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Immigration Department
The Government of the Hong Kong
Special Administrative Region



-
177
10
Request for a certified copy of document
- Section 10 of the Registration of Persons Ordinance, Chapter 177, Laws of Hong Kong

(1)
Note: This form may be completed in English or Chinese.
(2) 177A 2 177 10


Under Schedule 2 to the Registration of Persons Regulations, Chapter 177A, Laws of Hong Kong, a fee of HK$425 is
payable for a certified copy of document furnished under section 10 of the Registration of Persons Ordinance, Chapter 177,
Laws of Hong Kong.
(3)
Please read the statement of purpose overleaf before completing this application form.
(4) 486 () 18 ()
OPS003
A data access request for personal data may be made under section 18 of the Personal Data (Privacy) Ordinance, Chapter
486, Laws of Hong Kong, in the specified form Personal Data (Privacy) Ordinance Data Access Request Form No.
OPS003; and non-certified copy of records may be supplied and a fee may be collected in accordance with the Ordinance.
(5)
This form is to be signed by the applicant, or where the applicant is under the age of 18, the applicants parent or legal
guardian.
:
To : Commissioner of Registration

:
Request for a certified copy of document in respect of the following person:

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

HK I/C No. Date of birth Sex ______________________

Residential address _____________________________________________________________________________________________

Correspondence address _______________________________________________ Contact telephone no. _____________________

Hereby request for a certified copy of the following document(s) : _________________________________________________________

Reason for request : _____________________________________________________________________________________________

*/
*Name of applicant/parent or legal guardian Signature Date

FOR OFFICIAL USE ONLY

*


Section A Issue of a certified copy of the document(s) specified above is * approved / refused / taken no further action.



Fee(s) to be charged Application reference



Name, signature and post of processing officer Date


Section B Amount $ Receipt no.



Name, signature and post of shroff Date
* *delete where inappropriate

SF/ROP/164 (2/2015)
 Submission of Completed Forms
(a) In Person To: Any one of the Registration of Persons office

Registrattion of Persoons Hoong Koong Offfice Im
mmigrattion annd Registrattion of Persoons Fo Tan Offfice

Address: Address:
7 2 18 8/F, Immigration Tower Shops 405 & 406
8 4 7 Gloucester Road, Wan Chai 4/F, Jubilee Square
( A5 ) 405 406 (MTR Wan Chai Station Exit A5) 2-18 Lok King Street, Fo Tan
( C ) (MTR Fo Tan Station Exit C)
2824 6111 Telephone: 2824 6111
2653 3116 Telephone: 2653 3116

Registrattion of Persoons Kowlooon Offfice Im
mmigrattion annd Registrattion of Persoons Yuen Loong Offfice

Address: Address:
303 23 3/F, Cheung Sha Wan Government Offices Shop B, G/F, Manhattan Plaza
3 B 303 Cheung Sha Wan Road, Sham Shui Po 23 Sai Ching Street, Yuen Long (Tai Tong Road Light Rail Station)
( C1 ) () (MTR Sham Shui Po Station Exit C1)
Telephone: 2475 4114
2150 7933
2475 4114 Telephone: 2150 7933

Registrattion of Persoons Kwun Toong Offfice

Address:
223 231 Office 3, 2/F, Manulife Financial Centre,
2 3 223-231 Wai Yip Street, Kwun Tong
( B1 ) (MTR Kwun Tong Station Exit B1)

2755 9545 Telephone: 2755 9545

(b)

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

St a t e me n t o f P ur p o s e
Purpose of Collection
1. 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
(a) ( 177 ) (Chapter 177) and its subsidiary Regulations;
(b) ( 3 ) (b) to enable the Registrar of the High Court to compile a provisional list of

jurors under the Jury Ordinance (Chapter 3);
(c)

(c) to enable the Registration and Electoral Office to revise the electoral register;
(d) to exercise the powers and carry out the duties under the Registration of
(d) ( 177 ) Persons Ordinance (Chapter 177) and its subsidiary Regulations including
11 disclosure of information as permitted in writing by the Chief Secretary for
Administration by virtue of section 11 of the Registration of Persons
Ordinance;
(e) ( 115 ) (
(e) to administer/enforce relevant provisions of the Immigration Ordinance
331 ) (Chapter 115) and Immigration Service Ordinance (Chapter 331), and to
assist in the enforcement of any other Ordinances and Regulations by other
(f) government bureaux and departments through carrying out immigration

control duties;
(f) to serve statistical and research purposes on the condition that the resulting
(g) 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
( 177A ) (g) 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 sufficient information, we would not be able to process your
2. 1 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.
3. () ( 486 ) 18 22 1
6
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
4. (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 Officer (Registration of Persons) Support
12/F Immigration Tower,
()
7 Gloucester Road,
2829 3429 Wanchai, Hong Kong
Tel: 2829 3429

Enquiries
5. www.immd.gov.hk
5. If you have any enquiry, please refer to the Immigration Department website:
(2824 6111) (2877 7711) (enquiry@immd.gov.hk) 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.