ﻃﻠـــــﺐ ﻣﻠﺼــــــــﻖ اﻻﺷﺘـــــــــﺮاك ﺑﺎﻟﻤـــﻮاﻗــــــــﻒ Parking Subscription Sticker Application ﺍﻟﺘﺎﺭﻳﺦ : / / Date Please read this application form. Make sure that you provide correct, complete and accurate details for issuing your Parking Sticker. ﻳﺮﺟﻰ ﻗﺮﺍﺀﺓ ﺍﺳﺘﻤﺎﺭﺓ ﺍﻟﻄﻠﺐ ﻭﺍﻟﺘﺄﻛﺪ ﻣﻦ ﺃﻥ ﺍﻟﺒﻴﺎﻧﺎﺕ ﺻﺤﻴﺤﺔ ﻭﺩﻗﻴﻘﺔ ﻣﻦ ﺃﺟﻞ ﺍﺻﺪﺍﺭ ﻣﻠﺼﻖ ﺍﳌﻮﺍﻗﻒ ﺍﳋﺎﺻﺔ ﺑﻚ. Documents required : اﻟﻤﺴﺘﻨﺪات اﻟﻤﻄﻠﻮﺑﺔ : )Copy of Emirates Identity Authority Card or Driving License Card.(along with the original )Copy of Vehicle License Card (along with the original ﺑﻄﺎﻗﺔ اﻟﻬﻮﻳﺔ اﻻﻣﺎراﺗﻴﺔ أو رﺧﺼﺔ اﻟﻘﻴﺎدة وﺻﻮرة ﻋﻨﻬﺎ. ﺑﻄﺎﻗﺔ ﻣﻠﻜﻴﺔ اﻟﺴﻴــﺎرة وﺻــﻮرة ﻋﻨﻬﺎ. ﻟﻼﺷﺘﺮاك اﻟﺘﺠﺎري ،ﺻﻮرة ﻋﻦ اﻟﺮﺧﺼﺔ اﻟﺘﺠﺎرﻳﺔ ﺳﺎرﻳﺔ اﻟﻤﻔﻌﻮل. For Commercial Subscription, copy of a valid Trade License. Customer details اﻟﺒﻴﺎﻧﺎت اﻟﺸﺨﺼﻴﺔ ﺍﻻﺳــــﻢ ﺍﻟﻜــــﺎﻣـــــــﻞ ﺭﻗــــﻢ ﺍﻟﻬــﺎﺗﻒ ﺍﳌﺘﺤـــﺮﻙ Full Name Mobile Number ﺭﻗﻢ ﺍﻟﺒﻄﺎﻗﺔ ﺍﻟﻬﻮﻳﺔ ﺍﻹﻣﺎﺭﺍﺗﻴﺔ Emirates ID Card Number ﺟﻬﺔ ﺍﻻﺻﺪﺍﺭ ﺭﻗــﻢ ﺭﺧﺼــﺔ ﺍﻟﻘﻴــــــﺎﺩﺓ Issuing Authority Driving License Number ﺍﻟــﺮﻣــﺰ ﺍﳌـــــــــــــﺮﻭﺭﻱ Traffic ID ﺭﻗـﻢ ﺍﻟﺮﺧﺼـــﺔ ﺍﻟﺘﺠﺎﺭﻳــﺔ Trade License Number ﺭﻗـﻢ ﺍﳌﻠﺼـﻖ ﺭﻗـــــﻢ ﺍﻟﻌـﻀــﻮﻳــــــﺔ ﻧﻮع اﻟﺨﺪﻣﺔ Sticker Number ﲡــﺪﻳــــــﺪ Renewal ﺟﺪﻳــﺪ New Membership Number ﲢـــﺪﻳــﺚ ﺍﻟﺒﻴــــــــﺎﻧــــﺎﺕ Update Information ﺑـــــﺪﻝ ﻓﺎﻗــــــﺪ Replacement Service Type Diamond Subscription for all Sharjah areas اﻻﺷﺘﺮاك اﻟﻤﺎﺳﻲ ﻟﺠﻤﻴﻊ ﻣﻨﺎﻃﻖ اﻟﺸﺎرﻗﺔ اﻟﺴﻌﺮ Price Period 3ﺷﻬﻮر 850درﻫﻢ 850 AED 3 months 6ﺷﻬﻮر 1400درﻫﻢ 1400 AED 6 months 12ﺷﻬﺮ 2300درﻫﻢ 2300 AED 12 months اﻟﻤﺪة اﻻﺷﺘﺮاك اﻟﺸﺨﺼﻲ )Personal Subscription (For two areas )ﻟﻤﻨﻄﻘﺘﻴﻦ ﻣﺤﺪودﺗﻴﻦ( ﻳﺮﺟﻰ ﺍﺧﺘﻴﺎﺭ ﻣﻨﻄﻘﺘﲔ ﻓﻘﻂ ﻣﻦ ﺍﳌﻨﺎﻃﻖ ﺍﳌﺬﻛﻮﺭﺓ ﺧﻠﻒ ﺍﻟﻄﻠﺐ ﻭﺗﺪﻭﻳﻨﻬﻢ ﺃﺩﻧﺎﻩKindly select two areas from the areas listed at the back of the application and write them below... ﺍﳌﻨﻄﻘﺔ ﺍﻻﻭﻟﻰ ________________________ ﺍﳌﻨﻄﻘﺔ ﺍﻟﺜﺎﻧﻴﺔ اﻟﻤﺪة ________________________ ________________________ ________________________ Second Area Price اﻟﺴﻌﺮ First Area Period 3ﺷﻬﻮر 500درﻫﻢ 500 AED 3 months 6ﺷﻬﻮر 900درﻫﻢ 900 AED 6 months 12ﺷﻬﺮ 1700درﻫﻢ 1700 AED 12 months Commercial Subscription For companies and shops For all Sharjah areas اﻻﺷﺘﺮاك اﻟﺘﺠﺎري ﻟﺠﻤﻴﻊ ﻣﻨﺎﻃﻖ اﻟﺸﺎرﻗﺔ ﻟﻠﻤﺆﺳﺴﺎت واﻟﻤﺤﻼت اﻟﺘﺠﺎرﻳﺔ اﻟﻤﺪة Price اﻟﺴﻌﺮ Period 3ﺷﻬﻮر 1050درﻫﻢ 1050 AED 3 months 6ﺷﻬﻮر 1750درﻫﻢ 1750 AED 6 months 12ﺷﻬﺮ 2850درﻫﻢ 2850 AED 12 months اﻻﺷﺘﺮاك اﻟﺘﺠﺎري )Commercial Subscription (For two areas )ﻟﻤﻨﻄﻘﺘﻴﻦ ﻣﺤﺪودﺗﻴﻦ( ﻳﺮﺟﻰ ﺍﺧﺘﻴﺎﺭ ﻣﻨﻄﻘﺘﲔ ﻓﻘﻂ ﻣﻦ ﺍﳌﻨﺎﻃﻖ ﺍﳌﺬﻛﻮﺭﺓ ﺧﻠﻒ ﺍﻟﻄﻠﺐ ﻭﺗﺪﻭﻳﻨﻬﻢ ﺃﺩﻧﺎﻩKindly select two areas from the areas listed at the back of the application and write them below... ﺍﳌﻨﻄﻘﺔ ﺍﻻﻭﻟﻰ ________________________ ﺍﳌﻨﻄﻘﺔ ﺍﻟﺜﺎﻧﻴﺔ ________________________ ________________________ ________________________ Second Area First Area اﻟﺴﻌﺮ Price Period 3ﺷﻬﻮر 600درﻫﻢ 600 AED 3 months 6ﺷﻬﻮر 1100درﻫﻢ 1100 AED 6 months 12ﺷﻬﺮ 2100درﻫﻢ 2100 AED 12 months اﻟﻤﺪة ﻟﻼﺳﺘﺨﺪام اﻟﺮﺳﻤﻲ ﻓﻘﻂ اﻟﻤﺴﺘﻨﺪات اﻟﻤﻄﻠﻮﺑﺔ : For Official Use Only ﻣﻌﺎﻣﻠﺔ ﺑﺪل ﻓﺎﻗﺪ : ﺻﻮرة ﺑﻄﺎﻗﺔ اﻟﻬﻮﻳﺔ اﻻﻣﺎراﺗﻴﺔ ﺻﻮرة رﺧﺼﺔ اﻟﻘﻴﺎدة ﺻﻮرة ﺑﻄﺎﻗﺔ ﻣﻠﻜﻴﺔ اﻟﺴﻴــﺎرة ﺻﻮرة ﻋﻦ اﻟﺮﺧﺼﺔ اﻟﺘﺠﺎرﻳﺔ ﺳﺎرﻳﺔ اﻟﻤﻔﻌﻮل رﻗﻢ اﻟﻤﻠﺼﻖ اﻟﻘﺪﻳﻢ ________________________ رﻗﻢ اﻟﻤﻠﺼﻖ اﻟﺠﺪﻳﺪ ________________________ ﺧﺘﻢ اﻟﻤﻮﻇﻒ Sharjah City Areas Area Al Layyeh Al Jubail Al Mareija Al Shuwaihean Al Mujarrah Bu Tina Al Nabba Al Ghuwair Um Tarafa Al Soor Al Majaz 1 Al Majaz 2 Al Majaz 3 Al Nud Al Manakh Al Musala Maysaloon Al Yarmook Abu Shagara Al Ghubaiba Al Abaar Samnan Al Shahba Al Khezamia Industrial 1 Industrial 4 Industrial 6 Al Shioukh Al Mahatta Bu Daniq ﻣﻨﺎﻃﻖ ﻣﺪﻳﻨﺔ اﻟﺸﺎرﻗﺔ Area Code 002 003 004 005 006 013 014 015 016 017 018 018 018 019 020 021 022 030 031 032 039 040 041 042 056 060 063 078 083 084 رﻣﺰ اﻟﻤﻨﻄﻘﺔ 2 3 4 5 6 13 14 15 16 17 18 18 18 19 20 21 22 30 31 32 39 40 41 42 56 60 63 78 83 84 اﻟﻤﻨﻄﻘﺔ اﻟﻠﻴﺔ اﻟﺠﺒﻴﻞ اﻟﻤﺮﻳﺠﺔ اﻟﺸﻮﻳﻬﻴﻦ اﻟﻤﺠﺮة ﺑﻮ ﻃﻴﻨﺔ اﻟﻨﺒﺎﻋﺔ اﻟﻐﻮﻳﺮ أم اﻟﻄﺮاﻓﺔ اﻟﺴﻮر 1 اﻟﻤﺠﺎز 2 اﻟﻤﺠﺎز 3 اﻟﻤﺠﺎز اﻟﻨﺪ اﻟﻤﻨﺎخ اﻟﻤﺼﻠﻰ ﻣﻴﺴﻠﻮن اﻟﻴﺮﻣﻮك ﺑﻮﺷﻐﺎرة اﻟﻐﺒﻴﺒﺔ ا¬ﺑــــﺎر ﺳﻤﻨﺎن اﻟﺸﻬﺒﺎء اﻟﺨﺰاﻣﻴﺔ 1 اﻟﺼﻨﺎﻋﻴﺔ 4 اﻟﺼﻨﺎﻋﻴﺔ 6 اﻟﺼﻨﺎﻋﻴﺔ اﻟﺸﻴﻮخ اﻟﻤﺤﻄﺔ ﺑﻮداﻧﻖ * * * * :اﻟﺸﺮوط اﻟﻌﺎﻣﺔ . ﻭ ﻳﺤﻖ ﻟﻠﺒﻠﺪﻳﺔ ﺇﻳﻘﺎﻑ ﺍﻻﺷﺘﺮﺍﻙ ﺃﻭ ﺇﻟﻐﺎﺋﻪ ﺇﺫﺍ ﲤﺖ ﻣﺨﺎﻟﻔﺔ ﺍﻟﺸﺮﻭﻁ ﻭ ﺫﻟﻚ ﺩﻭﻥ ﺍﻟﺮﺟﻮﻉ ﻟﺼﺎﺣﺐ ﺍﳌﺮﻛﺒﺔ،ﻫﺬﺍ ﺍﳌﻠﺼﻖ ﻋﺒﺎﺭﺓ ﻋﻦ ﺍﺷﺘﺮﺍﻙ ﻟﻨﻈﺎﻡ ﺍﳌﻮﺍﻗﻒ ﺍﻟﻌﺎﻣﺔ ﺍﳋﺎﺿﻌﺔ ﻟﻠﺮﺳﻮﻡ ﻭ ﻻ ﻳﺴﻤﺢ ﺑﺎﺳﺘﻌﻤﺎﻟﻪ ﻟﻐﻴﺮ ﻏﺮﺿﻪ ﺍﶈﺪﺩ .ﻳﺤﻖ ﻟﻠﺒﻠﺪﻳﺔ ﺍﺗﺨﺎﺫ ﺍﻹﺟﺮﺍﺀ ﺍﻟﻘﺎﻧﻮﻧﻲ ﺿﺪ ﺻﺎﺣﺐ ﺍﳌﺮﻛﺒﺔ ﻓﻲ ﺣﺎﻝ ﰎ ﺗﺰﻭﻳﺮ ﺍﳌﻠﺼﻖ . ﻭﻻ ﺗﻌﺘﺒﺮ ﺍﻟﺒﻠﺪﻳﺔ ﻣﺴﺆﻭﻟﺔ ﻋﻦ ﺃﻱ ﻣﺨﺎﻟﻔﺎﺕ ﻳﺘﻢ ﲢﺮﻳﺮﻫﺎ ﺇﺫﺍ ﲤﺖ ﻣﺨﺎﻟﻔﺔ ﺗﻌﻠﻴﻤﺎﺕ ﺍﳌﻠﺼﻖ، ﻛﻤﺎ ﻫﻮ ﻣﻮﺿﺢ ﻓﻲ ﻭﺭﻗﺔ ﺍﻟﺘﻌﻠﻴﻤﺎﺕ،ﻳﺠﺐ ﺍﻟﺘﺄﻛﺪ ﻣﻦ ﺗﺜﺒﻴﺖ ﺍﳌﻠﺼﻖ ﻋﻠﻰ ﺍﻟﻮﺍﺟﻬﺔ ﺍﻷﻣﺎﻣﻴﺔ ﻟﻠﻤﺮﻛﺒﺔ . ﻭ ﻳﺘﻮﺟﺐ ﺩﻓﻊ ﺭﺳﻮﻡ ﺇﺿﺎﻓﻴﺔ ﻟﻠﺤﺼﻮﻝ ﻋﻠﻰ ﺑﺪﻝ ﻓﺎﻗﺪ،ﺍﻟﺒﻠﺪﻳﺔ ﻏﻴﺮ ﻣﺴﺆﻭﻟﺔ ﻋﻦ ﺳﻮﺀ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳌﻠﺼﻖ ﺃﻭ ﺗﻠﻔﻪ ﺃﻭ ﺿﻴﺎﻋﻪ .ﻳﺘﻮﺟﺐ ﻋﻠﻰ ﺍﳌﺸﺘﺮﻙ ﺩﻓﻊ ﺭﺳﻮﻡ ﺇﺿﺎﻓﻴﺔ ﻓﻲ ﺣﺎﻝ ﺍﻟﺮﻏﺒﺔ ﺑﺘﻐﻴﻴﺮ ﺑﻴﺎﻧﺎﺕ ﺍﻻﺷﺘﺮﺍﻙ ﺍﻟﺴﺎﺭﻱ ﺍﳌﻔﻌﻮﻝ .ﻻ ﺗﻌﻔﻰ ﺍﳌﺮﻛﺒﺎﺕ ﺍﳌﺸﺘﺮﻛﺔ ﺑﻨﻈﺎﻡ ﺍﳌﻮﺍﻗﻒ ﻣﻦ ﻣﺨﺎﻟﻔﺎﺕ ﺳﻮﺀ ﺍﺳﺘﺨﺪﺍﻡ ﺍﳌﻮﻗﻒ ﺃﻭ ﺍﻟﻮﻗﻮﻑ ﻓﻲ ﻣﻮﺍﻗﻒ ﺫﻭﻱ ﺍﻻﺣﺘﻴﺎﺟﺎﺕ ﺍﳋﺎﺻﺔ . ﻭﻻ ﻳﺠﻮﺯ ﻭﺿﻌﻬﺎ ﻋﻠﻰ ﺍﻟﻮﺍﺟﻬﺔ ﺍﻷﻣﺎﻣﻴﺔ ﻟﻠﻤﺮﻛﺒﺎﺕ،ﺗﺴﺘﺨﺪﻡ ﺑﻄﺎﻗﺔ ﺍﻟﻌﻀﻮﻳﺔ ﻓﻘﻂ ﻷﻏﺮﺍﺽ ﲡﺪﻳﺪ ﺍﻻﺷﺘﺮﺍﻙ ﺃﻭ ﺍﻻﺷﺘﺮﺍﻙ ﻓﻲ ﺧﺪﻣﺎﺕ ﺃﺧﺮﻯ . ﻭﻻ ﺗﻌﻔﻰ ﻣﻦ ﺍﻟﺮﺳﻮﻡ ﻓﻲ ﺍﳌﻨﺎﻃﻖ ﺍﻷﺧﺮﻯ،ﺗﻠﺘﺰﻡ ﺍﳌﺮﻛﺒﺎﺕ ﺍﳌﺸﺘﺮﻛﺔ ﺑﺎﻻﺷﺘﺮﺍﻙ ﺍﻟﺸﺨﺼﻲ ﺑﺎﻟﻮﻗﻮﻑ ﻓﻲ ﺍﳌﻨﺎﻃﻖ ﺍﻟﺘﻲ ﰎ ﺗﺴﺠﻴﻞ ﺍﻻﺷﺘﺮﺍﻙ ﻋﻠﻴﻬﺎ .ﻳﺠﺐ ﻣﺮﺍﺟﻌﺔ ﺧﺪﻣﺔ ﺍﻟﻌﻤﻼﺀ ﻗﺒﻞ ﺍﻧﺘﻬﺎﺀ ﻣﻠﺼﻖ ﺍﻻﺷﺘﺮﺍﻙ ﻟﺘﺠﺪﻳﺪ ﺍﳌﻠﺼﻖ .ﻻ ﳝﻜﻦ ﻟﻠﻤﺸﺘﺮﻙ ﲡﺪﻳﺪ ﺍﻻﺷﺘﺮﺍﻙ ﺃﻭ ﻃﻠﺐ ﺍﺷﺘﺮﺍﻙ ﺟﺪﻳﺪ ﻓﻲ ﺣﺎﻝ ﻭﺟﻮﺩ ﻣﺨﺎﻟﻔﺎﺕ ﻣﺪﺭﺟﺔ ﲢﺖ ﺭﻗﻢ ﺍﳌﺮﻛﺒﺔ ﺍﳌﺮﺍﺩ ﻋﻤﻞ ﺍﻻﺷﺘﺮﺍﻙ ﻟﻬﺎ ﺇﻻ ﻋﻨﺪ ﺳﺪﺍﺩ ﺟﻤﻴﻊ ﺍﺨﻤﻟﺎﻟﻔﺎﺕ .ﺗﻌﺘﺒﺮ ﻫﺬﻩ ﺍﻟﺒﻨﻮﺩ ﺍﺗﻔﺎﻗﻴﺔ ﺑﲔ ﺍﻟﻄﺮﻓﲔ ﻭﻋﻠﻰ ﺍﳌﺸﺘﺮﻙ ﺍﻻﻟﺘﺰﺍﻡ ﺑﻬﺎ .١ .٢ .٣ .٤ .٥ .٦ .٧ .٨ .٩ .١٠ .١١ Terms and Conditions: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. This sticker is a subscription for public paid parking areas and it should not be used for other purposes. If terms and rules are not followed, the Municipality has the right to stop or cancel the subscription without user permission. The Municipality has the right to take the legal action if the sticker is forged. User should make sure to place the sticker on the front windshield of the vehicle as the instruction paper show, and the Municipality is not responsible for any violation issued as a result of not following instructions. The Municipality is not responsible for losing or misusing the sticker, and the user must pay for the replacement in the mentioned cases. If user wishes to change the subscription; an extra fees are charged in force. Registered vehicles on public paid parking system are not exempt from violations issued against taking actions that impact negatively on the usage of parking areas or interrupt traffic or put anyone in risk as well as using handicapped parking areas. The membership card is used only for the renewal of subscriptions or registering for other services and should not be placed on the vehicle’s windshield or dashboard as a sort of permission. Customers with personal subscription should park on areas that they subscribed, and should pay for parking on other areas. Customers should come to renew their subscriptions before they expire. Customers can not renew their subscriptions or ask for a new one unless they pay all the violations. These terms are considered as an agreement between the two parties and the customer should be committed to it. ﻧﺘﻌﻬﺪ ﺑﺈﻋﻼم ﺑﻠﺪﻳﺔ ﻣﺪﻳﻨﺔ/ ﻧﺆﻛﺪ أن اﻟﺒﻴﺎﻧﺎت أﻋﻼه دﻗﻴﻘــﺔ ﻛﻤﺎ أﺗﻌﻬﺪ/ و أؤﻛﺪ،ﺣﻜﺎم اﻟﻤﺮﻓﻘﺔ واﻟﺨﺎﺻﺔ ﺑﺈﺻﺪار ﻣﻠﺼﻖ اﻟﻤﻮاﻗﻒ£ ﻧﻮاﻓﻖ ﻋﻠﻰ اﻟﺸﺮوط وا/أواﻓﻖ .اﻟﺸﺎرﻗﺔ ﺑﺄي ﺗﻌﺪﻳﻞ I/ We agree to the attached Terms and Conditions of issuing the Parking Sticker, I/ We confirm that the above information is accurate and I/ We commit to advise Sharjah City Municipality of any changes. Signature/ Stamp اﻟﺨﺘﻢ/اﻟﺘﻮﻗﻴﻊ
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