www.zain.com

Number Porting in RequestService Application

2. Porting in Request

3. Service/Package (CPR of customer and “bearer” of application must be attached)

Prepaid Postpaid

Package:

Additional Data Line:

Additional Fax Line:

For Postpaid Only:

Contract No:

SIM Card No:

Mobile No:

Mobile Brand/Model (If purchased with service):

Directory Listing Service: Listed Unlisted

Roaming Service:

International Calls: Yes No

Detailed National Billing:

Invoice preferred language: Arabic English

Yes No

Yes No

Additional Services:

Deposit Paid: Yes No Amount:

1. Applicant

International Address:

House/Flat/Shop No: Building No: Road No: Block No:

Mailing Address: (If different from Residence Address) P.O.Box:

Email:

Office Tel: Fax:

Other Mobile No: Home Tel:

Residence Address: House/Flat/Shop No: Building No: Road No: Block No:

Gender: Male Female Date of Birth:

Name:

Title:

Profession:Nationality:

Dr.Ms.Mrs.Mr. Other:

Ext:

ID No:

ID Type: CPR Other(For Prepaid Only)

I choose to receive information from Zain via SMS/MMS about the following:

Promotions New Services Service UpdateDisclaimer - Zain will not disclose personal information to any third party.

Events & Campaigns

Staff code:

Dealer Code:

Shop Code:

(DD/MM/YY)

I, the undersigned, have read, understood and agreed to Zain's terms & conditions - detailed on the back of this application - and accepted the credit limit assigned to me of BD

If the stated credit limit is exceeded, then Zain Bahrain reserves the right to pursue the course of action

it deems appropriate. I am fully responsible to pay the entire invoice even if it exceeds this credit limit.

Customer’s Name:

Customer’s Signature:

Bearer’s Name:

Bearer’s Signature:

Date: (DD/MM/YY)

Date: (DD/MM/YY)

holder of CPR No.

to collect the mobile package on my behalf.

I authorize Mr. Mrs. Ms.

Terms & Conditions:

Fields to be filled by a Zain representative.

Fields to be filled by the Applicant.

International calls and Roaming services are subject to guarantee conditions.

I hereby request to port my number to Zain Bahrain. I would like to apply for the below Service/Package (detailed in section 3)

The ported in: Number: Multiple Numbers: From to

Donor ICC ID (sim-card serial)

I hereby confirm and certify that I have full authority and capacity to request for porting stated in this application form and information provided herein are true and correct. I, by signing this application form, empower Zain BH, as the Recipient Network Operator ("RNO"), to terminate all services (voice, data, and value added services) provided to my ported number(s) by the Donor Network Operator ("DNO"). I acknowledge and agree that; (1) in case the porting is successful, any benefits, unused credit, or balance with DNO shall not be transferred to Zain BH, (2) successful porting does not release me of any or all debts and/or liability incurred under my contract with DNO and Zain BH shall have the right to unilaterally disconnect the

service, if I fail to pay the outstanding charges as notified by DNO,(3) Any change of ownership is not allowed after successful porting, (4) to waive and release Zain BH of any and all claims, damages, or liabilities regarding the porting, (5) there will be temporarily service interruptions to my ported number(s) during the Number Portability provisioning process, and (6) in case the porting is successful, any disconnection of the service afterwards for whatever reason, Zain BH will return back the ported number(s) to the numbering block operator owner. I have read and agree to be bound by the Number Portability terms and conditions as well as any applicable Number Portability Regulation or its amendment(s), if any.