傷殘人士車主泊車優惠記錄

Record of Concessionary Parking for Disabled Person

停車場名稱

Name of Car Park:

月租

Monthly Parking [          ]

時租

Hourly Parking [          ]

傷殘人仕泊車許可証 Disabled Person’s Parking Permit

編號 Serial No.

屆滿日期Date of Expiry

駕駛執照編號

Driving Licence No.:

車輛登記號碼

Vehicle Registration No.:

姓名

Name:

For office only

checked with I.D. Card [                    ]

(請出示身份証核對)

(Please show your Identity card for checking.)

簽署

Signature:

日期

Date:

FOR OFFICE USE ONLY (此欄由停車場職員填寫)

( I )

Monthly(月租)

( II )

Hourly(時租)

月份

Monthly:

停泊共

Parked for

小時

hour/s

月票編號

Serial No:

時租票編號

Serial No:

票價

Parking Charge:

泊車費

Parking Charge:

處理人

Handled by:

職員編號

Staff No: