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[接上页] (Delete this paragraph if application is not made in accordance with the simplified procedure.) (L.N. 128 of 1997) 7. *I/We declare that all the information given by *me/us in this application is true and correct to the best of *my/our knowledge and belief. Signature of Applicant: (1) ......................... ( ) (2) ......................... ( ) (3) ......................... ( ) (4) ......................... ( ) Date: ............................*Delete as appropriate. NOTES 1. The applicant is advised to read Part IIIA of the Travel Agents Ordinance (Cap 218) before submitting this application. 2. Additional information and documentary evidence may be required in support of this application. 3. This application must be submitted to the Secretary of the Travel Industry Compensation Fund Management Board or the person appointed under section 3(5)(a) of the Travel Industry Compensation Fund (Procedure for Ex gratia Payments) Rules within 24 months beginning on the date the outbound traveller(s) first sustained his/her/their loss/losses. 4. The Travel Industry Compensation Fund Management Board shall have absolute discretion to refuse any application for ex gratia payment. 5. This form must be completed in duplicate and sent by post or delivered in person to the Secretary of the Travel Industry Compensation Fund Management Board at the following address- Travel Agents Registry, 8/F, West Wing, Central Government Offices, Lower Albert Road, Hong Kong. or the person appointed under section 3(5)(a) of the Travel Industry Compensation Fund (Procedure for Ex gratia Payments) Rules at the following address- (Enacted 1993. L.N. 103 of 1996; L.N. 136 of 1996) FORM B TRAVEL AGENTS ORDINANCE (Cap 218) APPLICATION FOR EX GRATIA PAYMENT IN RESPECT OF AN OUTBOUND FARE FROM THE TRAVEL INDUSTRY COMPENSATION FUND UNDER SECTION 32E OF THE ORDINANCE (For use by applicant acting on behalf of the traveller(s)) I, ...................................., authorized by the traveller(s) listed in the Annex, *a client/ (applicant) clients of ................................................, a licensed travel agent whose licence number is (name of travel agent) ......................, hereby apply for ex gratia payments from the Travel Industry Compensation Fund under section 32E of the Ordinance for and on behalf of the traveller(s). 2. My personal particulars are as follows- (a) Name (*Mr/Mrs/Miss/Ms) ............................................. ( ) (English) (Chinese)Alias (if any) ..................................................................................................... (b) Date of birth ...................................................................................................... (c) *Hong Kong Identity Card/Passport No. ............................................................. (d) Residential address ............................................................................................ ..................................... (Telephone No : ........................) # (e) Office address ...................................................................... .................................. (Telephone No : ............................) # (# Please tick the appropriate box at the end of (d) or (e), if it is also a correspondence address.) 3. The personal particulars of *the/each traveller and his authorization for me to act on his behalf in applying for and receiving ex gratia payments from the Fund and to assign on his behalf his right to receive dividends, if any, from the Official Receiver/liquidator/trustee are at the Annex. 4. The application is in respect of a loss incurred in respect of a payment for travel services made by the traveller(s) to the travel agent. Moreover, the application is for an amount not exceeding the specified amount. (Delete this sentence if application is not made in accordance with the simplified procedure.)- (a) particulars of which loss are- ........................................................................................................................ ........................................................................................................................ *(b) the circumstances in which the loss occurred are- ........................................................................................................................ (not necessary to complete where a judgment has been obtained)........................................................................................................................ ........................................................................................................................ 5. In support of this application, I attach the following documents- (a) One/ ............... original(s) of receipt(s) or certified true *copy/copies thereof duly stamped/franked to show payment of levy to the Travel Industry Compensation Fund and a total payment of $ ............................... made to the travel agent. |