Id (E) 981
Id (E) 981
Surname in English
Place of birth
Sex Male Female Date of birth
dd mm yyyy
Travel documents held (i.e. Passport, Re-entry Permit, Certificate of Identity, Affidavit, PRC Travel Permit, Exit-entry Permit for Travelling to and from Hong Kong and Macao, etc.)
Place of issue
Type Number
Country/territory of domicile Have you acquired permanent residence in your country/territory of domicile? Yes No
The information given on this page is correct, complete and true.
Spouse
Children
Not applicable
Not applicable
Not applicable
Not applicable
Brothers and
Sisters
Not applicable
Not applicable
Not applicable
Not applicable
3.2 Are you capable of supporting and accommodating yourself and your accompanying dependent family members as indicated
in section 2 of this form, (if any), on your own financial resources without relying on public assistance during your stay in
Hong Kong?
If yes, please list details of personal net worth below to support your statement in section 3.2 above.
3.21 Assets
Description
Amount (HK$)
(e.g. Bank deposits/Real Estate/Securities/Name of a privately-owned enterprise)
0
Subtotal in HK$ (A)
3.22 Liabilities
Description
Amount (HK$)
(e.g. Mortgage, Personal loan)
0
Subtotal in HK$ (B)
0
3.23 Personal Net Worth (C) = (A)-(B)
3.3 Have you ever been convicted of any crimes or offences either in Hong Kong or elsewhere?
□ YES □ NO
If yes, please state details in chronological order:
3.31 Have you ever been refused entry to, deported from, removed from or required to leave Hong Kong or elsewhere?
□ YES □ NO
If yes, please state in details in chronological order:
3.32 Have you ever been refused a visa/entry permit for entry to Hong Kong or elsewhere?
□ YES □ NO
If yes, please state in details in chronological order:
3.33 Have you ever breached any immigration law in Hong Kong or elsewhere?
□ YES □ NO
If yes, please state in details in chronological order:
3.34 Have you ever applied for a visa/entry permit for entry to Hong Kong or entered Hong Kong using a name or identity
which is different from that stated on the travel document, and/or People’s Republic of China resident identity card,
currently held by you as mentioned in section 1 of this application form?
□ YES □ NO
If yes, please state in details in chronological order:
3.4 Are you proficient in written and spoken Chinese (Putonghua or Cantonese) or English?
3.5 Do you have a minimum of graduate level education or a good technical qualification?
Please indicate below your points claimed under the General Points Test.
5.1 Age (Max. 30 points)
POINTS CLAIMED
18-39 30 40-44 20 45-50 15 51 or above 0 A
K=(A+B+C+D+E+F+G+H+I+J) 0
6.1 Please summarise below in not more than 500 words your achievement in order to claim a maximum point under the
Achievement-based Points Test. Do not write on any separate sheet.
6.2 Proofs of my achievement are (you may tick more than one):
□ Published work □ Press article □ Scholarship/Research award certificate □ International award/honour certificate
□ Intellectual property rights (*Patent/Copyright/Trademark/Others______________________) □ Reference from industrial peers
□ Others (please specify) _______________________________________________
Information provided below is for statistical purpose only.
6.3 Is your accompanying married spouse educated to the equivalent level of a degree or above?
□ YES □ NO □ N/A
225
225
POINTS CLAIMED
The information given on this page is correct, complete and true.
List all academic attainments, professional qualifications and memberships in chronological order. Continue on a separate
sheet in the same format if necessary.
Please tick if it
has met the
Awarding Institution City/Province/Country specifications of
Degree/Qualification
(Full time/Part time/Distance (Period of Study(Fr./To)/
(Major)
Learning) Year Obtained)
the respective
profession under the
Talent List
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8. Work Experience (Please refer to ‘Guidance Notes’ Paragraph 92)
8.1 List full-time graduate/specialist level work experiences in chronological order. Continue on a separate sheet in the same format if necessary.
Period Please tick if it
(Fr/To) has met the
Name and City/Province/Country
Position specifications of
of Employer Nature of Duties
(Occupational Level) Duration the respective
(Employer Nature)
(Yrs.) profession under
the Talent List
/
□
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/
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/
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/
..
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/
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/
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/
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( ) ( )
8.2 Total number of years of full-time graduate/specialist level work experience
Please summarise below in not more than 500 words your key career or academic accomplishments, your future plans in
Hong Kong and other information which you think we should take into consideration when assessing your application. Do
not write on any separate sheet.
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(b) I consent to releasing my information to any organisations and authorities, including those inside or outside the Hong Kong Special
Administrative Region (HKSAR), for the processing of this application.
(c) I authorise all private and public 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.
(d) I consent to the use/disclosure of any information herein by/to any government bureaux, departments (including the Inland Revenue
Department) and any other private or public organisations inside or outside the HKSAR (including the Mandatory Provident Fund Schemes
Authority) for verification purposes.
(e) I understand that the Director of Immigration has absolute discretion to award points under the two points-based tests to applicants as the
Director thinks fit and to approve or refuse any application without giving any reason. The Quality Migrant Admission Scheme (‘the
Scheme’) or details of the Scheme may also be subject to change as the Director thinks fit without prior notice.
(f) I understand that any person who knowingly and wilfully makes a statement or gives information which he/she knows to be false or does not
believe to be true under or for the purpose of the Scheme shall be guilty of an offence under the Laws of Hong Kong and is liable to
prosecution and subsequent removal from Hong Kong. His/her application may be refused, and that any visa/entry permit/extension of stay
so granted or issued to him/her and his/her dependants and any conditions of stay so imposed on him/her and his/her dependants may
become null and void.
(g) I declare that, to the best of my knowledge, my personal net worth is not less than the amount stated in section 3.23 of this application form.
(h) I declare that should this application be successful, I will apply for an Exit-entry Permit for Travelling to and from Hong Kong and Macao
(EEP) and the relevant exit permission from the relevant Mainland authorities for travelling to Hong Kong to take up residence. I
understand that an entry permit granted to me under the Scheme is to be affixed onto an EEP with the relevant exit permission prior to my
arrival in Hong Kong. In case my EEP bearing the relevant exit permission is an electronic EEP, I should present it together with the entry
permit granted to me under the Scheme for immigration arrival clearance. Should I enter Hong Kong on other travel document for the
purpose of admission under the Scheme, I will be refused entry to Hong Kong. (Note2)
(i) I declare that information given in this application form is correct, complete and true to the best of my knowledge and belief.
Note2: (h) Applicable to residents in the Mainland of China including those who are currently residing in Hong Kong or Macao on a temporary basis.
Purpose of Collection
The personal data provided in the application form will be used by the Immigration Department for one or more of the following purposes:
2. 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. to process other person’s application for immigration facilities in which you are named as a sponsor or referee;
4. for statistics 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
The provision of personal data by means of this application form is voluntary. If you do not provide sufficient information, we may not be able to process
your application or to conduct the record search or positively identify the record.
Classes of Transferees
The personal data you provide may be disclosed to other government bureaux, departments and other organisations for the purposes mentioned above.
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.
Enquiries concerning the personal data collected by means of the application form, including making of access and corrections, should be addressed to:
General Enquiries