Invest finance bank

Authorised Signatory

8. 
   
   Disbursement Receipt
   

Date:
Islamic Corporation for the Development of the Private Sector (ICD)

P.O. Box 54069 Jeddah 21514
Kingdom of Saudi Arabia
Tel: [phone] 7963
Fax: [phone]
Attention: Finance Division

Project No._____
Disbursement Receipt No. [_____]

We, ……………………….., hereby acknowledge receipt on the date hereof, of the sum of USD ………………… disbursed to us, or utilized by the Islamic Corporation for the Development of the Private Sector (ICD), to finance the acquisition of goods required by us, pursuant to the Murabaha Facility Agreement entered into between us and [the Bank] (as agent of the ICD) dated [ ].

Yours truly,
[]

By __________________

Authorized Representative⁴
SIGNATORIES
MURABAHA FACILITY AGREEMENT
JOINT-STOCK COMMERCIAL BANK “INVEST FINANCE BANK” WITH FOREIGN CAPITAL
Name: Mr. Bobir Burkhanov
Title: Chairman of the Board

Signature: _________________________

Name: Mr. Jamolkhuja Toshpulatkhujaev
Title: Chief Accountant
Signature: _________________________
*Signature of Witness: _______________ *Signature of Witness: ___________________
Name of Witness: Name of Witness:
Address: Address:
Occupation: Occupation:
THE BUYER
[FULL NAME OF END CLIENT]:
Name: Mr. XXXXX XXXXXXX
Title: Director
Signature: _________________________
Name: Mr. XXXXX XXXXXXXXX
Title: Chief Accountant
Signature: _________________________

*Signature of Witness: ___________________ *Signature of Witness: ______________________

Name of Witness: Name of Witness:
Address: Address:
Occupation: Occupation:

*Each witness declares himself an adult Muslim.

1^To be amended on a transaction specific basis.

2^To be inserted on a transaction specific basis.

3^To be inserted on a transaction specific basis.

4^As named in the Clients’ certificate of incumbency and authority.