗﻨﺸﻴﻂ‬ ‫ﺣﺬف‬ ‫إﺿﺎﻓﺔ‬
Activate Delete Add
E-mail ‫اﻟﺒﺮﻳﺪ اŒﻟﻜﺘﺮوﻧﻲ‬ Office Telephone No. ‫رﻗﻢ ﻫﺎﺗﻒ اﻟﻌﻤﻞ‬ Mobile No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬

Level of Authority ‫ﻛﻼﻫﻤﺎ‬ ‫دﻓﻊ اﻟﻔﻮاﺗﻴﺮ وﻃﺒﺎﻋﺔ ﺗﺼﺎرﻳﺢ اﻟﻌﻤﻞ‬ ‫إدﺧﺎل اﻟﺒﻴﺎﻧﺎت وﺗﻘﺪﻳﻢ اﻟﻄﻠﺒﺎت‬ ‫اﻟﺼﻼﺣﻴﺎت‬
Both Bill Payments/Work Permit Printing Data Entry and Submission

Personal No. ‫اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ‬ Name ‫اﻻﺳﻢ‬

‫ﺗﻨﺸﻴﻂ‬ ‫ﺣﺬف‬ ‫إﺿﺎﻓﺔ‬
Activate Delete Add
E-mail ‫اﻟﺒﺮﻳﺪ اŒﻟﻜﺘﺮوﻧﻲ‬ Office Telephone No. ‫رﻗﻢ ﻫﺎﺗﻒ اﻟﻌﻤﻞ‬ Mobile No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬

Level of Authority ‫ﻛﻼﻫﻤﺎ‬ ‫دﻓﻊ اﻟﻔﻮاﺗﻴﺮ وﻃﺒﺎﻋﺔ ﺗﺼﺎرﻳﺢ اﻟﻌﻤﻞ‬ ‫إدﺧﺎل اﻟﺒﻴﺎﻧﺎت وﺗﻘﺪﻳﻢ اﻟﻄﻠﺒﺎت‬ ‫اﻟﺼﻼﺣﻴﺎت‬
Both Bill Payments/Work Permit Printing Data Entry and Submission

Employer / Responsible Person ‫ اﻟﺸﺨﺺ اﻟﻤﺴﺆول‬/ ‫ﺻﺎﺣﺐ اﻟﻌﻤﻞ‬

LMRA-QFM-009-01-01 v5.0

Date ‫اﻟﺘﺎرﻳﺦ‬ Signature ‫اﻟﺘﻮﻗﻴﻊ‬ Name ‫اﻻﺳﻢ‬

- -

* Mandatory field ‫* ﺣﻘﻮل إﻟﺰاﻣﻴﺔ‬

 Authorised Persons Details ‫ﺑﻴﺎﻧﺎت ا ﺷﺨﺎص اﻟﻤﺨﻮﻟﻴﻦ ﺑﺘﻘﺪﻳﻢ اﻟﻄﻠﺒﺎت‬
Personal No. ‫اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ‬ Name ‫اﻻﺳﻢ‬
‫ﺗﻨﺸﻴﻂ‬ ‫ﺣﺬف‬ ‫إﺿﺎﻓﺔ‬
Activate Delete Add
E-mail ‫اﻟﺒﺮﻳﺪ ا€ﻟﻜﺘﺮوﻧﻲ‬ Office Telephone No. ‫رﻗﻢ ﻫﺎﺗﻒ اﻟﻌﻤﻞ‬ Mobile No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬

Level of Authority ‫ﻛﻼﻫﻤﺎ‬ ‫دﻓﻊ اﻟﻔﻮاﺗﻴﺮ وﻃﺒﺎﻋﺔ ﺗﺼﺎرﻳﺢ اﻟﻌﻤﻞ‬ ‫إدﺧﺎل اﻟﺒﻴﺎﻧﺎت وﺗﻘﺪﻳﻢ اﻟﻄﻠﺒﺎت‬ ‫اﻟﺼﻼﺣﻴﺎت‬
Both Bill Payments/Work Permit Printing Data Entry and Submission
Personal No. ‫اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ‬ Name ‫اﻻﺳﻢ‬
‫ﺗﻨﺸﻴﻂ‬ ‫ﺣﺬف‬ ‫إﺿﺎﻓﺔ‬
Activate Delete Add
E-mail ‫اﻟﺒﺮﻳﺪ ا€ﻟﻜﺘﺮوﻧﻲ‬ Office Telephone No. ‫رﻗﻢ ﻫﺎﺗﻒ اﻟﻌﻤﻞ‬ Mobile No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬

Level of Authority ‫ﻛﻼﻫﻤﺎ‬ ‫دﻓﻊ اﻟﻔﻮاﺗﻴﺮ وﻃﺒﺎﻋﺔ ﺗﺼﺎرﻳﺢ اﻟﻌﻤﻞ‬ ‫إدﺧﺎل اﻟﺒﻴﺎﻧﺎت وﺗﻘﺪﻳﻢ اﻟﻄﻠﺒﺎت‬ ‫اﻟﺼﻼﺣﻴﺎت‬
Both Bill Payments/Work Permit Printing Data Entry and Submission

Notes ‫اﻟﻤﻼﺣﻈﺎت‬
1. All correspondences shall be addressed to the responsible and authorised persons. .‫ ﺳﻴﺘﻢ إرﺳﺎل ﺟﻤﻴﻊ اﻟﻤﺮاﺳﻼت إﻟﻰ اﻟﺸﺨﺺ اﻟﻤﺴﺆول واﺷﺨﺎص اﻟﻤﺨﻮﻟﻴﻦ‬.١
2. For further information queries, please contact the call centre on 17506055. .17506055 ‫ ﻟﻼﺳﺘﻔﺴﺎر وﻟﻠﻤﺰﻳﺪ ﻣﻦ اﻟﻤﻌﻠﻮﻣﺎت ﻳﺮﺟﻰ اﺗﺼﺎل ﺑﻤﺮﻛﺰ اﺗﺼﺎل ﻋﻠﻰ اﻟﺮﻗﻢ‬.٢
3. The system’s access password will be sent to your email within 24 hours after registration. .‫ ﺳﺎﻋﺔ ﺑﻌﺪ اﻟﺘﺴﺠﻴﻞ‬24 ‫ ﺳﻴﺘﻢ إرﺳﺎل اﻟﺮﻣﺰ اﻟﺴﺮي إﻟﻰ ﺑﺮﻳﺪك اﻟﻜﺘﺮوﻧﻲ اﻟﻤﺴﺠﻞ ﻓﻲ اﻟﻬﻴﺌﺔ ﺧﻼل‬.٣

Required Documents ‫اﻟﻤﺴﺘﻨﺪات اﻟﻤﻄﻠﻮﺑﺔ‬

Fill the required form. .‫ﻣﻞء اﻻﺳﺘﻤﺎرة اﻟﻤﻄﻠﻮﺑﺔ‬
Copy of the commercial registration (commercial sector). .(‫ﻧﺴﺨﺔ ﻣﻦ اﻟﺴﺠﻞ اﻟﺘﺠﺎري )ﻟﻠﻘﻄﺎع اﻟﺘﺠﺎري‬
The Central Informatics Organisation Unit No. (NCNG). .(‫ﻧﺴﺨﺔ ﻣﻦ اﻓﺎدة اﻟﺠﻬﺎز اﻟﻤﺮﻛﺰي ﻟﻠﻤﻌﻠﻮﻣﺎت )ﻟﻠﻘﻄﺎع ﻏﻴﺮ اﻟﺘﺠﺎري وﻏﻴﺮ اﻟﺤﻜﻮﻣﻲ‬
Copy of the license (NCNG). .‫ﻧﺴﺨﺔ ﻣﻦ اﻟﺘﺮﺧﻴﺺ ﻟﻠﻤﻨﺸﺂت ﻏﻴﺮ اﻟﺘﺠﺎرﻳﺔ وﻏﻴﺮ اﻟﺤﻜﻮﻣﻴﺔ‬
A Copy of the recent electricity bill (for non-governmental entities). .(‫ﻧﺴﺨﺔ ﺣﺪﻳﺜﺔ ﻣﻦ ﻓﺎﺗﻮرة اﻟﻜﻬﺮﺑﺎء )ﻟﻠﺠﻬﺎت ﻏﻴﺮ اﻟﺤﻜﻮﻣﻴﺔ‬
Copy of the responsible person Identity card. .‫ﻧﺴﺨﺔ ﻣﻦ ﺑﻄﺎﻗﺔ اﻟﻬﻮﻳﺔ ﻟﻠﺸﺨﺺ اﻟﻤﺴﺆول‬
Copy of the authorised person Identity card and clearing agent ID or the power of attorney. .‫ﻧﺴﺨﺔ ﻣﻦ ﺑﻄﺎﻗﺔ اﻟﻬﻮﻳﺔ ﻟﻠﺸﺨﺺ اﻟﻤﺨﻮل وﺑﻄﺎﻗﺔ اﻟﺘﺨﻠﻴﺺ أو اﻟﺘﻮﻛﻴﻞ اﻟﺮﺳﻤﻲ‬
Letter in case of registering a company. .‫رﺳﺎﻟﺔ ﻣﻦ اﻟﺸﺮﻛﺔ ﻓﻲ ﺣﺎﻟﺔ ﺗﺴﺠﻴﻞ اﻟﺸﺮﻛﺎت‬
MOIC registration form for companies .‫اﺳﺘﻤﺎرة اﻟﺘﺴﺠﻴﻞ ﻣﻦ وزارة اﻟﺘﺠﺎرة ﻟﻠﺸﺮﻛﺎت‬
Proof of Board members names in case of societies. .‫ﻣﺎ ﻳﺜﺒﺖ أﻋﻀﺎء ﻣﺠﻠﺲ ادارة ﻓﻲ ﺣﺎﻟﺔ ﺗﺴﺠﻴﻞ اﻟﺠﻤﻌﻴﺎت‬

Terms and Conditions ‫اﻟﺸﺮوط وا ﺣﻜﺎم‬

1. All documents and information stated in the application should be correct. ،‫ﻳﺠﺐ أن ﺗﻜﻮن ﺟﻤﻴﻊ اﻟﻤﺴﺘﻨﺪات واﻟﻤﻌﻠﻮﻣﺎت اﻟﻤﺪوﻧﺔ ﻓﻲ اﻟﻄﻠﺐ ﺻﺤﻴﺤﺔ‬ .١
The applicant is held liable for all the above. ً ‫وﻳﻜﻮن ﻣﻘﺪم اﻟﻄﻠﺐ ﻣﺴﺆو‬
.‫ﻻ ﻋﻨﻬﺎ‬
2. The Authority shall keep confidential all the information about employer and ‫ وﻟﻬﺎ اﻟﺤﻖ‬،‫ﺗﺤﺎﻓﻆ اﻟﻬﻴﺌﺔ ﻋﻠﻰ ﺳﺮﻳﺔ ﻟﻤﻌﻠﻮﻣﺎت اﻟﺨﺎﺻﺔ ﺑﺼﺎﺣﺐ اﻟﻌﻤﻞ واﻟﻌﺎﻣﻞ اﺟﻨﺒﻲ‬ .٢
expatriate employee. However, the Authority is entitled to release such information .‫ﺑﺘﺰوﻳﺪ اﻟﺴﻠﻄﺔ اﻟﻘﻀﺎﺋﻴﺔ أو أﻳﺔ ﺟﻬﺔ ﺣﻜﻮﻣﻴﺔ ﺑﺎﻟﻤﻌﻠﻮﻣﺎت ﺑﻨﺎء ﻋﻠﻰ ﻃﻠﺐ ﻛﺘﺎﺑﻲ ﻣﻨﻬﺎ ﺑﺬﻟﻚ‬
upon a written request from a judicial or government agency. .‫ﻳﺨﻀﻊ اﻟﻄﻠﺐ ﺣﻜﺎم اﻟﻘﻮاﻧﻴﻦ واﻧﻈﻤﺔ واﻟﻘﺮارات اﻟﻨﺎﻓﺬة ﻓﻲ ﻣﻤﻠﻜﺔ اﻟﺒﺤﺮﻳﻦ‬ .٣
3. The application is subject to Acts, Regulations, orders and resolutions, currently in
.‫ﺗﻌﺘﺒﺮ اﻟﺸﺮوط واﺣﻜﺎم ﻧﺎﻓﺬة ﻣﻦ ﺗﺎرﻳﺦ اﻃﻼع ﻋﻠﻴﻬﺎ وﺗﻮﻗﻴﻊ اﻟﻄﻠﺐ‬ .٤
force, in the Kingdom of Bahrain.
.‫ﻳﻠﺘﺰم ﺻﺎﺣﺐ اﻟﻌﻤﻞ ﺑﺈﺧﻄﺎر اﻟﻬﻴﺌﺔ ﻓﻮر¼ ﻋﻨﺪ ﺗﻐﻴﻴﺮ أو ﺗﺤﺪﻳﺚ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻮاردة ﻓﻲ اﻟﻄﻠﺐ‬ .٥
4. The above mentioned terms and conditions are enforceable as from the date of
perusal and signature of the application. .‫ اﻟﺸﺨﺺ اﻟﻤﺴﺆول ﺑﺤﺪود ﻣﺎ ﺧﻮل ﺑﻪ‬/‫ﻳﻠﺘﺰم اﻟﺸﺨﺺ اﻟﻤﺨﻮل ﻣﻦ ﻗﺒﻞ ﺻﺎﺣﺐ اﻟﻌﻤﻞ‬ .٦
5. The employer undertakes to immediately inform the authority of any changes or ‫ ﺧﺪﻣﺔ ﺗﺠﺪﻳﺪ أو إﻟﻐﺎء ﺗﺼﺮﻳﺢ‬،‫ ﺧﺪﻣﺔ إﺻﺪار ﺗﺼﺮﻳﺢ ﻋﻤﻞ ﺟﺪﻳﺪ‬:‫ﺗﺘﻀﻤﻦ ﻃﻠﺒﺎت رﺧﺺ اﻟﻌﻤﻞ‬
updates to the information stated in the application. .‫ ﺗﺤﺪﻳﺚ ﺑﻴﺎﻧﺎت اﻟﻤﻮﻇﻔﻴﻦ واﻟﻌﻤﺎل اﺟﺎﻧﺐ وﺑﻴﺎﻧﺎت اﻟﻤﻨﺸﺄة‬،‫ ﺧﺪﻣﺔ ﺗﻐﻴﻴﺮ اﻟﻤﻬﻨﺔ‬،‫اﻟﻌﻤﻞ‬

6. The person authorised by the employer/ person in charge, undertakes to be liable

within the limits of the level of his authority.
Work permit applications include: Issuing new, renew and cancellation of work permits
and dependants residence permits, occupation change, entering and updating employer,
expatraite employee and establishment details.

Declarations (Business Owner / Person In Charge) (‫ اﻟﺸﺨﺺ اﻟﻤﺴﺆول‬/ ‫إﻗﺮار )ﺻﺎﺣﺐ اﻟﻌﻤﻞ‬
.‫ ﻛﻤﺎ أﻗﺮ ﺑﺼﺤﺔ اﻟﻤﻌﻠﻮﻣﺎت اﻟﻮاردة ﻓﻴﻬﺎ‬،‫أﻗﺮ أﻧﺎ اﻟﻤﻮﻗﻊ أدﻧﺎه ﺑﺎﻃﻼﻋﻲ ﻋﻠﻰ ﻛﺎﻓﺔ اﻟﺸﺮوط واﺣﻜﺎم اﻟﻮاردة ﻓﻲ ﻫﺬه اﻻﺳﺘﻤﺎرة وﺑﻤﻮاﻓﻘﺘﻲ ﻋﻠﻴﻬﺎ‬
I, the undersigned, declare that all the information mentioned above is correct and I shall be held liable if it was proved otherwise.
Personal No. ‫اﻟﺮﻗﻢ اﻟﺸﺨﺼﻲ‬ Signature ‫اﻟﺘﻮﻗﻴﻊ‬ Name ‫اﻻﺳﻢ‬

Date ‫اﻟﺘﺎرﻳﺦ‬ Mobile No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ اﻟﻨﻘﺎل‬ Phone No. ‫رﻗﻢ اﻟﻬﺎﺗﻒ‬
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LMRA-QFM-009-01-01 v5.0

For Official Use Only ‫ﻟﻼﺳﺘﻌﻤﺎل اﻟﺮﺳﻤﻲ ﻓﻘﻂ‬

Date ‫اﻟﺘﺎرﻳﺦ‬ Signature ‫اﻟﺘﻮﻗﻴﻊ‬ Application received by ‫ﺗﻢ ﺗﺴﻠﻢ اﻟﻄﻠﺐ ﻣﻦ ﻗﺒﻞ‬
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