Social Security Allowance Scheme – Guangdong Scheme and Fujian Scheme Application Form

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Applicant

Appointee(only applicable to the condition where an applicant is medically certified to be unfit to make a statement on rendering him/her unable to make application by himself/herself)

Application details

Note:
1) Please read carefully the "Application for Guangdong Scheme and Fujian Scheme Guidance Notes" before completing this form.
2) Social Welfare Department accepts application for Old Age Living Allowance/Old Age Allowance within one month prior to the applicant's reaching the respective qualifying age (i.e. 65^th or 70^th birthday) for the allowance. Under this arrangement, the date the applicant reaching the respective qualifying age for the allowance is regarded as the date of application. The payment of allowance will be calculated from the date the applicant fulfils the qualifying age and satisfies all the eligibility criteria.

Please select one scheme below:*

Guangdong Scheme

Fujian Scheme

Please select one below in accordance with the type of allowance you would like to apply:*

Old Age Living Allowance

Old Age Allowance

Personal Information Collection Statement

Please read this notice before you provide any personal data^# to the Social Welfare Department

Purposes of Collection

1. The personal data supplied by you will be used by the Social Welfare Department (SWD) and/or those non-governmental organisations (“NGOs”) which receive subventions or subsidies from or which are commissioned by SWD to provide you/the applicant and/or your/the applicant’s family members with assistance or service from SWD and/or the aforementioned NGOs which is relevant to the needs of you/the applicant and/or your/the applicant’s family members, including but not limited to monitoring and reviewing of services, handling complaints related to the services provided to you/the applicant and/or your/the applicant’s family members, conducting research and surveys, preparing statistics and discharging statutory duties, as well as recovering debt related to the assistance/service provided to you/the applicant and/or your/the applicant’s family members. The provision of personal data to SWD is voluntary. However, if you fail to provide the personal data requested of you, we may not be able to process your application or provide assistance/service to you/the applicant and/or your/the applicant’s family members.

Classes of Transferees

2. The personal data you provide will be made available to persons working in SWD on a need-to-know basis. Apart from this, they may be disclosed to the parties or in the circumstances listed below for the purposes mentioned in paragraph 1 above -
(a) Other parties such as government bureaux/departments, the Hospital Authority, NGOs and public utility companies if they are involved in:

(i) processing and/or assessing any application from you/the applicant and/or your/the applicant’s family members for the provision of service/assistance to you/the applicant and/or your/the applicant’s family members by SWD and/or the NGOs mentioned in paragraph 1 above;
(ii) the provision of service/assistance to you/the applicant and/or your/the applicant’s family members by SWD and/or the NGOs mentioned in paragraph 1 above; or
(iii) monitoring and reviewing of the services provided by SWD and/or the NGOs mentioned in paragraph 1 above or preparing statistics;

(b) Complaint handling authorities such as the Office of the Ombudsman, the Office of the Privacy Commissioner for Personal Data, the Social Workers Registration Board, the Legislative Council, etc. if they are handling complaints about the services or assistance provided to you/the applicant and/or your/the applicant’s family members by SWD;
(c) Where such disclosure is authorised or required by law; or
(d) Where you have given your prescribed consent to such disclosure.

Access to Personal Data

3. You have the right to request access to and correction of your personal data held by SWD in accordance with the Personal Data (Privacy) Ordinance, Cap. 486. A fee is charged for supplying copies of personal data. Requests for access to and correction of personal data collected by SWD should be addressed to the supervisor of the Social Security Field Unit (Guangdong Scheme and Fujian Scheme) (please refer to part VIII of the Guidance Notes for the address and telephone number of the Social Security Field Unit (Guangdong Scheme and Fujian Scheme)).

# Under the Personal Data (Privacy) Ordinance, Cap. 486, personal data means any data -

(a) relating directly or indirectly to a living individual;
(b) from which it is practicable for the identity of the individual to be directly or indirectly ascertained; and
(c) in a form in which access to or processing of the data is practicable.

I have read the "Personal Information Collection Statement" and understand its content.

*Mandatory fields