1964_ADOPTION_RULES — Page 16

A 16

[Subsidiary]

L.N.228/77.

L.N.337/82.

CAP.290]

Adoption Rules

[1986 Ed.

(4)

(註四)

Where a birth certificate is not attached, enter the place (including country) of birth if known. 如無出生證,但知其出生地者,則填明其出生地(包括國家)。

(5)

(註五)

If the infant is illegitimate, the father's name should not be given in this entry; but see paragraph 7. 如該童係私生子(女),則本段不應填寫其父之姓名,請參閱第七段。

(6)

(註六)

(7)

(註七)

(8)

(註八)

(9)

(註九)

(10)

(註十)

(11)

(註二)

(12) (註三)

This paragraph should be completed only if the infant has a legal guardian other than the father or mother of the infant. 如該童之合法監護人非該童之父或母,則須填寫本段。

If the infant is illegitimate, enter the name of any person known to the applicant who has been adjudged by an order to be the putative father of the infant or who has acknowledged himself to be the father of the infant and agreed to contribute to his or her maintenance. 如該童係私生子(女),則應據申請人所知填寫經法院命令裁定爲該童之推定父之姓名,或其本人已承認爲該童之父且同意付給該童之養育費用者之姓名。

The names to be entered here (or in the following paragraph) are those of the persons named in paragraphs 5, 6 and 7, and (where the application is made by one of two spouses alone) of the spouse of the applicant. 本段(及下段)所填寫之姓名係第五、第六及第七段所開之姓名,(如僅由夫婦中一人申請者),則申請人之配偶之姓名,亦一併填寫。

*

This paragraph should be completed with the name of any of the persons mentioned in the previous note who has not signified his or her consent. See subsections (1) and (2) of section 6 of the Adoption Ordinance. 此處應填寫前註(即註八)所指之人,其中有對申請並未表示同意者,請參閱領養子女條例第六條第(一)及(二)節。

This paragraph need not be completed if the applicant or either of the applicants is a "relative" of the infant as defined by section 2 of the Adoption Ordinance. 如申請人或申請人中之任何一人係領養子女條例第二條所界說之該童之「親屬」,則本段不須填寫。

This paragraph need not be completed if the applicant or either of the applicants is a "relative" of the infant as defined by section 2 of the Adoption Ordinance. Where it is completed, more than one referee may be named if desired. 如申請人或申請人中之一人係領養子女條例第二條所界說之該童之「親屬」,則本段無須填寫,如填寫則可填寫多過一人以上之名字,以備查詢。

If the applicant wishes his name to be kept confidential, insert serial number obtained in pursuance of rule 6 of the Adoption Rules. 如申請人欲將姓名保持秘密,則應填寫根據領養子女規則第六條規定所取得之順次號碼。

FORM 4

第四表格

[rule 10.]

【規例第十條】

Specific consent to an adoption order in respect of an infant named A.B.*

同意有關名爲（註一）之幼童之領養令特別同意書

Whereas an application is to be made [by C.D./C.D. and E.D.](2) or（註二） 兹因[（註二）將申請(領養一子或女)]或[將以順次...

E

[under the serial number 號碼申請(領養一子或女)];

Whereas the said A.B. (hereinafter called the infant) is not less than 6 weeks old, having been born in 生於 on the 其年歲已不止六星期,亦即於一九 年 月 日出生。