(for additional Claimant(s), please fill out the section below for each Claimant) [ADGM Registration#] ADGM Registration No. (if applicable) [name] Full Name* [address] Address* Claimant(s) Contact Details (complete if self-represented or by authorised officer as applicable) [name] Name of authorised officer [e.g. Director] Capacity to act for Claimant [address] Address for service* [telephone] Telephone* [email address] Email* Claimant(s) Legal Representative (complete if legally represented) [name] Name [name of firm] Firm [address of firm] Address of Firm [contact person] Contact person [email address] Email [telephone] Telephone [firm reference] Firm Ref Defendant(s) in Intended Claim [name] Full Name* [address] Address* [email address] Email (for additional Defendant(s), please fill out the section below for each Defendant) [name] Full Name* [address] Address* [email address] Email
(for additional Claimant(s), please fill out the section below for each Claimant) ADGM Registration No. (if applicable) [ADGM Registration#] Full Name* [name] Address* [address] Claimant(s) Contact Details (complete if self-represented or by authorised officer as applicable) Name of authorised officer [name] Capacity to act for Claimant [e.g. Director] Address for service* [address] Telephone* [telephone] Email* [email address] Claimant(s) Legal Representative (complete if legally represented) Name [name] Firm [name of firm] Address of Firm [address of firm] Contact person [contact person] Email [email address] Telephone [telephone] Firm Ref [firm reference] Defendant(s) in Intended Claim Full Name* [name] Address* [address] Email [email address] (for additional Defendant(s), please fill out the section below for each Defendant) Full Name* [name] Address* [address] Email [email address]
cfi-12a-application-notice-pre-claim-interim-remedy-rev-date-1-july-2018.docx