发还选举按金.doc

REO/C/15 (2002 EC By-e) - PAGE 4 - 發還選舉按金 RETURN OF ELECTION DEPOSIT 選舉委員會界別分組補選 Election Committee Subsector By-elections _________________________ [界別分組/小組名稱] [Name of Subsector/Sub-subsector] 補選日期：2002年1月6日 Date of By-elections: 6 January 2002 第一部份 （由候選人填寫及簽署） PART I (This part must be completed and signed by the candidate) 發還按金指示 INSTRUCTION ON RELEASE OF DEPOSIT 致： 選舉主任 To: Returning Officer 1. 本人現要求退還本人就上述補選提名為候選人而繳交之選舉按金，請以支票（抬頭寫*本人／下述代候選人繳存按金人士的姓名）郵寄至下述地址：─ I hereby request refund of the election deposit made by me in connection with the nomination of myself as a candidate for the above by-election to be made by cheque (payable to *me/the following person lodging the deposit on behalf of the candidate) sent through the post to the following address:- ＊候選人／代候選人繳存按金人士的姓名（如適用）： Name of *candidate/person lodging the deposit on behalf of candidate (if applicable) 地址： Address 2. 現交回繳交選舉按金收據的正本。 The original receipt of the election deposit is returned herewith. 簽署： Signature 候選人姓名： Name of Candidate 身分証號碼： Hong Kong Identity Card No. 日期： Date 第二部份 （由選舉主任填寫） PART II (to be completed by Returning Officer) 收款証明 CERTIFICATION OF RECEIPT 致： 庫務署署長 To: Director of Accounting Services 3. 本人証明就下列候選人繳存之按金經已收訖：─ I certify that the election deposit in respect of the following candidate has been received :- 候選人姓名 ： Name of Candidate 身分証號碼 ： Hong Kong Identity Card No. 所收按金總額 ： 港幣 HK$1,000 Amount of deposit received 雜項收據編號 ： Miscellaneous Receipt Number 按金收訖日期 ： Date of receipt of deposit 簽署 ： Signature 選舉主任姓名 ： Name of Returning Officer 日期 ： Date ? 第三部份 （由選舉主任填寫） PART III (to be completed by Returning Officer) 發還按金簽署 ENDORSEMENT FOR RELEASE 致： 庫務署署長 To: Director of Accounting Services 4. 本人証明下述款項可按第一部份第1段所述方式發還：─ I certify that the following sum may now be released in the manner as specified in paragraph 1 of Part I:- 按金總額 ： 港幣 HK$1,000 Amount of deposit 5. 現附上按金收據正本給你辦理。 The original receipt of the election deposit is attached for your a