Sadara Chemical Company

ID CARD REQUEST
Form: Sadara/ISD/F-001
(April/2017)
Location*
1-REQUESTER  INFORMATION
Card Type * IF contractor / SMP specify: Date*
Request Type*
Applicant Info. * Sex*
First Name* Middle Name* Last Name*
Name in Arabic *

Name in English *

Nationality * Birth Date* Blood Type* Department*

Gov’t ID/IQAMA No* Place of Issue: * Exp Date * Exp Date Hijri *

Job Title * ID No. from HRS Signature & date     Phone Ext.

Access Type * SBC Slot No.

Office Services Manager Ali S. ALGhamdi

In case of emergency* Jason Serfontein ( 055 136 3876 )

Special Req./ Justification

2-ID CARD APPROVAL*

Name* Badge#* Signature & Date* Phone Ext.
Department Director / Manager* Abdullah Alsogair 1002992 3476
ISD Director* Mohammed AlMosa 1003541

For security ID  Office only

Card Type Old Serial# New Serial # Issued / Expired Supervisor's Approval

Abdulsalam Alqahtani

Signature & Date

Badge# & Signature

‫*إقرار‬
‫ كما اتعهد بإعادة بطاقة (اثبات الشخصية) إلى مكتب إثبات الشخصية عند إنتهاء خدمتي أو‬. ‫ بطاقة اثبات الشخصية من شركة صدارة للكيميائيات‬,‫ استلمت أنا الموقع أدناه‬,‫وفقا ً للتوجيهات الحكومية‬
‫تقاعدي أو استقالتي من العمل‬

*ACKNOWLEDGEMENT
As Per Saudi Arabian Government directive, I, the undersigned have received my ID card from SADARA CHEMICAL Company, I am responsible for returning my ID
card to Industrial Security ID Office on termination, retirement or resignation

Applicant’s signature & Date* Badge #*

Sadara - General Use Information