Fill - Free fillable Immigration Department The Government of the Hong Kong (Workplace English Campaign) PDF form

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

申請索

取文件

核證副本

- 香港法例第 177 章《人事登記條例》第 10 條

Request for a certied copy of document

- Section 10 of the Registration of Persons Ordinance, Chapter 177, Laws of Hong Kong

注意： (1) 本表格可用中文或英文填寫。

Note: This form may be completed in English or Chinese.

(2) 根據香港法例第 177A 章《人事登記規例》附表 2 的規定，凡按香港法例第 177 章《人事登記條例》第 10 條提供

的文件核證副本，申請人須繳費港幣 425 元正。

Under Schedule 2 to the Registration of Persons Regulations, Chapter 177A, Laws of Hong Kong, a fee of HK$425 is

payable for a certied copy of document furnished under section 10 of the Registration of Persons Ordinance, Chapter 177,

Laws of Hong Kong.

(3) 填寫本申請書前，請先閱讀背頁有關收集個人資料的目的。

Please read the statement of purpose overleaf before completing this application form.

(4) 申請人可根據香港法例第 486 章《個人資料(私隱)條例》第 18 條，填寫「個人資料(私隱)條例查閱資料要求表格

編號 OPS003」，要求查閱其個人資料。申請人可獲提供毋須核證的紀錄副本，有關費用會按該條例的規定收取。

A data access request for personal dat

a may be made under section 18 of the Personal Data (Privacy) Ordinance, Chapter

486, Laws of Hong Kong, in the specied form ‘Personal Data (Privacy) Ordinance Data Access Request Form No.

OPS003’; and non-certied copy of records may be supplied and a fee may be collected in accordance with the Ordinance.

(5) 本表格必須由申請人簽署，如申請人為 18 歲以下人士，則由父、母或合法監護人簽署。

This form is to be signed by the applicant, or where the applicant is under the age of 18, the applicant’s parent or legal

guar

dian.

致 : 人事登記處處長

To : Commissioner of Registration

申請索取下列人士的核證副本一份:

Request for a certied copy of document in respect of the following person:

*本人/本人的子女/受監護兒童 (姓名)

*I / My child / My ward, (Name) _______________________________________________________________________

香港身份證號碼出生日期性別

HK I/C No.

Date of birth Sex ______________________

住址

Residential address _____________________________________________________________________________________________

通訊地址聯絡電話號碼

Correspondence address _______________________________________________ Contact telephone no. _____________________

現申請索取下列文件的核證副本

Hereby request for a certied copy of the following document(s) : _________________________________________________________

申請理由

Reason for request : _____________________________________________________________________________________________

*申請人/父、母或合法監護人姓名簽署日期

*Name of applicant/parent or legal guardian

Signature Date

此欄由本處填寫 FOR OFFICIAL USE ONLY

甲部

Section A

簽發上述文件的核證副本

*予以批准／已被拒絕／未能繼續辦理。

Issue of a certied copy of the document(s) specified above is * approved / refused / taken no further action.

收取費

用

Fee(s) to be charged

申請書檔案號

碼

Application reference

辦理職員的姓

名、簽署及職位

Name, signature and post of processing ofcer

日

期

Date

*請刪去不適用者 *delete where inappropriate

SF/ROP/164 (2/2021)

乙

部

Section B

金額

Amount $

收據號

碼

Receipt no.

收款職員的姓名、簽署及職位

Name, signature and post of shroff

日

期

Date

遞交填妥表格方式 Submission of Completed Forms

(a) 親自遞交：任何一間人事登記辦事處 In Person: To any Registration of Persons offices

(b) 郵寄地址：香港灣仔告士打道 7 號入境事務大樓 15 樓人事登記紀錄組

Mailing Address: Registration of Persons Records Section, 15/F Immigration Tower, 7 Gloucester Road, Wanchai, Hong Kong

人事登記處

––

港島辦事處

地址：

灣仔告士打道 7 號

入境事務大樓 8 樓

(港鐵灣仔站 A5 出口)

電話：2824 6111

入境事務及人事登

記

––

火炭辦事處

地址：

火炭樂景街 2 至 18 號

銀禧薈 4 樓

405 至 407 號舖位

(港鐵火炭站 C 出口)

電話：2653 3116

egistration of Persons – Hong Kong Office

Address:

8/F, Immigration Tower,

7 Gloucester Road, Wan Chai

(MTR Wan Chai Station – Exit A5)

Tel.: 2824 6111

mmigration and Registration of Persons – Fo Tan Office

Address:

Shops 405 - 407,

4/F, Jubilee Square,

2-18 Lok King Street, Fo Tan

(MTR Fo Tan Station – Exit C)

Tel.: 2653 3116

人

事登記處 – 九龍辦事處人事登記處 – 屯門辦事處

地址：

深水埗長沙灣道 303 號

長沙灣政府合署 3 樓

(港鐵深水埗站 C1 出口)

電話：2150 7933

地址：

屯門兆麟街 19 號

屯門兆麟政府綜合大樓3 樓

(輕鐵三聖站)

電話：2653 1035

入境事務及人事登

記 – 元朗辦事處

地址：

元朗橋樂坊 2 號

元朗政府合署 1 樓

(港鐵朗屏站E出口)

(輕鐵康樂路站)

電話：2475 4114

egistration of Persons – Kowloon Office Registration of Persons – Tuen Mun Office

Address:

3/F, Cheung Sha Wan Government Offices,

303 Cheung Sha Wan Road, Sham Shui Po

(MTR Sham Shui Po Station – Exit C1)

Tel.: 2150 7933

Address:

3/F, Tuen Mun Siu Lun Government Complex,

19 Siu Lun Street, Tuen Mun

(Light Rail Sam Shing Stop)

Tel.: 2653 1035

mmigration and Registration of Persons – Yuen Long Office

Address:

1/F, Yuen Long Government Offices,

2 Kiu Lok Square, Yuen Long

(MTR Long Ping Station – Exit E)

(Light Rail Hong Lok Road Stop)

Tel.: 2475 4114

人事登記

處 – 觀塘辦事處

地址：

觀塘偉業街 223 至 231 號

宏利金融中心 2 樓 3 號舖位

(港鐵觀塘站 B1 出口)

電話：2755 9545

egistration of Persons – Kwun Tong Office

Address:

Office 3, 2/F, Manulife Financial Centre,

223-231 Wai Yip Street, Kwun Tong

(MTR Kwun Tong Station – Exit B1)

Tel.: 2755 9545

有關收集個人資料的目的

收集資料的目的

1. 你在是項申請所提供的個人資料，香港特別行政區政府入境事務處會用

作下列一項或多項的用途：─

(a) 根據《人事登記條例》(第 177 章) 及其附屬規例，辦理你的申請；

(b) 根據《人事登記條例》(第 177 章) 及其附屬規例，行使權力和執

行職務，包括按政務司司長根據《人事登記條例》第 11 條所作的

書面批准披露資料；

331章) 的有關條文規定，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；

(d)

供政府決策局、部門或機構作統計及研究用途，但所得的統計數

字或研究成果不會以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

(e)

供作法例規定、授權或准許的其他合法用途。

根據《人事登記規例》(第 177A 章)，登記人士必須提供其個人資料。若你無合理

辯解而沒有遵從有關法例規定，即會觸犯法例。此外，如果你未能提供充分個人

資料，本處亦無法辦理你的申請。

資料轉交的類別

2. 為了上文第 1 段所述的目的，你在本表格內所提供的個人資料或會向其

他政府決策局、部門或機構披露。

查閱個人資料

3. 根據《個人資料 (私隱) 條例》(第 486 章) 第 18 及 22 條以及附表 1 第

6 項原則，你有權查閱及改正你的個人資料。你的查閱權利包括在繳交有關費用

後，索取你在本表格內所提供的個人資料的副本。

4. 如就本表格所收集的個人資料有任何查詢，包括查閱或改正有關資料，

可向下列人員提出：─

香港灣仔

告士打道 7 號

入境事務大樓 12 樓

行政主任 (人事登記) 支援

電話：2829 3429

查詢

如有任何查詢，請瀏覽入境事務處網頁：www.immd.gov.hk。你亦可致電

查詢熱線 (2824 6111)，或以圖文傳真 (2877 7711) 或電郵 (enquiry@immd.gov.hk)

，向入境事務處查詢及聯絡組提出。

Stat ement of Purpose

Purpose of Collection

1. The personal data furnished in the application will be used by Immigration

Department, the Government of the HKSAR for one or more of the following purposes:—

(a) to process your application under the Registration of Persons Ordinance

(Chapter 177) and its subsidiary Regulations;

(b) to exercise the powers and carry out the duties under the Registration of

Persons Ordinance (Chapter 177) and its subsidiary Regulations including

disclosure of information as permitted in writing by the Chief Secretary for

Administration by virtue of section 11 of the Registration of Persons

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;

(d)

(e) for any other legitimate purposes as may be required, authorised or permitted

by law.

The provision

of personal data is obligatory for registration under the Registration of

Persons Regulations (Chapter 177A). Any person who without reasonable excuse, fails to

comply with the statutory requirement shall be guilty of offences under the Ordinance. In

addition, if you do not provide sufcient information, we would not be able to process your

application.

Classes of Transferees

2. The personal data you provide may be disclosed to government bureaux,

departments and other organisations for the purposes mentioned in paragraph 1 above.

Access to Personal Data

3. 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 to the Personal Data

(Privacy) Ordinance (Chapter 486). Your right of access includes the right to obtain a copy

of your personal data provided in this form subject to payment of a fee.

4. Enquiries concerning the personal data collected by means of this form, including

making of access and corrections, should be addressed to:—

Executive Ofcer (Registration of Persons) Support

12/F Immigration Tower,

7 Gloucester Road,

Wan Chai, Hong Kong

Tel.: 2829 3429

Enquiries

5. If you have any enquiry, please refer to the Immigration Department website:

www.immd.gov.hk. You may also call our enquiry hotline at 2824 6111, or send your questions

to our Information and Liaison Section by fax at 2877 7711 or e-mail at enquiry@immd.gov.hk.

to enable government bureaux, departments or other organisations to

compile statistics for 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

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