Certificate of No Criminal Conviction Applicant Data Collection Form (LOCAL)
(Please complete this form to assist the processing of your application for a Certificate of No Criminal Conviction.) /

For official use only

Application Date / /
day / month / year
Please give details of your application for visa/permanent residency status below:
COUNTRY FOR
WHICH VISA
APPLICATION
HAS BEEN MADE / DATE OF VISA
APPLICATION
/
(month/year) / ARE YOU THE PRINCIPAL
VISA APPLICANT
1 Yes 2No / IF YES, HOW MANY DEPENDENT
MINORS ARE COVERED IN YOUR
VISA APPLICATION FOR WHOM
CNCCs ARE NOT REQUIRED.
TYPE OF VISA APPLIED FOR
1Immigrant
2Student & Exchange visitor
3Others (including Business & Tourist) / (To be completed by applicants for Immigrant Visa only.)
HOW MANY CNCC APPLICATIONS FOR
IMMIGRATION PURPOSE HAVE YOU MADE IN
THE LAST TWELVE MONTHS
TYPE OF TRAVELLING DOCUMENT HELD
1Hong Kong Passport
2Hong Kong Certificate of Identity
3Hong Kong Document of Identity
4Other Hong Kong Travelling Document, specify:
5Other National Passport, specify issuing country:
6Other typeof Travelling Document, specify issuing country: / IMMIGRATION CLASS
1Family/Marriage
2Independent/Employment
3Investment/Business
4Retirement
5Others, specify
AGE (in complete year) / SEX
1Male
2Female
EDUCATIONAL ATTAINMENT
1Primary & below (Primary VI & below)
2Secondary (Form I-III)
3Secondary (Form IV-V) (including Craft/ Apprenticeship courses at Technical Institutes)
4Matriculation (Form VI)
5Matriculation (Form VII)
6Post-secondary (non-degree courses, including Polytechnic and Technician level courses at Technical Institutes)
7First degree
8Postgraduate / PLEASE STATE WHETHER GRADUATED
1Graduated 2Not graduated
MARITAL STATUS
1Never married 3Divorced/Legally separated
2Married 4Widowed
LENGTH OF STAY IN HONG KONG
(in complete year)
CURRENT ACTIVITY
STATUS
1Working
2Studying
3Not Working / IF 1 IS TICKED. PLESE STATE:
JOB TITLE
(e.g. teacher, accounting clerk,
restaurant manager, etc. Avoid
using general terms such as
government servant, factory
workers, etc.) / JOB DUTIES
(e.g. teaching at high school,
accounting work, restaurant
management, quality check in
garment production, etc.) / JOB ENTRY
QUALIFICATIONS
(e.g. a University Degree, an
associateship in accounting, a
business management diploma,
a certificate in quality control,
etc.)

DCS 331 (Rev. 1/99)