CO537-4801 — Page 15

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Identity Card No:

Identity Card

No.

Form 2 (a). (Rule 7)

Registration of Persons Rules, 1949.

Form 2 (APPLICATION FORM).

Pursuant to the provisions of the Registration of Persons Ordinance, 1949, 1, the undersigned, do hereby certify that the following is a true record of the particulars in respect of myself as on the (a)......... and that in the attached (b).......

sheets is recorded the information

truly given by me in respect of members of my family of the age of twelve years and upwards.

余本人部署名於後之人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余本 人之各事項以(a).

等均屬眞確無訛並註明在所附表格(b).

張之內已

註明余家內人口足十二歲以上者所報告於余之各項眞確詳情

Signature of Applicant.

申請人署名

(1)(a) Applicant's Reference No.

申請人自己之編號

(2) Name (in English):

英文姓名

(3) Name (in Chinese characters) :

中文姓名

(4) Address (in English):

英文住址

(5) Address (in Chinese characters):

中文住址

(6) Age last birthday:

足若干歲

(8) Race (if Chinese write "C" or if

of other race write in full) :

種族(尙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

倘係別國國籍者則寫明是何國籍)

(10) Occupation:

職業

Date:

日期

Signature of Registration Officer.

登記員署名

(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

Form 2 (b) (Rule 12)

(Applicant should not

make any entry here 申請人不可於此處填寫任何事項(一)(甲) except at (I) (a) or (b)或(一)(乙)則可填寫此係應與上項之(一) which should be the (甲)或(一)(乙)相同者

same as the entry at (1)

(a) or (b) above)

(1)(a) Applicant's Reference

No:

申請人自己之組編號

(1)(b) Subsidiary Serial No. for

members of the 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

Thumb Print.

above Reference.

Date:

Signature.

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