Fillable Application for Verification of Eligibility for Immigration Department, (Workplace English Campaign)

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Application for Verification of Eligibility for Immigration Department, (Workplace English Campaign)

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Country of origin: HONG-KONG
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1
警
告 :
Warning:
任何人士 ，如 明 知故 犯作 失實 聲明 或填 報虛 假 或自 己亦 不 相 信 為 正 確 的 資 料 ， 即 屬 違 法 。
A person who knowingly and wilfully makes a statement or gives information which he knows to be false or does not believe to be true shall be
guilty of an offence under the law.
1. 個人 資 料 Personal Particulars
姓名
(
中文
)
Name in Chinese
姓 (英 文)
Surname in English
名 (英 文)
Given names in English
別名
(如 有 )
Alias (if any) in Chinese
姓
(
英文
)
Surname in English
名
(
英文
)
Given names in English
性別
Sex
男
Male
女
Female
出生日期
Date of birth
日 dd
月 mm
年 yyyy
出生地點
Place of birth
香港身份證號碼 (如 有 )
HK identity card no.
(if any)
(
)
國籍
Nationality
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 copy.
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
香
港 特 別 行 政 區 政 府 入 境 事 務 處
Immigration Department, the Government of
the Hong Kong Special Administrative Region
核
實 永 久 性 居 民 身 份 證 資 格 申 請 表
Application for Verification of Eligibility for
Permanent Identity Card
Note :
(i)
填 寫 此 表 格 前 請 先 參 閱 「 填 表 須 知 」 (表 格 ROP 145A)。
Please read the ‘Notes for Guidance’ (Form ROP 145A) before completing this form.
(ii)
十 八歲或 以上申 請 人 須 填寫申 請 表 第
1
、
2
及
6
欄 ，並加 簽署。 十八歲 以 下 兒 童
的 申請必 須由該 兒童的 父、母 或合法 監護人 ，填寫 申 請 表 第 1、 2 及 5 欄，並加
簽 署 。
Applicants aged 18 or over should complete Parts 1, 2 and 6 and sign the application. For a child
under 18 years of age, the parent or legal guardian of the child should complete Parts 1, 2 and 5
and sign the application.
(iii) 領 取本表 格 無 須 繳 費 。 This form is issued free of charge.
(iv) 請 用黑色 或藍色 筆 以 正 楷填寫 本 表(iv) 請 用黑色 或藍色 筆 以 正 楷填寫 本 表 格 。 Please complete this form in BLOCK letters using black or blue pen.
(v)
請 在適當 方格內 填上「 」號。 Please tick as appropriate.
此 欄 由 辦 理 機 關 處 理
FOR OFFICIAL USE ONLY
檔 案 條 碼
Reference barcode
注 意
:
(vi)
* 請將不適用者刪去 。Please delete if inapplicable.
(中文)
旅行證件號碼
Travel document no.
簽發日期
Date of issue
日 dd
月 mm
年 yyyy
簽發地點
Place of issue
前往港澳通行證（慣稱‘單程通行 證 ’ 或 ‘ 單程證 ’ ） 號 碼 (如適用 )
Permit for Proceeding to Hong Kong and Macao (commonly known as‘One-way Exit Permit’) no.
(if applicable)
在香港特別行政區的居留身份
Residential status in the HKSAR
無條件限制逗 留
Unconditional stay
獲准在港居留至
Permitted to remain until
日
dd
月
mm
年
yyyy
聯絡電話號碼
Contact telephone no.
內 線
Ext.
/
內 線
Ext.
住宅電話號碼
Home telephone no.
傳真號碼
Fax no.
香港通訊地址 (請於邊界內填 寫 )
Postal address in Hong Kong
(Please fill in within border)
* Signature of applicant/parent/legal guardian
ROP 145 (9/2018)
2
2.
申請人屬下述《入境條例》附表
1
第
2
段
(a)
至
(f)
項任何一項，或第
6
段
(1)
項或
(2)
項，是香港特別行政區永久性居民
:
The applicant is a permanent resident of the Hong Kong Special Administrative Region (HKSAR) by virtue of one of the
following criteria under paragraph 2(a) to (f), or paragraph 6(1) or (2) of Schedule 1 to the Immigration Ordinance :
(1)
在香港特別行政區成立以前或以後在香港出生的中國公民。
Chinese citizens born in Hong Kong before or after the establishment of the HKSAR.
(2)
在香港特別行政區成立以前或以後通常居於香港連續七年或以 上的中國公民。
Chinese citizens who have ordinarily resided in Hong Kong for a continuous period of not less than 7 years before or after the establishment of the HKSAR.
前往港澳通行證（ 慣 稱 ‘單程通行 證’ 或 ‘單程證 ’） 持有人 (如適用 )
Permit for Proceeding to Hong Kong and Macao (Commonly known as ‘One-way Exit Permit’) holder (if applicable)
(3) 第(1)或 (2)項的香港特別行政區 永 久 性 居民在香港以外所生的中國 籍子女。
Persons of Chinese nationality born outside Hong Kong to a parent who is a permanent resident of the HKSAR listed in category (1) or (2).
(4)
在香港特別行政區成立以前或以後持有效旅行證件進入香港、 通 常居於香港 連續七 年 或 以 上並以 香港為永久 居住地 的非中國籍
人士 。
Persons not of Chinese nationality who have entered Hong Kong with valid travel documents, have ordinarily resided in Hong Kong for a continuous
period of not less than 7 years and have taken Hong Kong as their place of permanent residence before or after the establishment of the HKSAR.
(5) 在香港特別行政區成立以前或以後第(4)項的香港特別行政區永久 性 居民在香港所生的未滿 21 歲的子女。
Persons under 21 years of age born in Hong Kong to a parent who is a permanent resident of the HKSAR listed in category (4) before or after the
establishment of the HKSAR.
(6)
第
(1)
至
(5)
項所列居民以外在香 港特別行政區成立以前只在香 港有居 留權的人 。
Persons other than those residents listed in categories (1) to (5), who, before the establishment of the HKSAR, had the right of abode in Hong Kong only.
(7)
在
1997
年
7
月
1
日以前是香港永久性居民的非中國籍人士或 在香港特別行政區成 立 以前已享有 香港居 留 權 的中國 籍人士 。
Persons not of Chinese nationality who were permanent residents of Hong Kong before 1 July 1997 or persons of Chinese nationality who had the right
of abode in Hong Kong before the establishment of the HKSAR.
3. (1)
父親 的 資 料 〔 適 用 於 第 2 欄 內 基 於 第 (1)、 (3)、 (5)或(7)項 條 件 提 出 的 申 請 〕
Particulars of Father
〔
Applicable to claim under category (1), (3), (5) or (7) as indicated in Part 2
〕
姓名
(
中文
)
Name in Chinese
姓 (英 文)
Surname in English
名 (英 文)
Given names in English
出生日期
Date of birth
日
dd
月
mm
年
yyyy
香港身份證號碼 (如 有 )
HK identity card no.
(if any)
(
)
3. (2)
母親 的 資 料 〔 適 用 於 第 2 欄 內 基 於 第 (1)、 (3)、 (5)或(7)項 條 件 提 出 的 申 請 〕
Particulars of Mother
〔Applicable to claim under category (1), (3), (5) or (7) as indicated in Part 2〕
姓名
(
中文
)
Name in Chinese
姓 (英 文)
Surname in English
名 (英 文)
Given names in English
出生日期
Date of birth
日 dd
月 mm
年 yyyy
香港身份證號碼 (如 有 )
HK identity card no.
(if any)
(
)
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 copy.
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
請填寫第
3
欄及第
5
或第
6
欄
Please complete Part 3 and Part 5 or 6
請填寫第
4
欄及第
5
或第
6
欄
Please complete Part 4 and Part 5 or 6
請填寫第
3
欄及第
5
或第
6
欄
Please complete Part 3 and Part 5 or 6
請填寫第
4
欄及第
5
或第
6
欄及呈 交 聲明 書
(
表格
ROP 146)
Please complete Part 4 and Part 5 or 6 and submit Declaration (Form ROP 146)
請填寫第
3
欄及第
5
或第
6
欄
Please complete Part 3 and Part 5 or 6
請填寫第
5
或第
6
欄
Please complete Part 5 or 6
請填寫第
3
、第
4
欄及第
5
或第
6
欄
Please complete Part 3, 4 and Part 5 or 6
ROP 145 (9/2018)
3
4. (1) 在香港通常 居 住 的期間
〔適 用於 第
2
欄內 基於 第
(2)
、
(4)
或
(7)
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
〕
由
F
rom
日 dd
月 mm
年 yyyy
至
T
o
日 dd
月 mm
年 yyyy
由
F
rom
日 dd
月 mm
年 yyyy
至
T
o
日 dd
月 mm
年 yyyy
由
F
rom
日
dd
月
mm
年
yyyy
至
T
o
日
dd
月
mm
年
yyyy
由
F
rom
日
dd
月
mm
年
yyyy
至
T
o
日
dd
月
mm
年
yyyy
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
Whereabouts
由
F
rom
日 dd
月 mm
年 yyyy
至
To
日 dd
月 mm
年 yyyy
由
F
rom
日
dd
月
mm
年
yyyy
至
To
日
dd
月
mm
年
yyyy
由
F
rom
日 dd
月 mm
年 yyyy
至
To
日 dd
月 mm
年 yyyy
(
註
:
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.)
5.
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
日 dd
月 mm
年 yyyy
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)
6.
4
十八 歲 或 以 上 申 請 人的聲明書
Declaration of Applicant Aged 18 or Over
本人，即下開簽署人，現謹此聲明：
I, the undersigned, declare that :
(1) 本人是中國公民，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〕
I am a Chinese citizen and I have not made any declaration of change of nationality to the Immigration Department, the Government of the HKSAR.
[Applicable to claim under category (1) to (3) or (7) as indicated in Part 2]
(2) 本人是中國公民，以及本人的父母從未向香港特別行政區政府入境事務處為本人申報國籍變更。〔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〕
I am a Chinese citizen and my parent has not made any declaration of change of nationality in respect of me to the Immigration Department, the
Government of the HKSAR. [Applicable to claim under category (1) to (3) or (7) as indicated in Part 2]
(3) 本人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〕
I have entered Hong Kong legally on strength of a valid travel document. 〔Applicable to claim under category (2) or (4) as indicated in Part 2〕
(4) 本人已通常居於香港連續七年或以上。 本人在以上第 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。 本人在
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〕
I have ordinarily resided in Hong Kong for a continuous period of not less than 7 years. I have 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 from Hong Kong for more than 6 months during the period of my
ordi
nary 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〕
(5) 本人在緊接此申請日期之前已通常居於香港連續七年或以上。 本人在以上第 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。 本人在以上第 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)項條件的申請〕
I have ordinarily resided in Hong Kong for a continuous period of not less than 7 years immediately before the date of this application. I have
not been absent from Hong Kong for any period of more than 6 months during the period of my ordi
nary residence in Hong Kong as stated in Part 4(1)
above. The period(s) of continuous absence from Hong Kong for more than 6 months during the period of my 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〕
(6) 本人在本申請表內的第 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
件提出的申請〕
I have 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〕
(7) 本人現身在香港特別行政區。
I am now present in the HKSAR.
(8) 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.
(9) 本人同意為處理此項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.
(10) 本人同意為處理此項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)提供本人的資料。
I consent to releasing my information to any Government authorities, public bodies or private organisations, including those inside or outside the
HKSAR, for the processing of this application.
(11) 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
處理此項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 Immigration Department of the Government of the HKSAR may require for the processing of this application.
日期 簽署
Date Signature _________________________________________________
以
下由辦理機關填寫 FOR OFFICIAL USE ONLY
7. 申請 審 批 結果 Application result
申請人符合入境條例附表 1 第 項的資格，是香 港 特 別 行 政 區 永久性居民 。
I am satisfied that the applicant is a permanent resident of the HKSAR under paragraph ( ) of Schedule 1, Immigration Ordinance.
申請人以香港為其永久居住地，申請香港特別行政 區 永 久 性 居 民 身 份 予 以 批 准 。
I am satisfied that the applicant has taken Hong Kong as his/her place of permanent residence. Application for the status of permanent resident in
the HKSAR is approved.
申請人未能符合香港特別行政區永久性居民 的 資 格 。
I am not satisfied that the applicant is a permanent resident of the HKSAR.
Name, signature and post of assessment officer
Date
日 dd
月 mm
年 yyyy
審批職員 (姓名、簽名及職位 ) 日期
ROP 145 (9/2018)
收集個人資料的目的
Statement of Purpose
收集資料的目的
Purpose of Collection
對於申請表內所提供的個人資料，入境事務處會用作下列一項或多項的用途：
The personal data provided in the application form will be used by Immigration Department, for one or more of the following purposes:
1. 辦理你的申請；
to process your application;
2. 實施／執行《入境條例》(第 115 章)及《入境事務隊條例》(第 33l 章 )的相關條文規定，以及履行入境管制職務，
藉此協助其他政府決策局和部門執行其他法例和規例；
to administer/enforce relevant provisions of the Immigration Ordinance (Chapter 115) and Immigration Service Ordinance (Chapter
331), and to assist in the enforcement of any other Ordinances and Regulations by other government bureaux and departments
through carrying out immigration control duties;
3. 供作統計及研究用途，但所得的統計數字或研究成果，不會以能 識辨各有關的資料當事人或其中任何人的身份
的形式提供；以及
to serve statistical and research purposes on the condition that the resulting statistics or results of the research will not be made
available in a form which will identify the data subjects or any of them; and
4. 供作法例規定、授權或准許的其他合法用途。
for any other legitimate purposes as may be required, authorised or permitted by law.
在申請表內提供 個人資料純屬自願。若你未能提供足夠的資料，本處可能無法辦理你的申請。
The provision of personal data in the process of
your application is voluntary. If you do not provide sufficient information, we may not be
able to process your application.
資料轉交的類別
Classes of Transferees
為達到上述的目的，你在申請表內所提供的個人資料，或會向其他政府決策局和部門，以及其他機構披露。
The personal data you provide may be disclosed to government bureaux, departments and other organisations for the purposes mentioned
above.
查閱個人資料
Access to Personal Data
根據《個人資料(私隱)條例》(第 486 章)第 18 及 22 條，以及附表 l 第 6 項原則，你有權要求查閱及改正其個人資料。
你的查閱權利包括在繳交有關費用後，索取你在申請表內所填報的個人資料的副本。
You have a right to request access to and correction of your personal data as provided for in sections 18 and 22 and Principle 6 of
Schedule 1 of the Personal Data (Privacy) Ordinance (Chapter 486).
Your right of access includes the right to obtain a copy of your
personal data provided in the application form subject to payment of a fee.
如欲查詢申請表 內的個人資料，包括查閱或改正，可向下列人員提出：
Enquiries concerning the personal data collected by means of the application form, including making of access and corrections, should be
addressed to:
香港灣仔 Chief Immigration Officer (Right of Abode)
告士打道七號 25/F Immigration Tower
入境事務大樓二十五樓 7 Gloucester Road
總入境事務主任(居留權) Wan Chai, Hong Kong
電話：2829 3983 Tel: 2829 3983
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ROP 145 (9/2018) 5
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Application for Verification of Eligibility for Immigration Department, (Workplace English Campaign)

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Completed 20 February 2021

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