For Bank Use Only Staff Name: Staff Source Code: FRM-IBD-000-0.10 V.3.0 Mar-2020 Document Classification: External Ver.03/March2020 Takaful Credit Shield Enrolment Form For detailed explanation of the Takaful Credit Shield policy terms, please refer to adcbislamic.com The indemnity amount in table and premium is subject to change, without further notice. Takaful products are underwritten by respective Takaful providers and issued subject to their terms and conditions. ADCB Islamic Banking does not offer Takaful advice, nor does it manage, underwrite or issue Takaful policies. ADCB Islamic Banking is not responsible for rejected applications or claims by any insurance/Takaful company. Premiums received by ADCB Islamic Banking for insurance/Takaful plans are not bank deposits. The premium stated herein is inclusive of 5% Value Added Tax (VAT), which may be amended from time to time in accordance with UAE VAT Law and ADCB Islamic Banking Coverd Card Terms and Conditions available on adcbislamic.com Customer Declaration: Unless defined herein the capitalised terms shall have same meaning as defined in ADCB Islamic Banking Covered Card Terms and Conditions. You irrevocably and unconditionally declare that all information provided herein is true and accurate and authorize ADCB Islamic Banking to verify all or any of such information, from whatever sources it considers appropriate, and you are aware of, and agree to be bound by the Shari’ah compliant Terms and Conditions for Consumer Banking, ADCB Islamic Banking Terms and Conditions and Schedule of Fees applicable to the respective ADCB Islamic Banking products and services available on adcbislamic.com You agree that the Bank may Process, Store, transfer and disclose your account information regarding your Takaful cover and/or your information regarding your use of any of the Bank’s services to any third party service provider through which the Bank may provide services to you as an intermediary. For the purpose of the disclosure referred to above, you expressly waive, so far as permitted by applicable law, any right to secrecy that you have under any applicable law. You hereby indemnify and hold harmless the Bank, its affiliates and any third party service providers from and against any liability or loss (including lost profits or loss of opportunity) arising out of or in relation to any disclosures made under the above mentioned circumstances. 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Maximum Indemnity limit per Primary Card holder by Card type: :ábÉ£ÑdG ºbQ ô°ûà樫°S â«æ«ØfEG á«ÑgP á«æ«JÓH ÜÉ°ùM øe º°üî∏d IQƒJÉa ¬H IQOÉ°üdG , k Éjô¡°T ó°UΟG ≠∏ÑŸG øe %0^9345 :ÚeCÉàdG §°ùb .¿ÉªàF’G ábÉ£H :ábÉ£ÑdG ´ƒf Ö°ùM ,»°ù«FQ ábÉ£H πeÉM πμd ¢†jƒ©à∏d ≈°übC’G ó◊G Type of Card Maximum Indemnity Limit Infinite Card AED 200,000 ábÉ£ÑdG ´ƒf ¢†jƒ©à∏d ≈°übC’G ó◊G :ábÉ£ÑdG ´ƒf Signature Card AED 100,000 Platinum Card AED 100,000 Gold Card AED 75,000 Classic Card AED 50,000 â«æ«ØfEG ábÉ£H ºgQO 200000 ô°ûà樫°S ábÉ£H ºgQO 100000 á«æ«JÓÑdG ábÉ£ÑdG ºgQO 100000 á«ÑgòdG ábÉ£ÑdG ºgQO 75000 á«μ«°SÓμdG ábÉ£ÑdG ºgQO 50000