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Drug Office - Application e-Form for Registration of Premises under Section 13

 

Notes:

  1. Item marked with * is compulsory field.

PART A: DETAILS OF APPLICANT

(As stated on Business Registration Certificate/ Hong Kong Identity Card)
Name of Business (in English):*
Name of Business (in Chinese):
:*

:

:
:* -
:* :
:*
:*
:*
: :* ()
:* :
: :
 
 
*:
: :*
: :*
 

PART B: DECLARATION OF APPLICANT

 
Full name of Applicant:*
Position of the Applicant:*
Signed on behalf of:*
Date: (dd/mm/yyyy)
 
 
(Revised in 07/2021)
 
Please enter the five letters as shown above.