Certificate of No Criminal Conviction Applicant Data Collection Form (LOCAL)

(Please complete this form

to assist the processing of For official use only
your application for a
Certificate of No Criminal
Conviction.)

Application Date /
/

day / month / year

Please give details

of your application
for visa/permanent
residency status
below:

COUNTRY FOR DATE OF VISA ARE YOU THE IF YES, HOW MANY
WHICH VISA APPLICATION PRINCIPAL DEPENDENT
APPLICATION VISA APPLICANT MINORS ARE
HAS BEEN MADE COVERED IN YOUR
/ VISA APPLICATION
1  Yes 2  FOR WHOM
(month/year) No CNCCs ARE NOT
REQUIRED.

TYPE OF VISA (To be completed by

APPLIED FOR applicants for Immigrant
Visa only.)
 Immigrant HOW MANY CNCC
Student & APPLICATIONS FOR
Exchange visitor IMMIGRATION
PURPOSE HAVE
 YOU MADE IN
THE LAST TWELVE
MONTHS
Others (including
Business & Tourist)

TYPE OF IMMIGRATION CLASS

TRAVELLING
DOCUMENT HELD 
Family/Marriage
 Hong Kong 
Passport
 Hong Kong Independent/Employm
Certificate of Identity ent
 Hong Kong 
Document of Identity
 Other Hong Investment/Business
Kong Travelling
Document, specify:
 Retirement
 Others, specify

 Other National
Passport, specify
issuing country:
  Other
type of Travelling
Document, specify
issuing country:

AGE (in complete year) SEX

 Male
 Female

EDUCATIONAL PLEASE STATE

ATTAINMENT WHETHER
GRADUATED
 Primary & below
(Primary VI & below)  Graduated 2
 Secondary (Form  Not graduated
I-III)
MARITAL STATUS
 Secondary (Form
IV-V) (including  Never married 3
Craft/
Apprenticeship  Divorced/Legally
courses at separated
Technical  Married 4
Institutes)
 Widowed
Matriculation (Form
VI) LENGTH OF STAY IN
HONG KONG
 Matriculation (in complete year)
(Form VII)
 Post-secondary
(non-degree
courses, including
Polytechnic and
Technician level
courses at
Technical
Institutes)
 First degree
 Postgraduate

CURRENT ACTIVITY IF 1 IS TICKED. PLESE

STATUS STATE:

 Working JOB TITLE JOB DUTIES JOB ENTRY

QUALIFICATIONS
 Studying (e.g. teacher, accounting (e.g. teaching at high (e.g. a University Degree,
clerk, school, an
 Not Working restaurant manager, etc. accounting work, associateship in
Avoid restaurant accounting, a
using general terms such management, quality business management
as check in diploma,
government servant, garment production, etc.) a certificate in quality
factory control,
workers, etc.) etc.)

DCS 331 (Rev. 1/99)

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