Village Representative Election - Resident Representative Application for New Voter Registration

IMPORTANT: Please read the accompanying guidance notes before completing this form in BLOCK LETTERS. A person who makes any

statement which the person knows to be false in a material particular or recklessly makes any statement which is incorrect in a material particular or knowingly omits any material particular commits an offence under the law.

The Home Affairs Department (HAD) / Electoral Registration Officer (ERO) will conduct random checking from time to time to verify the eligibility of an applicant / a registered elector, requesting him / her to provide documentary evidence to prove that the 3-year residence requirement is met. [Note 7(c)]

1. HK IDENTITY CARD NUMBER Prefix Number Check Digit ( )

2. SEX Male Female

3. INFORMATION AS SHOWN ON THE HK IDENTITY CARD

Name in Chinese

in Chinese Commercial Code

Surname

Other Names in Full

Date of Birth (dd / mm / yyyy)

4. PRINCIPAL RESIDENTIAL ADDRESS (Notes 7 and 11).Please complete in ENGLISH Block Letters.

Flat / Room Floor Block Name of Estate /

Building

House No. Name of Village

Number & Name of Street / Lot Number & Demarcation District

District

Home Telephone Number

Mobile Phone Number Fax Number

E-mail Address

□ If you agree to provide the above e-mail address to the candidates of the Village concerned for the purpose of sending election advertisement,please put a tick “” in this box. Otherwise, the e-mail address will only be used by the Home Affairs Department / Electoral Registration Officer forcommunication. The candidates may choose to send election advertisement via e-mail in lieu of hardcopy.

5. LANGUAGE PREFERENCE FOR ELECTION-RELATED COMMUNICATION (Note 8)

Please tick as appropriate: □ Chinese □ English

6. DECLARATION

I declare that the particulars entered in this form are true and accurate, and that

(a) The principal residential address entered above is my sole or main home; and

(b) I have been a resident of (Village) of (Rural Committee)

since Day Month Year (Date since then residing in the Village) and for the 3 years immediately

before this application and I am eligible to be registered as an elector for an Existing Village (Notes 5 and 7); and

(c) I am not subject to any disqualification from registration (Note 6).

My consent and authorisation is hereby given to the Home Affairs Department (HAD) / Electoral Registration Officer (ERO), in assessing my eligibility for registration as an elector, to compare and cross check my personal data entered in this application form with my personal data collected by other organisations for any other purposes (whether or not it is collected by manual means) so as to verify if such data are true and accurate. I understand that if the personal data provided by me are false or misleading, the HAD / ERO may take appropriate action against me (including referral of the case to other law enforcement agencies for follow up action). I expressly agree that the HAD / ERO may approach other relevant government departments or public / private organisations for proof of data collected and matching of data. I hereby consent and authorise the relevant government departments (including but not limited to the Registration and Electoral Office, the Housing Department, the Correctional Services Department, the Land Registry, the Immigration Department, the Transport Department, the Inland Revenue Department, and the Companies Registry) or any other public / private organisations (including but not limited to the Hong Kong Housing Society), to release my personal data to the HAD / ERO, so that the HAD / ERO can compare and cross check such data with those on this application form when processing this application and updating the voter registration and election-related records annually. (Note 9)

Date : Day Month Year

Signature :

R E F - 2 a ( E n g l i s h Ve r s i o n ) ( 2 0 1 8 ) P l e a s e Tu r n O ve r

ReR

Attention: "Resident" means a person whose principal residential address is in the Village. [Note 5(b)]

Application Reference No

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CORRESPONDENCE ADDRESS (Only if there is no postal service available for your principal residential address or if you are a prisoner) (Note 11)

FOR OFFICIAL USE ONLY

Work Code (HQ)

FOLD HERE

Please ensure that you have completed the items below before submitting the application form:

Fill in the HK Identity Card Number clearly

Fill in your only or principal residential address in the field of “PRINCIPAL RESIDENTIAL ADDRESS”

Sign the application form

Note : You may return this application form by post or by FAX to 2591 6392.

FOLD HERE

Electoral Registration Officer Home Affairs Department 30/F, Southorn Centre 130 Hennessy Road Wan Chai, Hong Kong

FOLD HERE

S E A L W IT H G LU E . D O N OT U S E S TA P LE S

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如在本港投寄 毋須貼上郵票 NO POSTAGE

STAMP NECESSARY IF

POSTED IN HONG KONG

郵費由持 牌人支付

POSTAGE WILL BE PAID BY

LICENSEE

BUSINESS REPLY SERVICE LICENCE NO. 商業回郵牌號﹕7410

香港灣仔

軒尼詩道一三Ｏ號

修頓中心三十樓

民政事務總署

選舉登記主任收

WCH.E27

Village Representative Election - Resident Representative Application for New Voter Registration

Guidance Notes (Please keep this Guidance Notes for reference)

For enquir ies on permanent res ident status, p lease cal l the Immigrat ion Department hot l ine: 2824 6111 or wr i te to the Immigrat ion Department (Address: Immigrat ion Tower, 7 Gloucester Road, Wan Chai , Hong Kong).

(6) General ly speak ing, persons who are d isqual i f ied f rom regis trat ion inc lude persons who:(a) are found under the Mental Health Ordinance (Cap. 136) to be incapable, by reason of

mental incapac ity, of managing and adminis ter ing their proper ty and affa irs; or

(1) This form is used for applying for new regis trat ion as an e lector of Res ident Representat iveElect ion for an Ex is t ing Vi l lage. I f you are a registered e lector and you wish to change theregis tered par t iculars , you must complete the appl icat ion form “Vi l lage Representat iveElect ion – Res ident Representat ive: Appl icat ion for Change of Registered Par t icu lars”(REF-2b) ins tead of th is appl icat ion form.

(2) For inc lus ion in the f ina l regis ter of e lec tors to be publ ished in October every year, thestatutory deadl ine for e l ig ible persons to apply for new voter registrat ion is 16 July of thesame year .

(3) You may check your la tes t regist rat ion part icu lars through the Rural Representat ive Elec t ionWebsite (www.had.gov.hk/rre) or by cal l ing the Rural Representat ive Elect ion Hotl ine (21521521). Elec tors have the respons ib i l i t y to update their registrat ion par t icu lars with the HomeAffa irs Department (HAD) / Electoral Regis t rat ion Off icer (ERO) as soon as poss ib le i f thepar t icu lars (e.g. pr incipal res ident ia l address) have changed.

(4) The above deadl ine refers to the date on wh ich an appl icat ion form reaches the HAD / ERO.Appl icat ions which reach the HAD / ERO after the above deadl ine wi l l be processed for thepurpose of compi l ing the register of e lectors for the fo l lowing year. Please submit th isappl icat ion form to the HAD / ERO by the fo l lowing means:(a) by post (Address: Home Affa irs Department , 30/F, Southorn Centre, 130 Hennessy Road,

Wan Chai , Hong Kong (or to any Dis tr ic t Off ices of the HAD)) ; or(b) by fax (No. : 2591 6392); or(c) in person or by a representat ive to the HAD Headquarters or Home Affairs Enquiry

Centres of any Distr ic t Off ices of the HAD; or(d) by emai l (email address: r re@had.gov.hk), wi th the s igned appl icat ion form scanned and

attached as an emai l a t tachment; or(e) by us ing the e lect ronic form and uploading the completed and s igned form to the HAD

(webs ite: www.had.gov.hk/rre).

(5) General ly speak ing, you are e l ig ib le to be regis tered as an e lector for an Ex ist ing Vi l lage i f :(a) you are a res ident of that Vi l lage; and(b) you have been a res ident of that Vi l lage for the 3 years immediate ly preceding the date of

your appl icat ion to be regis tered as an elec tor ( “ res ident” means a person whose pr inc ipalres ident ia l address is in the Vi l lage and “principal resident ial address” means theaddress of the dwell ing place at which the person resides and which const itutes theperson’s sole or main home) . In the case of a pr isoner, for the purpose of th is res idencerequirement , a term of impr isonment does not normally break the per iod of res idenceprovided the person has res ided in that Vi l lage immediate ly before serv ing the sentenceand has been mainta in ing his pr inc ipal resident ia l address in that Vi l lage throughout theper iod of impr isonment; and

(c) you have reached 18 years of age or wi l l reach 18 years of age on or before the nextcoming 20 October fo l lowing your appl icat ion for registrat ion; and

(d) you are a permanent res ident of the Hong Kong Spec ial Adminis trat ive Region as def inedby the Hong Kong Special Adminis trat ive Region Passpor ts Ordinance (Cap. 539); and

(e) you hold a val id ident i ty document, e.g. a Hong Kong permanent ident i t y card; and(f ) you are not subjec t to any d isqual i f icat ion f rom regis trat ion (Note 6).

(b) are members of the armed forces of the People ’s Republic of China or any other country or terr i tory.

(7) (a) You wi l l be regis tered in the Ex ist ing Vi l lage to which you belong according to your pr inc ipal res ident ia l address which const i tutes your sole or main home.

(b) Please not i f y the HAD / ERO immediate ly by complet ing the appl icat ion form “Vi l lage Representat ive Elec t ion – Res ident Representat ive: Appl icat ion for Change of Registered Part icu lars” (REF-2b) and attaching the re levant address proof required for any subsequent change of your pr inc ipal res ident ia l address (regardless of whether the pr inc ipal resident ial address is s t i l l in the Ex ist ing Vi l lage as registered) . For deta i ls , p lease refer to the aforesaid form (REF-2b) .

(c) To ensure the accuracy of the register, the HAD / ERO wi l l conduct random check ing f rom t ime to t ime to ver i f y the e l ig ib i l i t y of an appl icant / a regis tered e lector, request ing h im / her to provide documentary evidence to prove that the 3-year residence requirement is met.

(d) In compi l ing a provis ional regis ter for an Exist ing Vi l lage, the HAD / ERO shal l s tr ike out the names and other re levant par t icu lars of the persons whom the HAD / ERO is sat is f ied on reasonable grounds as being no longer el ig ib le to have their names included in the f ina l regis ter for the Vi l lage. Such names and other re levant par t icu lars of those persons wi l l be entered on an omissions l is t .

(e) If a registered elector of the Resident Representative Elect ion no longer resides in the Vil lage for which he / she is registered, or his / her resident ial address in the Vil lage is no longer his / her sole or main home, he / she is no longer eligible to remain registered as an elector. Even though his / her name is sti l l on the f inal register, the person concerned will commit an offence if he / she votes at the election. Vot ing right in an election is restr icted to el igible elector having cont inued residence within the same registered Vil lage. I f the person has moved to another Exist ing Vil lage, he / she has to meet the 3-year residence requirement and apply for change of principal residential address and should submit address proof to conf irm that he / she has been a resident of that Existing Vil lage for at least 3 years immediately before making the application. As the qual if ications for registrat ion as an elector and the voting right for the Exist ing Vil lages (Resident Representative elections) and Indigenous Vi l lages / Composite Indigenous Vil lages ( Indigenous Inhabitant Representat ive elect ions) are different, even if the registered elector of an Existing Vil lage is an indigenous inhabitant or a spouse / surviving spouse of an indigenous inhabitant , he / she should also comply with the residence requirement upon change of principal resident ial address.

(8) Under normal c ircumstances, e lec t ion-re lated communicat ions issued to e lectors by the HAD /

ERO are both Chinese and Engl ish. This language preference is to fac i l i ta te candidates ’ communicat ion wi th you at e lec t ions in the language of your choice. I f you do not complete th is par t , i t wi l l be assumed that your preferred language is Chinese.

(9) In assess ing your e l ig ibi l i t y for regist rat ion as an e lec tor, the HAD / ERO wi l l compare and

cross check your personal data entered in the appl icat ion form with your personal data col lec ted by other organisat ions for any other purposes (whether or not i t is co l lec ted by manual means) so as to ver i fy i f those data are true and accurate. I f your personal data provided are fa lse or mis leading, the HAD / ERO may take appropr iate ac t ion against you ( including referra l of the case to other law enforcement agencies for fol low up act ion). Upon s igning the appl icat ion form, you express ly agree the HAD / ERO to approach other re levant government depar tments or publ ic / pr ivate organisat ions for proof of data col lec ted and matching of data, and you hereby consent and author ise the re levant government departments ( inc luding but not l im ited to the Regis trat ion and Elec tora l Off ice, the Hous ing Depar tment, the Correct ional Services Department, the Land Regis try, the Immigrat ion Depar tment , the Transpor t Depar tment , the In land Revenue Depar tment, and the Companies Regis try) or any other publ ic / pr ivate organisat ions ( inc luding but not l im ited to the Hong Kong Housing Society) , to re lease your personal data to the HAD / ERO, so that the HAD / ERO can compare and cross check such data wi th those on the appl icat ion form when process ing th is appl icat ion and updat ing the voter registrat ion and e lect ion-re lated records annual ly.

(10)This appl icat ion form must be s igned by the appl icant ; o therwise, the HAD / ERO wi l l not

process your appl icat ion.

(11) (a) Please provide a cor respondence address only i f there is no posta l serv ice avai lab le for your pr inc ipal resident ial address or i f you are a pr isoner. Please do not f i l l in th is par t i f you do not meet e ither of the above two cr i ter ia.

(b) I f you are a pr isoner, you may choose to provide the address of the correct ional ins t i tut ion where you are impr isoned or other address as your correspondence address. I f you choose to use the address of a correc t ional inst i tu t ion as your cor respondence address, p lease provide the pr isoner number for easy del ivery of the e lec t ion-related mater ia ls wi thin / among the cor rect ional ins t i tut ions.

(c) Please note that the principal residential address and correspondence address ( if provided) wil l be provided to candidates for the purpose of sending election-related materials to the electors concerned.

(12)In addit ion to sending wr i t ten regis t rat ion not ices after complet ion of processing the

appl icat ion for voter registrat ion, the HAD / ERO wi l l not i f y e lec tors by shor t message serv ice ( i f the e lec tors have provided such information) that their appl icat ions for voter regis trat ion have been completed.

(13)These notes are for general guidance only. Appl icants should a lso refer to the Rural

Representat ive Elec t ion Ordinance (Cap. 576) , the Electora l Affa irs Commission Ordinance (Cap. 541), the Elec t ions (Corrupt & I l legal Conduct) Ordinance (Cap. 554) and the subs id iary legis lat ions made thereunder.

(14)For enquir ies on voter regis trat ion, please cal l 2152 1521 or wr i te to the HAD / ERO (Address:

30/F, Southorn Centre, 130 Hennessy Road, Wan Chai , Hong Kong) .

Personal Information Collection Statement Purpose of Col lec t ion

The personal data and other re lated informat ion provided by you by means of th is form (REF-2a) wi l l be used by the HAD / ERO for voter regis trat ion and e lec t ion-re lated purposes. The provis ion of personal data and other re lated information by means of th is form is vo luntary. However, i f you do not provide adequate and accurate data, the HAD / ERO may not be able to process your appl icat ion for registrat ion as an e lector. I f the ERO has determined that you are e l ig ib le to be regis tered as an e lector, your name and pr incipal resident ia l address provided in th is form wi l l be compi led in a regis ter and made avai lable for publ ic inspect ion.

I f necessary, the HAD / ERO may require a publ ic author i ty to furn ish your personal data for data matching when prepar ing a regis ter. Any person who uses the personal data provided in th is form wi thout the express consent of the data subjec t for any purpose other than the purposes s tated above may contravene the Personal Data (Pr ivacy) Ordinance (Cap. 486). Transfer of Informat ion The HAD / ERO may provide the information suppl ied by you to other author ised departments / organisat ions / persons for the purposes of voter regist rat ion, e lect ion and a l l purposes re lated thereto under the re levant Ordinances and / or subsid iary legis lat ions. Access to Personal Data and Enquiry You have a r ight to request access to, and to request the correc t ion of , the personal data and other re lated informat ion you suppl ied in accordance wi th the provis ions of the Personal Data (Pr ivacy) Ordinance (Cap. 486) . Such requests and enquir ies should be made in wr i t ing to the Electoral Registrat ion Off icer at 30/F, Southorn Centre, 130 Hennessy Road, Wan Chai , Hong Kong.