個人八達通申請表PersonalisedOctopusApplicationForm.PDFVIP

lIA/1.$lItI fli¥im. PERSONALISED OCTOPUS APPLICATION FORM OCTOPUS )i1E: 1..m.~..~.~~...tt ••• • 2. 1IiII.A.Jl• .i.I;;ttl!l~HK$1 00 1i!li!iHK$50nc~ , HK$30..tj:.HIIIIHK$20fiiJ~li~.tt 0 MWj.A.~(lj]1I.A.Jl• .i.I )\iliiTliIIIW;;] li.jftli!~,*,lIlIlllHK$l 0 ( liIi*2};;]~iI);\!~~~IIi) 1t~UM.A.Jli1ifi..tt 0 3. lia3l;illI••mIl1lill.A.Jli1Dli.A.z!±l!tBJIIj1I.A.Jli1J.1..1::d~Aft!!.ffi ( 141M )lIllliMi11!llJf 0 4.••JIt •••1II tII •••IIISi\UaT••( aT••• 11I.A./IJIIIIII•••( ••••• I· - •••tt ••• lI.iftfoij ••lf1IiI .lJzaT••• •••iIII!lUUIJIII • gTU~Jt*iiJji;]AlIilTlilll2};;] -i1lll:aliMAlIilTlilll2};;]IiI!i (.hk)ell 0 OIUlliJ9iJMJIt0Il!1J 0 .e•••a.3l ••jlll ••••fj}.I!jjJtfl~ ••J1 • 5. MIlHI!lI!ltilft!!.A.Rtiillll*li 0I~1I.A.Jli1J.1 ~JII{EIt••..I::1Alii:ltilR@.A.zAE~ A.!!-ffiO!!IIJlJt1F!Illil tt-m!±l;r, OI.A.z.!!-ffiO!!1IJl Jt1F (HPflilO.!!-ffiil/,*,IiI.!!-ffiil/llll.!!-19i1/lil!il/fIilO~lIl(lj]ilOiI) ~~EPiiil* tJ..~ti 0 {E@1Ill1lill.A.Jlif* It.Rtii.A.~JII!±l;r,AfIilO .ffim;,*,IiI.ffim;1l1l.ffim;U/.ilO~l!I(lj]ilOmtJ.1IU.ti 0 6. MIln~18i1tJ.e~iIII.A.Jl• .i.I.A.zQjij/!!l.A.;IH-eA, ../tiillll*li~1I.A.Jl.J.I Ile~~II!±l;r, ...A.z1!iilO.!!-190!1/,*,1I.!!-190!1/ 1l1l.!!-ffim;fIilO!±l!t0!l1lJl./~/fIilO~~(lj]ilO~EPW*lleZ.!!-ffiO!l(lj]ilOO!I,,~,tJ..~ti° Note: 1. Please use black or blue pen to complete this application fonn in BLOCK LETTERS. 2. The application fee for a Personalised Octopus is HK$100 which includes a deposit of HK$50, an initial stored value of HK$30 and a non-refundable handling fee of HK$20. Octopus Cards Umited is entitled to deduct HK$10 (or such other reasonable amount as we may determine from time to time) as the refund handling f