弱能儿童学前服务-SocialWelfareDepartment社会福利署.doc

- PAGE 2 - - PAGE 1 - SWD/CLEIC Form 1 Annex 1社会福利署SOCIAL WELFARE DEPARTMENT暴力及执法伤亡赔偿计划申请表 SWD/CLEIC Form 1 Annex 1 CRIMINAL AND LAW ENFORCEMENT INJURIES COMPENSATION SCHEME APPLICATION FORM 受害人／申请人须知： 请参阅赔偿计划小册子，然后签署填妥的申请表，连同受害人的身份证明文件副本一并寄回。 Notice to victim/applicant: Please read the leaflet of the compensation scheme and then complete, sign and return this application form together with a photocopy of the victims identity document. 本人拟申请*暴力／执法伤亡赔偿，有关案件发生于 (日期) 地点为 I wish to apply for *Criminal/Law Enforcement Injuries Compensation in respect of an incident occurring on at 该案件已呈报 警署，报案日