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G Form To: Qatar Financial Intelligence Unit PO Box 1234, Doha Fax: 4410327 Tel: 4456293 From: Tel: Fax: SUSPICIOUS TRANSACTION REPORTING UNDER LAW NO. (4) OF YEAR 2010 ON ANTI-MONEY LAUNDERING AND COMBATING THE FINANCING OF TERRORISM Your reference: 1 1.1 QFIU Ref: Incident date: Person subject of the suspicious transaction report If the subject of the disclosure is an individual, fill in the following Surname(s) Other name(s) Father s Name: Address Telephone(s) Aliases Gender Male.

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