200 / / ‫هﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ‬

Republic of Iraq ‫ﺟﻤﻬﻮرﻳﺔ اﻟﻌﺮاق‬

Wasit province ‫ﻣﺤﺎﻓﻈﺔ واﺳﻂ‬
Wasit investment commission ‫هﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻓﻲ واﺳﻂ‬

‫اﺳﺘﻤﺎرة ﻃﻠﺐ ﺗﻘﺪﻳﻢ اﻟﻤﺸﺮوع اﻻﺳﺘﺜﻤﺎري‬

Project Application Form

( ) ‫اﺳﺘﻤﺎرة‬

‫ اﻟﻌﺮاق‬/ ‫ﺗﻘﺪم اﻟﻰ هﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ‬

Form No.( )
This form should submit to investment
commission in Wasit Province \ Iraq

IRAQ-Wasit-Alkut 5-1
WEB: [Link] ‫ﻣﻘﺎﺑﻞ ﻓﻨﺪق ﻣﺼﺎﻳﻒ اﻟﻜﻮت‬-‫دور اﻟﻤﻌﻠﻤﻴﻦ‬-‫اﻟﻜﻮت‬-‫واﺳﻂ‬-‫اﻟﻌﺮاق‬
Email: wasit_invest@[Link]
,wasit_invest@[Link],[Link]@[Link]
Tel +964 7803396115 (MTC) , +964 7706937893 (Asicell)
 200 / / ‫هﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ‬

‫اﺳﺘﻤﺎرة ﻃﻠﺐ ﺗﻘﺪﻳﻢ اﻟﻤﺸﺮوع اﻻﺳﺘﺜﻤﺎري‬

APPLICATION FORM FOR AN INVESTMENT PROJECT
‫ ﻳﺘﻢ ﻣﻨﺢ اﺟﺎزة اﻗﺎﻣﺔ‬2006 ‫ ﻟﺴﻨﺔ‬13 ‫اﺳﺘﻨﺎدا اﻟﻰ اﻟﺼﻼﺣﻴﺎت اﻟﻤﺨﻮﻟﺔ ﻟﻬﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ ﺑﻤﻮﺟﺐ ﻗﺎﻧﻮن اﻻﺳﺘﺜﻤﺎر اﻟﻌﺮاﻗﻲ ذو اﻟﺮﻗﻢ‬
. ‫اﻟﻤﺸﺎرﻳﻊ اﻻﺳﺘﺜﻤﺎرﻳﺔ اﻟﺨﺎﺻﺔ ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ‬
‫ﻋﻠﻰ اﻟﻤﺴﺘﺜﻤﺮ اﻟﻤﺘﻄﻠﻊ ﻟﻼﺳﺘﺜﻤﺎر ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ ان ﻳﺮﻓﻖ ﻣﻊ هﺬﻩ اﻻﺳﺘﻤﺎرة اﻟﻤﻌﻠﻮﻣﺎت واﻟﻤﺴﺘﻨﺪات اﻟﻤﻄﻠﻮﺑﺔ ﻟﻬﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻟﻐﺮض دراﺳﺘﻬﺎ ﻣﻦ ﻗﺒﻞ‬
.. ‫ اﺳﺘﻨﺎدا اﻟﻰ اﻟﻤﻌﺎﻳﻴﺮ اﻟﻤﻌﺘﻤﺪة ﻣﺤﻠﻴﺎ وﻋﺎﻟﻤﻴﺎ‬، ‫ﻣﺠﻠﺲ ادارة اﻟﻬﻴﺌﺔ ﻟﺘﻘﻴﻴﻢ ﻣﺸﺮوﻋﻪ وﺗﻘﻴﻴﻢ ﻣﺆهﻼﺗﻪ‬
.(1) ‫ﺑﺎﻻﺿﺎﻓﺔ اﻟﻰ اﺳﺘﻤﺎرة اﻟﺘﻘﺪﻳﻢ ﻋﻠﻰ اﻟﻤﺴﺘﺜﻤﺮ ان ﻳﻘﺪم آﻞ اﻟﻮﺛﺎﺋﻖ اﻟﻤﻄﻠﻮﺑﺔ واﻟﻤﺪرﺟﺔ ﻓﻲ اﻟﻤﻠﺤﻖ‬
Based on the wasit investment commission authority according to Iraqi investment
law no.(13) on 2006,
investment projects can license to achievable in wasit province.
An investor interested in benefiting from these facilities, is kindly invited to provide the
qualifications to the
set In addition to application form , the investor must submit all required documents listed in
Annex I.

[Link] DETAILS ‫ﺗﻌﺮﻳﻒ اﻟﻤﺴﺘﺜﻤﺮ‬

NAME OF THE COMPANY OR INVESTOR ‫اﺳﻢ اﻟﺸﺮآﺔ أو اﻟﻤﺴﺘﺜﻤﺮ‬

REGISTRIATION NUMBER ‫رﻗﻢ اﻟﺘﺴﺠﻴﻞ‬
OWNERSHIP STRUCTURE ‫ﺳﻨﺪ اﻟﻤﻠﻜﻴﺔ‬
ADRESS ‫اﻟﻌﻨﻮان‬
STREET ‫اﺳﻢ اﻟﺸﺎرع‬
CITY ‫اﻟﻤﺪﻳﻨﺔ‬
COUNTRY ‫اﻟﺒﻠﺪ‬
P.O BOX ‫ﺻﻨﺪوق اﻟﺒﺮﻳﺪ‬
TELEPHONE ‫رﻗﻢ اﻟﻬﺎﺗﻒ‬
FAX ‫رﻗﻢ اﻟﻔﺎآﺲ‬
E-MAIL ‫ﻋﻨﻮان اﻟﺒﺮﻳﺪ اﻻﻟﻜﺘﺮوﻧﻲ‬

[Link] DESCRRIPTION ‫ﺗﻌﺮﻳﻒ اﻟﻤﺸﺮوع‬

NAME OF THE PROJECT ‫اﺳﻢ اﻟﻤﺸﺮوع‬

sector ‫اﻟﻘﻄﺎع‬

Information ,communication and technology

Industry ‫ﺻﻨﺎﻋﻲ‬ ‫ اﻟﺘﻜﻨﻠﻮﺟﻴﺎ‬، ‫ اﻻﺗﺼﺎﻻت‬، ‫اﻟﻤﻌﻠﻮﻣﺎﺗﻴﺔ‬
agriculture ‫زراﻋﻲ‬ technology ‫اﻟﺘﻜﻨﻠﻮﺟﻲ‬
Agro Industry ‫زراﻋﻲ ﺻﻨﺎﻋﻲ‬ telecommunication ‫اﻻﺗﺼﺎﻻت‬
Tourism ‫ﺳﻴﺎﺣﻲ‬ media ‫اﻻﻋﻼم‬
Housing ‫اﻻﺳﻜﺎﻧﻲ‬ Other ,mention below ‫ ﺗﺬآﺮ‬/ ‫اﺧﺮى‬

IRAQ-Wasit-Alkut
WEB: [Link] 5-2
Email: wasit_invest@[Link] ‫ﻣﻘﺎﺑﻞ ﻓﻨﺪق ﻣﺼﺎﻳﻒ اﻟﻜﻮت‬-‫دور اﻟﻤﻌﻠﻤﻴﻦ‬-‫اﻟﻜﻮت‬-‫واﺳﻂ‬-‫اﻟﻌﺮاق‬
,wasit_invest@[Link],[Link]@[Link]
Tel +964 7803396115 (MTC) , +964 7706937893 (Asicell)
 200 / / ‫هﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ‬

location ‫اﻟﻤﻮﻗﻊ‬
Plot (s)No. ‫رﻗﻢ اﻟﻘﻄﻌﺔ أو اﻟﻤﻘﺎﻃﻌﺔ‬
City ‫اﻟﻤﺪﻳﻨﺔ‬
Sub_ District ‫اﻟﻨﺎﺣﻴﺔ‬
District ‫اﻟﻘﻀﺎء‬
Area of the land (s) m² ²‫ﻣﺴﺎﺣﺔ ارض اﻟﻤﺸﺮوع م‬
Total built up area in m² ²‫ﻣﺠﻤﻮع اﻟﻤﺴﺎﺣﺎت اﻟﻤﻄﻠﻮﺑﺔ م‬
Summary of project activities ‫ﻣﻠﺨﺺ ﻋﻦ ﻓﻌﺎﻟﻴﺎت اﻟﻤﺸﺮوع‬

( ‫)ﻳﺘﻀﻤﻦ ﺗﺤﺪﻳﺪ اﻟﻮﻗﺖ اﻟﻤﺨﻄﻂ ﻹﻧﺠﺎز اﻟﻤﺸﺮوع –ﺗﺎرﻳﺦ اﻟﺒﺪا واﻻﻧﺘﻬﺎء‬

Included time schedule to implement project , stating & finishing date

[Link] of investment (USD) ‫دوﻻر) أﻣﺮﻳﻜﻲ ( ﻗﻴﻤﺔ اﻻﺳﺘﺜﻤﺎر‬

‫رأس اﻟﻤﺎل اﻟﻤﺴﺘﺜﻤﺮ ﻣﺘﻀﻤﻨﺎ ﻗﻴﻤﺔ اﻻرض واﻟﺒﻨﺎء واﻟﻤﻜﺎﺋﻦ واﻟﻤﻌﺪات‬
Invested capital including the value of land , construction , machinery and equipments

D. Recourse Of Pounding ‫ﻣﺼﺪر اﻟﺘﻤﻮﻳﻞ‬

[Link] Of Investment ‫ﻧﻮع اﻻﺳﺘﺜﻤﺎر‬

Local ‫ﻣﺤﻠﻲ‬ Foreign ‫أﺟﻨﺒﻲ‬ Combined ‫ﻣﺸﺘﺮك‬

IRAQ-Wasit-Alkut 5-3
WEB: [Link] ‫ﻣﻘﺎﺑﻞ ﻓﻨﺪق ﻣﺼﺎﻳﻒ اﻟﻜﻮت‬-‫دور اﻟﻤﻌﻠﻤﻴﻦ‬-‫اﻟﻜﻮت‬-‫واﺳﻂ‬-‫اﻟﻌﺮاق‬
Email: wasit_invest@[Link]
,wasit_invest@[Link],[Link]@[Link]
Tel +964 7803396115 (MTC) , +964 7706937893 (Asicell)
 200 / / ‫هﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ‬

[Link] .
Number of local workforce ‫ﻋﺪد اﻟﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻟﻤﺤﻠﻴﺔ‬
Number of foreign workforce ‫ﻋﺪد اﻟﻘﻮى اﻟﻌﺎﻣﻠﺔ اﻷﺟﻨﺒﻴﺔ‬

‫ اﻟﻌﻤﺎل‬، ‫ اﻟﻔﻨﻴﻮن‬، ‫ اﻹدارﻳﻮن‬/ ‫وﻳﺘﻀﻤﻦ ﻧﻮع اﻟﻘﻮى اﻟﻌﺎﻣﻠﺔ‬

‫ﻓﺮص اﻟﻌﻤﻞ واﻋﺘﺒﺎرا ﻣﻦ ﺑﺪأ ﻋﻤﻠﻴﺔ اﻟﺘﺴﺠﻴﻞ ﻟﻠﻤﺸﺮوع اﻻﺳﺘﺜﻤﺎري ﻳﺠﺐ ان ﺗﻮﻓﺮ وﻳﺴﺠﻞ اﻟﻤﺴﺘﺨﺪﻣﻮن ﻓﻲ ﺻﻨﺪوق اﻟﻀﻤﺎن‬
. ‫اﻻﺟﺘﻤﺎﻋﻲ‬
. ‫اﻟﻤﺸﺮوع اﻻﺳﺘﺜﻤﺎري ﻳﺠﺐ ان ﻳﺒﻘﻲ ﻗﻮة ﻋﻤﻞ ﻣﺤﻠﻴﺔ‬
Workforce include: administrators, technicians and workers
Starting from the commencement of the operation, the job opportunities should be created, all employees
should
be registered in the Social Security Fund. The investment project should maintain a local labor force.

[Link] Person For Reference And Flow Up ‫اﻟﺸﺨﺺ اﻟﻤﻜﻠﻒ ﺑﺎﻟﻤﺮاﺟﻌﺔ واﻟﻤﺴﺆول ﻋﻦ اﻟﻤﺘﺎﺑﻌﺔ‬

Name ‫اﻻﺳﻢ‬
Title ‫اﻟﻌﻨﻮان اﻟﻮﻇﻴﻔﻲ‬
Address ‫اﻟﻌﻨﻮان اﻟﻜﺎﻣﻞ‬
Street ‫اﺳﻢ اﻟﺸﺎرع‬
City ‫اﻟﻤﺪﻳﻨﺔ‬
Country ‫اﻟﺒﻠﺪ‬
P.O Box ‫ﺻﻨﺪوق اﻟﺒﺮﻳﺪ‬
Telephone ‫رﻗﻢ اﻟﻬﺎﺗﻒ‬
Fax ‫رﻗﻢ اﻟﻔﺎآﺲ‬
Email ‫ﻋﻨﻮان اﻟﺒﺮﻳﺪ اﻻﻟﻜﺘﺮوﻧﻲ‬

.. ‫• أﺗﻌﻬﺪ ﺑﺄن اﻟﻤﻌﻠﻮﻣﺎت واﻟﺒﻴﺎﻧﺎت واﻟﻤﺴﺘﻤﺴﻜﺎت اﻟﺘﻲ ﻗﺪﻣﺘﻬﺎ ﺻﺤﻴﺤﺔ وﺑﺨﻼﻓﻪ اﺗﺤﻤﻞ اﻟﻤﺴﺆوﻟﻴﺎت اﻟﻘﺎﻧﻮﻧﻴﺔ‬
I pledge that the information and data provided by the archives and correct, and the succession
to assume legal responsibility.

(………………………………………….)

‫اﻻﺳﻢ واﻟﺘﻮﻗﻴﻊ واﻟﻤﻬﻨﺔ‬

Signature: Date:

IRAQ-Wasit-Alkut
WEB: [Link]
Email: wasit_invest@[Link] 5-4
,wasit_invest@[Link],[Link]@[Link] ‫ﻣﻘﺎﺑﻞ ﻓﻨﺪق ﻣﺼﺎﻳﻒ اﻟﻜﻮت‬-‫دور اﻟﻤﻌﻠﻤﻴﻦ‬-‫اﻟﻜﻮت‬-‫واﺳﻂ‬-‫اﻟﻌﺮاق‬
Tel +964 7803396115 (MTC) , +964 7706937893 (Asicell)
 200 / / ‫هﻴﺌﺔ اﻻﺳﺘﺜﻤﺎر ﻓﻲ ﻣﺤﺎﻓﻈﺔ واﺳﻂ‬

Annex 1 (1) ‫اﻟﻤﻠﺤﻖ‬

Requested Document ‫اﻟﻮﺛﺎﺋﻖ اﻟﻤﻄﻠﻮﺑﺔ‬

. ‫ دراﺳﺔ اﻟﺠﺪوى اﻻوﻟﻴﺔ‬-1

.‫ ﺗﺼﻤﻴﻢ اﻟﻤﺸﺮوع اﻟﺘﻤﻬﻴﺪي‬-2
.‫ ﺑﻴﺎن اﻟﺘﺎﺛﻴﺮ اﻟﺒﻴﺌﻲ‬-3
-: ‫( وﺗﺘﻀﻤﻦ ﻋﻠﻰ‬1) ‫ ﺧﺘﻢ ﺑﺎﻟﺴﺠﻞ اﻟﺘﺠﺎري ﺻﺎدرة ﻗﺒﻞ ﻓﺘﺮة ﺷﻬﺮ واﺣﺪ‬، ‫ اﻟﻨﺴﺨﺔ اﻟﻤﺼﺪﻗﺔ ﻟﻮﺛﺎﺋﻖ ﺗﺄﺳﻴﺲ اﻟﺸﺮآﺔ‬-4

.‫ ﻗﻮاﻧﻴﻦ اﻟﺸﺮآﺔ اﻟﻤﺤﻠﻴﺔ )اﻟﻨﻈﺎم اﻟﺪاﺧﻠﻲ( ﺑﻜﻞ ﺗﻌﺪﻳﻼﺗﻪ‬-‫أ‬

.‫ ﺷﻬﺎدة ﺗﺆﻳﺪ ﻋﺪم اﻓﻼس اﻟﺸﺮآﺔ او ﻓﺴﺎدهﺎ اﻟﻤﺎﻟﻲ واﻻداري‬-‫ب‬
.‫ اﻟﺘﺨﺼﺺ اﻟﻌﺎم اﻟﻘﻄﺎﻋﻲ ﻟﻠﺸﺮآﺔ‬/ ‫ دور او ﻋﻤﻞ اﻟﺸﺮآﺔ اﻟﺤﻘﻴﻘﻲ‬-‫ج‬
. ‫ اﻟﺘﻌﺎﻣﻼت اﻟﺘﺠﺎرﻳﺔ اﻟﻌﺎﻟﻤﻴﺔ‬-‫د‬
. ‫ اﻻﻋﻤﺎل اﻟﻤﻤﺎﺛﻠﺔ‬-5
. ‫ ﻧﺴﺨﺔ ﺑﻄﺎﻗﺔ ﺗﻌﺮﻳﻒ اﻟﺸﺨﺺ اﻟﻤﺨﻮل ﺑﺎﻟﺘﻮﻗﻴﻊ ﻧﻴﺎﺑﺔ ﻋﻦ اﻟﺸﺮآﺔ‬-6
. ‫ ﻧﺴﺨﺔ ﺷﻬﺎدة ﺗﺴﺠﻴﻞ اﻟﺸﺮآﺔ ﻓﻲ اﻟﻮزارات اﻟﻤﻌﻨﻴﺔ‬-7
. ‫ آﻔﺎﺋﺔ ﻣﺎﻟﻴﺔ ﻣﻦ ﻣﺼﺮف ﻣﻌﺘﻤﺪ‬-8
. ‫ اﻟﺠﺪول اﻟﺰﻣﻨﻲ ﻻﻧﺠﺎز اﻟﻤﺸﺮوع‬-9

1. Feasibility Study
2. Preliminary Project Design
3. Environmental Impact Statement
4. Certified copy, stamped by the Commercial Register, and not withstanding one (1) month period of
the:
a. Company Bylaws with all amendments
b. Incorporation Certificate
c. Company Formation Deed
d. Commercial Circular
5. Others investment projects that achieved
6. Copy of the identity card of the person authorized to sign on behalf of the company
7. Copy of the company registration certificate at the Iraqi related ministries.
8. Financial efficiency from approved Bank
9. Timing Schedule for project’s completion
10. Copy of the purchase contract of the land as registered at the Real Estate Directorate

IRAQ-Wasit-Alkut
WEB: [Link] 5-5
Email: wasit_invest@[Link] ‫ﻣﻘﺎﺑﻞ ﻓﻨﺪق ﻣﺼﺎﻳﻒ اﻟﻜﻮت‬-‫دور اﻟﻤﻌﻠﻤﻴﻦ‬-‫اﻟﻜﻮت‬-‫واﺳﻂ‬-‫اﻟﻌﺮاق‬
,wasit_invest@[Link],[Link]@[Link]
Tel +964 7803396115 (MTC) , +964 7706937893 (Asicell)