1961-HKRS30-8-51_Part04 — Page 26

1. Surname

Mr.

МІБ.

(Please ore Miss

Other names athome

2. Date of birth

3. Place of birth sing

4. Nationality

(Day)

Моши

5. Occupation

6. Permanent address amon

7. Address in Hong Kong

8. Port of embarkation

9. Travel document number

18. Place and date of issGo

11. Reason for visit (mark appropriate box with a crow),

Holiday.

Business or official mission.

Hong Kong resident.

Other

12. Port of disembarkation

13. Date of last arrival in Hong Kong

****

Taking employment.

|

וM5

Signature of traveller.

7

* Passport No.

9. Date of issue

(Noves--AN persom over 16 year of age mon have separate pasiporta),

IQ Place of issu2

naudatusio......

11. Name and present address

of father or mother

ཏྟཾཨཉྙཾ ཏཾ ཨཱཝཾ ཡཱ སྶ F༥༥--༞:r*-

12. Name and address of any unitoamalprisilieteneational Phase

relative in Hong Kong

༄ ྂ པཿཔཿ ་ 、 " " ༥ ,༥ | ཀ ཤ ས སཱ - - པཱÎ ཀ ཡ ཥྭ - ( ཁ ཝཾ ཀཱས བྷཏྟམསྶ ཝཱ ཝཱ ཝཱ ཝཱ སཱིཡ

Signature

---་་་་་་།----------་་་་་་་---**

Date --

FOURTH SCHEDULE.

PART 1.

Form of record for purposes of section 36(1) of the Ordinance.

Same

Nationality

Occupation... kedadea

Cote of arrival

Name of vessel or airline by which arrived dii.......-4+++++++

Date of departure

Name of vessel or airline by which departed .........

[reg. 2.]

PART II.

Prescribed form for purposes of section 24 of the Ordinance.

IMMIGRATION DEPARTMENT, HONG KONG.

Particulars to be reported by an alien on attaining the age of 16 yearı in the Colony.

1. Name in full Mr.

(Plex prot Miss

2. Date of birth

3. Place of birth

4. Nationality

6. Address in Hong Kong .........be.

7. Address in country

of nationality

5. Occupation

PART [I

Form of return for purposes of section 28(2) of the Ordinance.

Name

IN BLOCK LETTERS

State wiccbar hir.

Mm. or Mis

From

Nationality Occupation

Place

Ship