1964_LEGAL_AID_REGULATIONS — Page 24

A 24

CAP. 91]

Legal Aid Regulations

[1988 Ed.

[Subsidiary]

FORM II

表格二

LEGAL AID ORDINANCE

(Chapter 91)

法律援助條例(香港法例第91章)

APPLICATION FOR LEGAL AID FOR AN INFANT 代未成年人申請法律援助的申請書

WARNING

It is an offence under the Legal Aid Ordinance punishable by a fine and/or imprisonment to make any false statement or representation or to fail to disclose any

material fact relating to your financial

means.

Your application for Legal Aid may be refused if you fail to co-operate with the Department or the Social Welfare

Department in providing particulars of your financial means.

I,

我

of

住址為

警告

根據法律援助條例,如果你在申報經濟 狀況時,作虚假供詞或陳述,又或隱瞞重要 事項,即屬違法,可被罰款及/或被判監

如果你在申報經濟狀況時,不與法律援 助署或社會福利署合作,本署可拒絕你的申 請。

infant and solemnly and sincerely declare that-

並以至誠聲明:

I.

My personal particulars are as follows--- 有關我個人的資料如下:

Name: Mr./Madam/Miss

姓名:先生/女士/小姐

Alias:

別名

Hong Kong Identity Card No.:

Date of Birth:

香港身份證號碼

Residential Address:

住址

出生日期

Correspondence Address:

通訊地址

hereby apply for Legal Aid for 現謹代未成年人申請法律援助,

Tel. No.:

電話號碼

Tel. No.:

電話號碼

}

...(

Occupation:

職業

Name of Employer

(or last employer if now unemployed).

僱主姓名(如目前失業,則填寫最後一名僱主的姓名)

Address of Employer (or last employer):

僱主(或前僱主)的地址

Tel. No.:

電話號碼