Central Bank of Jordan: Ultimate Beneficial Owner Declaration Form

Ref: 17/3/9.07
Date: 15/10/1446 AH
Corresponding to: 1/6/2026 AD

Dear Insurance Companies,

Subject: Ultimate Beneficial Owner Declaration Form

Greetings,

Based on the provisions of paragraph (b) of Article (109) of the Insurance Activities Regulation No. (12) of 2021 and paragraph (b) of Article (3) of the Instructions on Acquiring Controlling Interests in Insurance Companies No. (9) of 2025 and its amendments, the following has been decided:

1. It is the responsibility of the Board of Directors of the insurance company to ensure the implementation of necessary procedures to guarantee the provision of sufficient, accurate, and up-to-date information on the ultimate beneficial owner of the shares in the insurance company's capital, as soon as possible. It is also necessary to provide all means of verifying the validity of documents and papers related to the data and information of the ultimate beneficial owner of those shares, by relying on reliable and independent sources.

2. From the date of issuance of this decision, insurance companies are required to create a special register to meet the requirements of the provisions of this decision. The insurance company must retain details of each ultimate beneficial owner's data as specified in this decision. This register must be updated with any changes to the ultimate beneficial owner of the shares, whether directly or indirectly, within (10) working days from the date the insurance company becomes aware of such changes. The special register containing the ultimate beneficial owner's data must be retained from the date the person acquired the status of ultimate beneficial owner until (5) years from the date that person ceases to have the status of ultimate beneficial owner.

3. The special register of the ultimate beneficial owner's data and information must include, at a minimum, the following, supported by all paper documents or those obtained from electronic databases, issued by reliable and independent entities, confirming the validity of the data and information used:

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To verify the identity of ultimate beneficial owners or for the purpose of accessing ultimate beneficial owners, such as (registration certificates, association registration certificates, Civil Affairs Department data, etc.):

a. The number of shares owned by the ultimate beneficial owner and their percentage of the insurance company's capital, clarifying the classes of those shares (nature of voting rights associated with them), as well as whether the shares are pledged in whole or in part, specifying the entity in whose favor the shares are pledged and the reasons for the pledge.

b. The determinants and criteria by which the person acquired the status of ultimate beneficial owner of the share in the insurance company's capital, and what reinforces the insurance company's adherence to the methodology specified in this decision to reach the ultimate beneficial owner, in a manner that enables any party reading the records to understand the reason for reaching this decision.

c. The date the natural person acquired the status of ultimate beneficial owner and the date the status ceased.

d. The full four-part name of the ultimate beneficial owner, their nationality, date and place of birth, and place of residence.

e. The national ID number and valid ID card number, if the ultimate beneficial owner holds Jordanian nationality.

f. The valid passport number, country and date of issue, and expiration date for persons who do not hold Jordanian nationality.

g. All contact means for the ultimate beneficial owner, including phone number and email address.

h. Marital status.

i. Names of children, mother, and spouse.

j. The country of tax residence of the ultimate beneficial owner, with details of tax identification numbers issued by those countries.

k. Evidence reinforcing that the insurance company has searched available databases to verify that the ultimate beneficial owner is not listed on international sanctions lists related to money laundering, terrorist financing, and proliferation of weapons, or on local terrorist lists, or any other negative information.

l. Evidence proving that the insurance company has updated the ultimate beneficial owner's information periodically and continuously, whether upon new developments or during periodic reviews.

m. The Ultimate Beneficial Owner Declaration Form for the share in the insurance company's capital, shown in Annex No. (1) of this decision, filled out by the ultimate beneficial owner and signed appropriately.

4. For the purpose of applying the requirements of this decision and for the purpose of identifying the ultimate beneficial owner, the following methodology must be followed sequentially:

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a. If the shareholder directly in the insurance company is a legal entity or any legal arrangement, the ultimate beneficial owner of that share must be traced by tracking the natural persons benefiting from the shares in those legal entities. This applies regardless of the number of legal entities or legal arrangements, leading to the natural person's indirect ownership of up to (5%) of the insurance company's capital, as illustrated in the diagram in Annex No. (2).

b. If it is not possible to identify the natural person who is the ultimate beneficial owner of the share as stated in item (a) above, the insurance company must conduct the necessary verification to determine the extent of control by another person (who is not a shareholder in the insurance company) over the natural or legal person owning the shares of the insurance company. This is done by studying a number of factors that may indicate control, such as (the ability to make decisions, the ability to influence decisions indirectly through family relationships or close relationships with the person owning the shares of the insurance company, or through any contract or arrangements or participation in financing projects, or through a general power of attorney or obtaining authorization to attend the General Assembly meetings, paying attention to persons who pay the debts and obligations of the legal entity if they are not owners, paying attention to persons to whom the revenues or profits of the legal entity are transferred).

c. If it is not possible to identify the natural person who is the ultimate beneficial owner of the share as stated in items (a) and (b) above, the insurance company must conduct the necessary verification by studying the nature of the management of the legal entity and obtaining accurate information about any person who has the authority to make influential strategic decisions, such as the General Manager or the Board of Directors, or any person exercising executive control over the regular daily affairs of the legal entity.

5. Emphasizing the necessity of following the methodology outlined in item (4) above, regardless of the nationality of the natural or legal person or the legal arrangement participating in the insurance company, whether Jordanian or foreign nationality; the requirements of this decision are exempted for shares in insurance companies owned by:

a. Legal entities participating in insurance companies owned by 40% or more by the Jordanian Government.

b. The Social Security Corporation.

c. Any other local public institutions.

d. Governments of countries participating in Jordanian insurance companies or any official entities in those countries.

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e. Insurance companies, banks, and financial institutions whose shares are listed in one of the financial markets, which are subject to disclosure requirements ensuring a sufficient degree of transparency regarding the ultimate beneficial owner of those companies, banks, and financial institutions, provided that the insurance company retains documents and evidence confirming this.

6. The ultimate beneficial owner's data must be disclosed in the annual report of the insurance company as shown in Annex No. (3) of this decision, taking into account the following:

a. If the status of ultimate beneficial owner applies to a natural person participating directly or indirectly in the capital of the insurance company, the word "himself" must be entered in the Ultimate Beneficial Owner field.

b. If the shareholder in the capital of the insurance company directly or indirectly falls under the exempted cases according to the provisions of item (5/a, b, c, d) above, the word "himself" must be entered in the Ultimate Beneficial Owner field, along with an appropriate description of the shareholder, including -if available- the law by which the public/official entity was established, if they are Jordanian public and official institutions.

c. If the shareholder in the capital of the insurance company directly or indirectly falls under the exempted cases according to the provisions of item (5/e), the name of the ultimate beneficial owner of these entities must be entered as disclosed by the financial market in which their shares are listed.

d. If the status of ultimate beneficial owner applies to the natural person according to the methodology contained in item (4) of this decision, the name of the natural person and the criteria by which they acquired the status of ultimate beneficial owner must be entered.

Please accept our highest respect,

The Governor
Dr. Adel Al-Sharqas

Copy: Dear Jordan Insurance Companies Union.

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Annex No. (1)
This form is to be filled out by the Ultimate Beneficial Owner (Natural Person)

1. Personal Data:
   1,1 Full Name in Arabic:
   First Name | Father's Name | Grandfather's Name | Family Name

2,1 Full Name in English according to passport:
First Name | Middle Name | Grandfather Name | Surname

3,1 Gender
[ ] Male [ ] Female
4,1 Date of Birth:
Day | Month | Year

5,1 Place of Birth:
6,1 Nationality:
7,1 Other Nationalities:
8,1 Jordanian Civil ID:
National Number | Document Number | Place of Issue | Expiry Date

9,1 Passport:
Passport Number | Place of Issue | Date of Issue | Expiry Date

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10,1 Marital Status:
[ ] Married [ ] Single [ ] Divorced [ ] Widowed 11,1 Name of Wife/Spouses according to identity proof document:
12,1 Names of Children according to identity proof document:
13,1 Name of Father according to identity proof document:
14,1 Name of Mother according to identity proof document:

2. Residence Information in the Hashemite Kingdom of Jordan:
   1,2 Residence:
   [ ] Resident [ ] Non-Resident
   2,2 Permanent Residence Address:
   Address (1)
   Address (2)
   Country
   City
   Region/State
   Postal Code
   Phone Number
   Mobile Number
   Fax Number
   Email Address

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3. Professional Experience:
   1,3 Name of Employer:
   2,3 Nature of Work:

4. Politicians
   1,4 Does the ultimate beneficial owner or any of their relatives (first degree) or business partners hold or have held a high public office in the Kingdom, such as head of government, judge, military officer, high-ranking government position, or was a prominent politician or prominent figure in a political party or senior executives in state-owned companies. [ ] Yes [ ] No If the answer is yes, provide the person's data and position.

2,4 Does the ultimate beneficial owner or any of their relatives (first degree) or business partners hold or have held a high public office in a foreign country, such as head of state, judge, military officer, high-ranking government position, or was a prominent politician or prominent figure in a political party or senior executives in companies owned by a foreign state. [ ] Yes [ ] No If the answer is yes, provide the person's data and position.

3,4 Does the ultimate beneficial owner or any of their relatives (first degree) or business partners hold or have held a prominent position in an international organization.
[ ] Yes [ ] No
If the answer is yes, provide the person's data and position.

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5. Financial Status:
   1,5 Source of the ultimate beneficial owner's wealth 2,5 Source of financing for purchasing shares in the insurance company (directly or indirectly) 3,5 Does the ultimate beneficial owner have a kinship relationship up to the third degree within the ultimate beneficial owners in the insurance company (directly or indirectly) 4,5 How the ultimate beneficial owner participates in the insurance company:
   [ ] Direct Investment
   [ ] Indirect Investment through:
   [ ] Trusteeship for:
   [ ] Guardianship for:
   [ ] Agency for:

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6. Criminal Record:
   1,6 Has the ultimate beneficial owner ever declared bankruptcy or filed for bankruptcy?
   [ ] Yes [ ] No
   Please provide details if the answer is yes:
   2,6 Has a final judicial ruling ever been issued against the ultimate beneficial owner for a misdemeanor involving honor or trust or for a felony?
   3,6 Has any government authority in the Hashemite Kingdom of Jordan or outside it, during the past ten years, done any of the following:
   1,3,6 Discovered that the ultimate beneficial owner, directly or indirectly, provided false data or omitted providing any data?
   [ ] Yes [ ] No
   If the answer is yes, please provide details:
   2,3,6 Discovered that the ultimate beneficial owner, directly or indirectly, is involved in violating their rules or regulations?
   [ ] Yes [ ] No
   If the answer is yes, please provide details:
   3,3,6 Discovered that the ultimate beneficial owner, directly or indirectly, was the cause of the rejection, suspension, cancellation, or imposition of restrictions on their license to practice any work related to financial activities? [ ] Yes [ ] No If the answer is yes, please provide details:

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4,3,6 Issued any ruling or decision against the ultimate beneficial owner, directly or indirectly, regarding financial activities?
[ ] Yes [ ] No
If the answer is yes, please provide details:
5,3,6 Imposed a financial penalty or fine on the ultimate beneficial owner regarding financial activities?
[ ] Yes [ ] No
If the answer is yes, please provide details:
6,3,6 Issued a ruling against the ultimate beneficial owner to cease any activity?
[ ] Yes [ ] No
If the answer is yes, please provide details:

7. Ultimate Beneficial Owner Declaration:
   I, the undersigned, declare that the information in this form (including all attached documents and papers) is complete, accurate, and correct.
   I also declare that I am the ultimate beneficial owner of the investments in ____________________ through investment in the company ____________________ and under my personal responsibility. I also undertake to notify the company ____________________ in writing without delay in the event of any change in the information or data provided under this form. Name of Ultimate Beneficial Owner: ____________________ Date: / / Signature of Ultimate Beneficial Owner: ____________________

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Annex No. (2)

[Structural Diagram]
Insurance Company (A)

• Legal Entity (B) 5%
• Natural Person (C) 5%
• Legal Entity (D) 90%

From (B):

• Natural Person (E) 45%
• Natural Person (F) 55%

From (D):

• Natural Person (G) 40%
• Natural Person (H) 10%
• Legal Entity (I) 50%

From (I):

• Natural Person (J) 100%

Ultimate Beneficial Owner	Ownership Percentage	Through	Calculation
Natural Person (E)	2.25%	Through Legal Entity (B)	(5%)*(45%)
Natural Person (F)	2.75%	Through Legal Entity (B)	(5%)*(55%)
Natural Person (C)	5%	Direct Shareholder	5%
Natural Person (G)	36%	Through Legal Entity (D)	(90%)*(40%)
Natural Person (H)	9%	Through Legal Entity (D)	(90%)*(10%)
Natural Person (J)	45%	Through Legal Entity (D)	(90%)(50%)(100%)

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Annex No. (3)

Major Shareholders whose share percentage is equal to or exceeds (5%)

Shareholder Name	Nationality	Number of Shares Owned	Share Percentage in Insurance Company Capital	Ultimate Beneficial Owner	Number of Pledged/Seized Shares	Percentage of Pledged/Seized Shares of Total Share	Pledge/Seizure Entity