CO537-4801 — Page 14

Employer's Sheet

Serial No:

12

SCHEDULE.

Identity Card No:

13

Identity Card No.

Form 1 (a). (Rule 4).

Registration of Persons Rules, 1949.

Form 1 (EMPLOYERS RETURN).

Pursuant to the provisions of the Registration of Persons Ordinance, 1949, I, the undersigned employer, do hereby certify that the following is a true record of the particulars in respect of the undermentioned person employed by me as on the (a)

1949, and that in. the attached (b)

sheets I have truly recorded the information given by him in respect of the members of his family of the age of twelve years and upwards.

Form 1 (b) (Employer

should not

(Rule 11) make any entry here except at (1) (a) or (b)

which should be the

same as the entry at 1 (a) or (b) above)

僱主不可在此處填寫任何事項(一)(甲) 或(一)(乙)則可填寫此係應與上開(一) (甲)或(一)(乙)相同者

余本人部署名於後之僱主茲依照一九四九年人口登記則例之規定証明下開所錄關於後 列一九四九年(日)

受余任用之僱員其各事項均屬眞確無訛並証明在所附表格 (b)... .張之內余已將其所報家內人口足十二歲以上者各項詳情照實錄明

Signature of Employer.

i

(1)(a) Employer's reference number

for Employee:

僱 主 簽名

Date: 日期

(I) (a) Employer's

(C) NAME OF EMPLOYER OR FJRM:

僱主姓名或店名

(d) ADDRESS OF EMPLOYER OR FIRM: 僱主之住址或店址

(e) Designation of Person Signing Above:

上開署名者之身份

reference number

for employee:

僱主所給予該僱員之編號

(2) Name (in English):

英文姓名

(3) Name (in Chinese characters):

中文姓名

(4) Address (in English):

英文址

(5) Address (in Chinese

characters):

中文址

(6) Age last birthday:

足若千歲

(8) Race (if Chinese write “C”or

if of other race write in full):

種族(倘係中國人可寫英文字母

“C”字其餘則寫明屬何種族)

(9) Nationality (if Chinese write

“C” or if of other nationality

write in full) :

國籍(尙係中國籍可寫英文字母“C”

字尙屬外國國籍則寫明是何國籍)

(ro) Occupation:

職

業

(1)(b) Subsidiary Serial No. for members of family of the age

of twelve years and upwards: 僱員家屬足十二歲以上者之分編號數

(7) Sex (M. or F.):

性 别

僱主所給予該

僱 員 之 翻 號

(1)(b) Subsidiary Serial No. for members of family of the

age of twelve years and upwards:

僱員家屬足十二歲以上者之分編號數

has been photographed and should produce this receipt when called

upon to receive his Identity Card.

Received Identity Card of

Date:

above reference.

Signature.

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