招致选举开支的人的授权书.doc

PAGE REO/C/3(FC)/2004LC(SF)(T) - PAGE 7 - 招致選舉開支的人的授權通知書 NOTICE OF AUTHORIZATION OF PERSON TO INCUR ELECTION EXPENSES 《選舉（舞弊及非法行為）條例》第23及24條及 《選舉管理委員會（選舉程序）（立法會）規例》第25條 Sections 23 and 24 of the Elections (Corrupt and Illegal Conduct) Ordinance and Section 25 of the Electoral Affairs Commission (Electoral Procedure) (Legislative Council) Regulation ﹝備註：在填寫此通知書前，請參閱夾附的《授權招致選舉開支的說明》。﹞ [Note: Before completing this notice, please read the attached Notes on Authorization of Person to Incur Election Expenses.] 立法會選舉 LEGISLATIVE COUNCIL ELECTION ﹝功能界別名稱﹞ (Name of Functional Constituency) 選舉日期：2004年9月12日 Date of Election: 1 第一部份 授權（由候選人填寫） PART I AUTHORIZATION (to be completed by candidate) 1. 本人是上述選舉的候選人，現授權下述人士為本人的選舉開支代理人，以在上述選舉或與上述選舉有關連的情況下招致選舉開支：－ I, the candidate for the above-named election, hereby authorize the following person to incur election expenses on my behalf at and in connection with the above election:- 中文姓名（正楷）： Name in Chinese 英文姓名（正楷）： Name in English (in BLOCK LETTERS): (姓Surname) (名Other name) ＊香港身份證／護照號碼： Hong Kong Identity Card/Passport Number 聯絡電話： Contact Telephone Number 住址： Residential Address 2. 本人現授權上述人士代表本人招致選舉開支，最高限額為HK$ 。該指定限額包括各項應計算入選舉開支的實物抵付形式的捐贈（以合理價值估計）。（請參閱說明第6項） I hereby authorize the above-named person to incur on my behalf election expenses up to a maximum amount of HK$ . This specified amount includes all expenses covered by donations in kind (assessed at a fair and reasonable value) which must be accounted for (see Note 6). ＊3. 本授權取代在 （日期）給予上述人士的授權，該原有授權的最高限額為HK$ 。 This authorization supersedes the previous authorization dated__________________ (date) to the above-named person in respect of a maximum amount of HK$__________________. 4. 本人清楚明白，本人要為本人之選舉開支全部款項負責。倘本人及本人之代表招致的選舉開支總額超逾規定上限，除非本人能證明任何超額開支是在並非因本人疏忽，以及在未經本人的同意或授權的情況下所招致的，否則本人要負觸法之責。 I understand that I shall be responsible for the overall amount of my election