All Fields Specified Or Indicated by * Are Mandatory

Important information

This form can be used to give notice ofchanges of particulars of directors.
For further information, please refer to Guidance Note – Event Driven Filings.

All fields specified or indicated by * are mandatory

Section 1: Application Details

Application Date* /
Company Registration Number* /
Company Name* /
Director’s Name* /
/ Please choose from options below the applicable notification.

☐Change of Personal Details (individual)

Individual (1)

Effective Date* /
Title*
Forenames*
Surname*
Former Names / Name by which the individual was formerly known for business purposes.
Country of Residence*
Nationality*
Date of Birth*
Business Occupation
Change Evidence* / ☐ Copy of Passport Evidence enclosed. / Please enclose any of the following documents that supports the change of personal details.
☐ Copy of Marriage Certificate enclosed.
☐ Copy of Name Change Certificate enclosed.

☐Change of Address (individual)

Residential Address

/ Please provide details of director’s new residential address.
Unit Number / Level Number*
Building Name*
Street / Area*
State / Province
Emirate
Country

Service Address

/ Please provide details of director’s new service address.
Effective Date* /
Unit Number / Level Number
Building Name
Street / Area
State / Province
PO Box Number*
Emirate
Country*

☐Change of name or entity structure (Body Corporate)

Body Corporate

/ Please provide new details of director.
Effective Date* /
Company / Firm Name*
Registration Number*
Place of Registration / Incorporation*
Legal Entity Structure*
Governing Law*
Certificate of Incorporation or Registration on change of name* / ☐ Copy of Certificate of Incorporation or Registration on change of name (or any document with similar effect) enclosed. / Please enclose copy of Certificate of Incorporation or Registration on change of name (or any document with similar effect).

☐Change of Address (body corporate)

Physical Address

/ Please provide details of director new service address.
Unit Number / Level Number*
Building Name*
Street / Area*
State / Province
Emirate
Country

Mailing Address

/ Please provide details of director’snew mailing address.
Unit Number / Level Number
Building Name
Street / Area
State / Province
PO Box Number*
Emirate
Country
Resolution* / ☐ Copy of resolution approving change of registered office address enclosed. / Please enclose copy of resolution approving change of registered office address.

Party lodging this application

Title*
Forenames*
Surname*
Designation*
Organisation
Office Number
Floor
Building Name
Street Name of Cluster / Square / Area on the island
State / Province
Emirate
Country
Telephone*
Email*

Checklist

Please make sure to complete all the required fields in the form and the following supporting document(s) are attached. Incorrect or incomplete applicationmay be returned for re‐submission.
IfanydocumentsarenotintheEnglishLanguage,theymustbeaccompaniedbyatranslation,certifiedtothesatisfaction of the Registrar. Please referto Registration Authority’sRules on translation and authentication.

Required Documents

No. / Requirement / Status
Change of Personal Details (Individual)
1. / Copy of passport / ☐ /
2. / Copy of marriage contract / ☐ /
3. / Copy of change of name / ☐ /
Change of name or entity name (Body Corporate)
4. / Copy of Certificate of Incorporation or Registration on change of name / ☐ /
Change of Address (Body Corporate)
5. / Resolution approving change of registered office address / ☐ /

Fee (Paper Form)

USD100

Currency Conversion – US$ = AED3.6735

HowtoPay?

Please choose the preferred method of payment.
For Debit or Credit Card payment, please visit the Registrar’s office.
For Bank transfer, please use the following bank account details:
USD Account
Bank Name: National Bank of Abu Dhabi
Account Name: ADGM Registration Authority
Account Number: 6205791613
IBAN Number: AE280350000006205791613
AED Account
Bank Name: National Bank of Abu Dhabi
Account Name: ADGM Registration Authority
Account Number: 6205791532
IBAN Number: AE810350000006205791532

Wheretosubmittheform?

Completed form along with relevant supporting documents and fees can be submitted to:
The RegistrationAuthority Level 3
Abu Dhabi Global Market Building,
ADGM Square, Al MaryahIsland,
P.O.Box111999, Abu Dhabi, UAE

ForFurtherInformation,pleasecontactus.

Telephone Number / Email Address
+9712 3338888 /