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BUILDING & TOILET ACCESS CARD APPLICATION FORM

[ CP-MK-FM010 (Rev.3) ]

"*" indicates required fields

CENTRAL PLAZA

BUILDING & TOILET ACCESS CARD APPLICATION FORM

To : Central Plaza Management Co. Ltd.
[ Suite 2802, Central Plaza / fax no.: 2136 8999 ]

From

Name of Tenant*

Suite No. / Floor*

Contact Person*

First Last

Tel. No.*

RE : APPLICATION FOR BUILDING & TOILET ACCESS CARD

We would like to apply for*

1. Name*

First Last

HKID Card No.*

Please provide the first 4 digits including the letter, e.g. K123XXX(X).

Toilet Access Function*

Female Toilet

Executive Female Toilet

Male Toilet

Executive Male Toilet

2. Name

First Last

HKID Card No.

Please provide the first 4 digits including the letter, e.g. K123XXX(X).

Toilet Access Function

Female Toilet

Executive Female Toilet

Male Toilet

Executive Male Toilet

3. Name

First Last

HKID Card No.

Please provide the first 4 digits including the letter, e.g. K123XXX(X).

Toilet Access Function

Female Toilet

Executive Female Toilet

Male Toilet

Executive Male Toilet

4. Name

First Last

HKID Card No.

Please provide the first 4 digits including the letter, e.g. K123XXX(X).

Toilet Access Function

Female Toilet

Executive Female Toilet

Male Toilet

Executive Male Toilet

We understand and agree to pay HK$200.00 per building access control card and / or HK$50.00 per toilet access card for lost or damaged card. For void card (refers to any mal-function access card except those due to improper use by cardholder), the card will be replaced free of charge.

pc(s) – Female Toilet Card

pc(s) – Executive Female Toilet Card

pc(s) – Male Toilet Card

pc(s) – Executive Male Toilet Card

Authorised Signature*

Company Chop*

Accepted file types: jpg, jpeg, png, gif.

Name*

First Last

Position*

Company Chop*

Accepted file types: jpg, jpeg, png, gif.

Comments

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