〔適 用於 第
欄內 基於 第
、
或
項條 件提 出的 申請 〕
Period of Ordinary Residence in Hong Kong
〔
Applicable to claim under category (2), (4) or (7) as indicated in Part 2
〕
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4. (2) 如在第 4(1)欄內 所述在香港通常居住期間內,有連續六個月 以 上不在香港,請在下列 註 明 連續六 個 月 以 上 不
在香 港 的 期 間、原因及當時的身處地方:
If there is/are any period(s) of continuous absence from Hong Kong for more than 6 months during the period(s) of ordinary residence in
Hong Kong as stated in Part 4(1) above, please state the period(s), reason(s) of absence and whereabouts in the following :
原因
請提供證明 文 件
) Reason(s) (Please produce proof)
身處地方
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如以上空位不敷 應用, 請 用 另 一 張 紙 填 寫 並 簽 名 。
) (Note : Please use a separate sheet and append signature if the space provided above is not sufficient.)
十八 歲 以 下 兒童申請人的父親或母親或合法監護人的聲明書
Declaration of Parent or Legal Guardian of Applicant Aged Under 18
本人,即下開簽署人,現謹此聲明:
I, the undersigned, declare that :
(1) 本人為上述兒童提出申請。
I apply in respect of the abovenamed child.
(2) 本人是該兒童的 父親/ 母親/ 合法監護人。
I am the father/ mother/ legal guardian of the child.
(3) 該兒童是中國公民,並且從未向香港特別行政區政府入境事務處申報國籍變更。〔適用於第 2 欄內基於第(1)至(3)項或第(7)項條件提出的申請〕
The child is a Chinese citizen and no declaration of change of nationality has been made to the Immigration Depa
rtment, the Government of the HKSAR in
respect of him/her. 〔Applicable to claim under category (1) to (3) or (7) as indicated in Part 2〕
(4) 該兒童是持有效旅行證件並合法進入香港。〔適用於第 2 欄內基於第(2)或(4)項條件提出的申請〕
The child has entered Hong Kong legally on strength of a valid travel document. 〔Applicable to claim under category (2) or (4) as indicated in Part 2〕
(5) 該兒童已通常居於香港連續七年或以上。 該兒童在以上第 4(1)欄所述在香港通常居住期間內並未連續六個月以上不在香港。 該兒童在
以上第 4(1)欄所述在香港通常居住期間內曾連續六個月以上不在香港的期間,已在第
4(2)欄內填報。〔適用於第 2 欄內基於第(2)項條件提出的申
請〕
The child has ordinarily resided in Hong Kong for a continuous period of not less than 7 years. The child has not been absent from Hong Kong for any
period of more than 6 months during the period of ordinary residence in Hong Kong as stated in Part 4(1) above. The period(s) of continuous absence
of the child from Hong Kong for more than 6 months during the period of
ordinary residence in Hong Kong as stated in Part 4(1) has been given in Part 4(2)
above.〔Applicable to claim under category (2) as indicated in Part 2〕
(6) 該兒童在緊接此申請日期之前已通常居於香港連續七年或以上。 該兒童在以上第 4(1)欄所述在香港通常居住期間內並未有連續六個月以上
不在香港。 該兒童在以上第 4(1)欄所述在香港通常居住期間內曾連續六個月以上不在香港的期間,已在第 4(2)欄內填報。〔適用於第 2 欄內
基於第(4)項條件提出的申請〕
The child has ordinarily resided in Hong Kong for a continuous period of not less than 7 years immediately before the date of this application. The
child has n
ot been absent from Hong Kong for any period of more than 6 months during the period of ordinary residence in Hong Kong as stated in Part 4(1)
above. The period(s) of continuous absence of the child from Hong Kong for more than 6 months during the period of ordinary residence in Hong
Kong as stated in Part 4(1) has been given in Part 4(2) above. 〔Applicable to claim under category (4) as indicated in Part 2
〕
(7) 該兒童在本申請表內的第 4 欄所述的七年通常居住期間內不曾因依據法院判處或命令而被監禁或羈留。〔適用於第 2 欄內基於第(2)或(4)項條件提
出申請的十四歲及以上申請人士〕
The child has not been imprisoned or detained pursuant to the sentence or order of any court during the period of 7 years ordinary residence as mentioned in
Part 4 of this application form. 〔Applicable to claim under category (2) or (4) as indicated in Part 2 for applicants aged 14 and over〕
(8) 該兒童現身在香港特別行政區。
Th
e child is now present in the HKSAR.
(9) 就本人所知及相信,此申請表內所填報的資料均屬正確、完備和真實。
The information given in this application form is correct, complete and true to the best of my knowledge and belief.
(10) 本人同意為處理該兒童的申請而進行所需的任何查詢。
I consent to the making of any enquiries necessary for the processing of this application for the child.
(11) 本人同意為處理該兒童的申請而向任何政府機關、公共機構或私營機構(包括在香港特別行政區境內或境外的機關或機構)提供該兒童的資料。
I consent to re
leasing the child’s information to any Government authorities, public bodies or private organisations, including those inside or outside the
HKSAR, for the processing of this application for the child.
(12) 本人現授權所有政府機關、公共機構或私營機構(包括在香港特別行政區境內或境外的機關或機構)向香港特別行政區政府入境事務處提供為處理
該兒童的申請所需的任何記錄或資料。
I authorise all Government authorities, public bodies or private organisations, including those inside or outside the HKSAR, to release any record or
information which the Immigr
ation Department of the Government of the HKSAR may require for the processing of this application for the child.
本人的香港身份證號碼 姓名
My HK identity card no. ______________________________________ Name
與該兒童的關係 父親 母 親 其他 ( 請 註 明 )
Relationship to child Father Mother Others
(Please specify) _____________________________________________
日期 簽 署
Date Signature _________________________________________________
如本表格為影印本或從互聯網下載,
請填寫此欄。
Please complete this column if this form
is a photocopy or downloaded cop
在本頁內所填報的資料均屬正確 、完備和真實 。
The information given on this page is correct, complete and true.
日期
Date
* 申請人╱父╱母╱合法監護人簽署
* Signature of applicant/parent/legal guardian
y.
ROP 145 (9/2018)