1964_MASSAGE_ESTABLISHMENTS_REGULATIONS — Page 2

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CAP. 266]

Massage Establishments Regulations

[1988 Ed.

[Subsidiary]

I

APPLICATION FOR THE ISSUE/RENEWAL OF A MASSAGE ESTABLISHMENTS LICENCE

I hereby apply for a licence to operate a massage establishment at

In support of my application I submit the following information and particulars-

PERSONAL DETAILS OF APPLICANT

1. Name (in English and in Chinese)

2. Identity Card No.

3. Residential address

4. Business address

5. Date and place of birth

PART I

(C.C.C. No. (Telephone No. ...)

(Telephone No.

6. Nationality

Note: If you are not a Hong Kong permanent resident, you are required to attach proof of entitlement to take up employment in Hong Kong.

7. Indicate by deleting as necessary whether you are literate in-

(a) the Chinese language only;

(b) the English language only; or

(c) both the Chinese language and the English language.

BUSINESS DETAILS

8. Name (in English and in Chinese) of the proposed massage establishment

9. Address of the proposed massage establishment (including floor, and flat/shop/unit number as appropriate)

10. Indicate by deleting as necessary whether the proposed massage establishment will be in premises that are--

(a) a wholly commercial building;

(b) a wholly residential building; or

(c) a mixed commercial and residential building.

11. If the premises is a mixed commercial and residential building is there direct access from the commercial to the residential area?

12. Indicate by deleting as necessary whether you are-

(a) the owner of the premises in which the massage establishment will be situated;

(b) the principal tenant of such premises; or

(c) a sub-tenant of such premises.

YES/NO