1. Full name_________________________________________________________

2. Father’s name _____________________________________________________

3. Date & place of birth _________________________________________________________

4. Religion ___________________________________________________________________

5. N.I.C. Number ____________________________ N.T.N. ___________________________

6. Education _________________________________________________________________

7. Present job/status and official address____________________________________________

8. Telephone numbers __________________________________________________________

9. Appointments held during the last five years (with dates) ____________________________

__________________________________________________________________________

10. Name(s) & designation's) of the supervisor (one grade up)

under whom Shariah advisor has served during the last five years

___________________________________________________________________________

___________________________________________________________________________

11. Present residential address in full ________________________________________________

12. Permanent residential address in full _____________________________________________

13. Has he ever been convicted of any offence? Yes No

If yes, nature of offence and penalty

imposed:____________________________________________________________________

14. Has he ever been censured and/or penalized by any financial authority (local or foreign)?

Yes No

If yes, the nature and reasons for adverse findings and amount of penalty imposed (if

any)_______________________________________________________________________

15. Has he ever been dismissed from employment? Yes No

If yes, name of the employer and reason for dismissal_______________________________

__________________________________________________________________________

16. Names & addresses of three respectable persons (not relatives) who

with the Shariah Advisor during the last five years.

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________

_____________________________________________________________________________________

* Use additional sheet if required