墳場及火葬場組

CEMETERIES & CREMATORIA SECTION

申請靈灰龕位
APPLICATION FOR A NICHE

(甲部) 有關所申請的靈灰龕位的詳情 (Section A) Particulars of Niche under Application

請在新或重用靈灰龕位中填選一項。Please tick either New Niche or Re-allocated Niche only.

‰ 新靈灰龕位 靈灰安置所
New Niche Columbarium 請只填選一項。Please tick one item only.
‰ 長洲 Cheung Chau
‰ 坪洲 Peng Chau
‰ 南丫島 Lamma

或 Or

‰ 重用靈灰龕位 靈灰安置所
Re-allocated Niche Columbarium 請只填選一項。Please tick one item only.
‰ 哥連臣角 Cape Collinson
‰ 鑽石山 Diamond Hill
‰ 和合石（I 期）Wo Hop Shek (Phase I)
‰ 和合石（II 期）Wo Hop Shek (Phase II)
‰ 和合石（III 期）Wo Hop Shek (Phase III)
‰ 和合石（IV 期）Wo Hop Shek (Phase IV)
‰ 和合石（V 期）Wo Hop Shek (Phase V)
‰ 富山 Fu Shan
‰ 葵涌（I 及 III 期）Kwai Chung (Phase I & III)
‰ 葵涌（II 期）Kwai Chung (Phase II)
‰ 長洲 Cheung Chau
‰ 坪洲 Peng Chau
‰ 南丫島 Lamma

(乙部) 靈灰龕、申請人及先人資料 (Section B) Particulars of Niche, Applicant and the Deceased

靈灰龕資料 Particulars of Niche

靈灰龕 Niche 請只填選一項。Please tick one item only.

‰ 標準 Standard （可安放多過二位先人靈灰；龕位大小會因個別場地而有所不同）(can hold the ashes of more than

two deceased persons; the size of niche will differ depending on individual venue)

‰ 大型 Large （可安放多過四位先人靈灰；龕位大小會因個別場地而有所不同）(can hold the ashes of more than four

deceased persons; the size of niche will differ depending on individual venue)
(不適用於和合石（I 及 IV 期）及葵涌（I，II 及 III 期））
(Not applicable for Wo Hop Shek (Phases I & IV) and Kwai Chung (Phases I, II & III)

‰ 請在適當方格內填上「9」號。Please tick the appropriate box(es). 請於第三頁簽署。Please sign on page 3.

FEHB 136 (3/2015) 1

 申請人資料 Particulars of Applicant

申請人姓名：(中文) (英文) (先生／女士*)

Name of Applicant (Chinese) English (Mr./Ms.*)
中文電碼： 香港身分證／護照*號碼：
Chinese Commercial Code HKID Card/Passport* No.
電話號碼： 流動電話號碼：
Tel. No. Mobile Phone No.
聯絡地址：
Correspondence Address 香港／九龍／新界*
HK/Kln/NT*
本署可為先人在「無盡思念」網站免費開設個人紀念網頁(請參閱注意事項第 3 項)。如欲獲得以上服務，請提供電郵地
址及表示同意如下：
The Department may create a dedicated memorial webpage for the deceased at the Internet Memorial Service free of charge
(please read Note 3). If you wish to receive the service, please provide your email address and indicate consent below:
‰ 本人同意使用我的電郵地址作上述用途。 電郵地址：__________________________________________
I agree to the use of my email address for the above Email Address
purpose.

擬安放先人靈灰的資料 Particulars of the Deceased(s) Whose Cremated Ashes to be Placed

其他先人
[1] 首位先人（備註）
[2] 先人 [3] 先人 [4] 先人 (請註明)
First Deposited
Deceased Deceased Deceased Other Deceased
Deceased (Remarks)
(Please specify)
中文
Chinese
姓名
Name 英文
English

性別
Sex
去世時年齡
Age at Death
死亡日期 Date of Death
(日 DD／月 MM／年 YYYY)
香港身分證／護照*號碼(如有)
HKID Card/Passport* No. (if any)
火葬場地點
Crematorium
火葬日期 Date of Cremation
(日 DD／月 MM／年 YYYY)
火葬許可證／令*編號
Cremation Permit/Order* No.
與申請人關係
Relationship with Applicant

備註 Remarks
申請靈灰龕位的人士如欲於同一靈灰龕位安放其他先人的靈灰，申請表內的其他先人必須是首位先人的近親或與其有密切關係的；如首位先人的靈
灰被移走，靈灰龕位必須騰出並交還予食物環境衞生署（食環署）。
If the cremated ashes of other deceased persons are to be placed in the same niche, the other deceased persons shall be a close relative of or in close relationship
with the first deposited deceased; the niche should be vacated and returned to the Food and Environmental Hygiene Department (FEHD) if the cremated ashes of
the deceased first deposited in that niche are removed.
‰ 請在適當方格內填上「9」號。Please tick the appropriate box(es).
* 請刪去不適用者。Please delete where appropriate. 請於第三頁簽署。Please sign on page 3.
FEHB 136 (3/2015) 2
 (丙部) 申請人聲明 (Section C) Declaration by Applicant

謹此聲明，就本人所知所信，在本申請表所填報的資料，均屬確實無訛。本人明白，如填報的資料經查明失實，
本申請將不獲批准，如已獲批准亦將會被撤回。本人並願意遵守食物環境衞生署所訂靈灰安置所存放骨灰的服務須知（附
件）。

I declare that to the best of my knowledge and belief all the information contained in this application form is true and
correct. I understand that no permission will be given or such permission if given will be revoked if I have made a false
declaration. I shall observe the notes stipulated by the Food and Environmental Hygiene Department in respect of the deposit
of ashes in the columbaria (Annex).

日期： ________ / ________ / ____________ ________________________________

Date 日 DD 月 MM 年 YYYY 申請人簽署
Signature of Applicant

此欄只供辦事處填寫 FOR OFFICE USE ONLY

查核人員：
Verified by

檔案編號： 收據編號：
Transaction Ref. No. Receipt No.

日期： / /
Date 日 DD 月 MM 年 YYYY 查核人員簽署 查核人員姓名及職位
Signature of FEHD Officer Name and Post Title

核准人員：
Approved by

日期： / /
Date 日 DD 月 MM 年 YYYY 核准人員簽署 核准人員姓名及職位
Signature of Approving Officer Name and Post Title

注意事項 Notes
1. 本表格不收費用。
No fee is charged for this form.
2. 申請人與食環署進行任何事務往來時，均不得向食環署人員提供任何利益。
Applicants, while having dealings of any kind with the FEHD, should not offer any advantage to FEHD officers.
3. 申請人必須填寫本表格的甲及乙部。
Applicant should complete Sections A and B of this form.
申請人可為先人在「無盡思念」網站(memorial.gov.hk)開設紀念網頁。申請人只需填寫電郵地址，本署會預設一個載有其先人姓名及去世日期的
個人紀念網頁，並於配售靈灰龕位後兩個工作天內發出確認通知電郵，以便申請人隨時啓動戶口及登入紀念網頁編輯網頁內容。網上追思服務費
用全免。如申請人已用相同的電郵地址為同一先人於「無盡思念」網站開設紀念網頁，則不會重複開設網頁。
Applicant interested in creating a memorial webpage at the Internet Memorial Service (memorial.gov.hk) for the deceased only needs to provide his/her
email address. The Department will then create a dedicated memorial webpage displaying the name and date of death of the deceased. A notification
email for confirmation will be issued within two working days after niche allocation. The applicant may then activate the account, log in to the webpage
and edit the contents at any time. The Internet Memorial Service is free of charge. If a memorial webpage at the Internet Memorial Service has already
been created for the same deceased by the applicant using the same email address, no additional webpage will be created.
4. 丙部須由申請人親自簽署，否則本申請將被視作無效。申請人如不懂簽名，則須在高級衞生督察（墳場及火葬場）、衞生督察（墳場及火葬場）
或高級管工（墳場及火葬場）面前畫上記號。
Section C must be signed by the applicant personally, otherwise this application will be treated as null and void. If the applicant is unable to sign the
application, he/she is required to attend either before the Senior Health Inspector (C&C), Health Inspector (C&C) or Senior Foreman (C&C) to make his/her
mark.
5. 靈灰龕位及設置紀念牌匾的收費如下：
The fees for the niche and the placing of a memorial plaque are:
標準靈灰龕位 2,800 元 Standard niche $2,800
設置紀念牌匾 90 元 Placing a memorial plaque $90
大型靈灰龕位 3,600 元 Large niche $3,600
設置紀念牌匾 90 元 Placing a memorial plaque $90
有關費用會不時調整，以付款當日的規定收費為準。已繳費用，恕不退還。
The respective fees may be adjusted from time to time and charged according to the prevailing prescribed fee on the day of payment. Fees paid are not
refundable.

FEHB 136 (3/2015) 3

 6. 申請人須帶備的文件：
The applicant has to produce the following documents:
i. 申請人的香港身分證正本及副本一份；
the original and a copy of his or her own HKID Card;
ii. 每位先人的香港身分證或用作證明先人為香港居民之文件正本及副本一份；
the original and a copy of each deceased person’s Hong Kong Identity Card or other documentary proof of the deceased’s Hong Kong resident
identity;
iii. 每位先人的領取骨灰許可證正本及副本一份；
the original and a copy of the Permit to Take Away Cremated Ashes of each deceased;
iv. 如同時申請安放二個先人骨灰或以上者，須帶備有關先人的關係證明。如無法提供有效文件，則可在本署位於跑馬地／紅磡的墳場及火葬
場辦事處宣誓辦理；
for application to deposit the ashes of two or more deceased persons in the same niche, the documentary proof of the relationship of the deceased to
each other is required. If such proof is not available, the applicant shall take an oath at the Cemeteries and Crematoria Office of FEHD in Happy
Valley/Hung Hom;
v. 如申請離島的靈灰龕則另須帶備離島鄉事委員會的證明信及首位先人的法定代理人或最近親作出的法定聲明文件正本及副本一份，以證明
該先人合乎資格。
for application for niches on outlying islands, the original and a copy of letter from the relevant islands rural committee and a statutory declaration
made by the legal representative or next of kin of the first decreased person are required to certify the eligibility of the deceased.
申請人可將已填妥的申請表格，連同上述文件的正副本親自交到食物環境衞生署墳場及火葬場辦事處（地址：香港跑馬地黃泥涌道 1 號 J／九龍
紅磡暢行道 6 號）[如以郵遞／傳真方式遞交申請，只須提交上述文件副本。]
Applicant can submit in person the completed application form, together with the originals and copies of the above documents, to the Cemeteries and
Crematoria Offices of FEHD at 1J Wong Nai Chung Road, Happy Valley, Hong Kong or 6 Cheong Hang Road, Hung Hom, Kowloon [for submission by
post/fax, only copies of the above documents are required].
7. 一般查詢
General Enquiry
如有任何查詢，可致電或傳真至：
For enquiries concerning the application, please call or fax to:
港島辦事處 － 跑馬地黃泥涌道 1 號 J（香港墳場側） 電話號碼：2570 4318
傳真號碼：2591 1879
九龍及新界辦事處 － 紅磡暢行道 6 號地下高層 電話號碼：2365 5321
傳真號碼：2176 4963
Hong Kong Office － 1J Wong Nai Chung Road, Happy Valley Tel.No. : 2570 4318
(Next to Hong Kong Cemetery) Fax No. : 2591 1879
Kowloon & NT Office － Upper Ground Floor, Tel.No. : 2365 5321
6 Cheong Hang Road, Hung Hom Fax No. : 2176 4963
8. 收集個人資料聲明
Personal Information Collection Statement
(i) 食環署會利用經本表格所提供的個人資料，處理轄下墳場及火葬場服務的申請事宜。提供個人資料與否，純屬自願性質，但在資料不足的
情況下，則恐怕不能處理有關的申請。
The personal data provided by means of this form will be used by FEHD for purposes relating to applications for cemeteries and crematoria services.
The provision of personal data by means of this form is voluntary. However, if the applicant does not provide sufficient information, we may not be
able to process the application.
(ii) 本表格內所提供的個人資料，可能會被轉交其他政府部門或機構，以達致上文第 8（i）段所載的目的。
The personal data provided by means of this form may be disclosed to other Government Departments and Agencies in pursuance of the purposes
mentioned in paragraph 8 (i) above.
(iii) 根據《個人資料（私隱）條例》第 18 條、第 22 條及附表 1 內第 6 原則的規定，申請人有權查閱及更正他／她的個人資料。查閱的權利包
括有權索取本表格內所提供的個人資料副本一份。
The applicant has a right of access and correction with respect to personal data as provided for in accordance with Sections 18 and 22 and Principle 6
of Schedule I of the Personal Data (Privacy) Ordinance. His/her right of access includes the right to obtain a copy of his/her personal data which he
/she has provided by means of this form.
(iv) 如對經由本表格提供個人資料一事有任何疑問，包括查閱及更正個人資料等，可向本署高級衞生督察（墳場及火葬場）提出，地址為：
Enquiries concerning the personal data collected by means of this form, including the making of access and corrections, should be addressed to the
Senior Health Inspector (Cemeteries and Crematoria) at:
港島辦事處 － 跑馬地黃泥涌道 1 號 J（香港墳場側） 電話號碼：2578 9406
九龍及新界辦事處 － 紅磡暢行道 6 號地下高層 電話號碼：2364 5405
Hong Kong Office － 1J Wong Nai Chung Road, Happy Valley Tel. No.: 2578 9406
(Next to Hong Kong Cemetery)
Kowloon & NT Office － Upper Ground Floor, Tel. No.: 2364 5405
6 Cheong Hang Road, Hung Hom

FEHB 136 (3/2015) 4

 附件
Annex
食物環境衞生署靈灰安置所存放骨灰的服務須知
Notes for the Deposit of Ashes in the Columbaria of Food and Environmental Hygiene Department
凡安放下列人士骨灰的靈灰甕，可以永久存放在食物環境衞生署轄下火葬場的靈灰安置所內：
Urns or caskets containing the cremated remains of any person:

(a) 死亡時是香港居民，而其遺骸於死亡後三個月內在政府火葬場內火葬#；
who was a resident of Hong Kong at the time of his death and whose remains were cremated in a Government
crematorium within three months after his death#;
(b) 在緊接其死亡前的二十年內，有最少十年是香港居民，而其遺骸是在香港以外的地方火葬，具備有關居港文
件（正本）及有效之合法證明文件（正本）；或
who was a resident of Hong Kong for a period of at least ten years during the period of twenty years immediately
preceding his death and whose remains were certified to be cremated in a lawful crematorium outside Hong Kong;
or
(c) 其遺骸是在香港經合法撿拾後並在政府火葬場火葬的。
whose remains are lawfully exhumed and cremated at a Government crematorium,

須遵守條件如下：
may be deposited permanently in the columbarium of Food and Environmental Hygiene Department on the following
conditions:

1. 靈灰安置所內每個靈灰龕均須收費##，另設置紀念牌匾行政收費##。
A fee## is payable for each niche in the columbarium. In addition, an administration fee is payable for the placing of a
memorial plaque##.

2. 在可行情況下，一個標準型靈灰龕可以放置多過二位先人靈灰，而一個大型靈灰龕可以放置多過四位先人靈灰。
惟每次加放靈灰前，必須獲得食物環境衞生署署長的批准。
As far as situation warrants, a standard niche can hold the ashes of more than two deceased persons and a large niche can
hold the ashes of more than four deceased persons. Prior approval from the Director of Food and Environmental Hygiene
should be obtained for placing additional cremated ashes every time.

3. 所有靈灰龕都有編號，以資識別。
Niches are numbered for identification purposes.

4. 靈灰甕必須在註明所獲編配靈灰龕編號的許可證發出日期起計三個月內，放置在該靈灰龕內。
Urns/caskets must be placed inside the allotted niche within three months from the date of the issue of a permit giving the
number of the niche allotted.

5. 如欲改裝石匾或更改其內容，則必須取得食物環境衞生署署長的批准。
Any alteration to the plaque or its content requires permission from the Director of Food and Environmental Hygiene.

6. 靈灰龕屬食物環境衞生署所有，經編配予申請人使用後，便不得轉讓或出售。而如欲取走置於其內的骨灰，取走
前必須獲得食物環境衞生署批准，另外，如首位放置的靈灰甕被移走，靈灰龕必須交還予食物環境衞生署。已繳
費用，恕不退還。
The niche, upon allocation is not transferable and not allowed to be sold. Prior permission must be obtained from the
Food and Environmental Hygiene Department for taking away the ashes deposited in the niche. In addition, the niche
should be returned to the Food and Environmental Hygiene Department if the urn or casket containing the ashes of the
deceased first deposited in that niche are removed. Funds paid are not refundable.

7. 將靈灰甕存放入靈灰龕後，必須以石匾把靈灰龕口封閉及必須由食物環境衞生署認可的承造商及在食物環境衞生
署人員監督下進行，及須符合下列條件：
It is necessary that the niche opening be closed by a plaque after the deposit of an urn inside the niche. The plaque,
which should be mounted by a contractor recognised by the Food and Environmental Hygiene Department under the
supervision of the Food and Environmental Hygiene Department staff, is subject to the following conditions:

(i) 必須選用一種名為「他拉維天奴」的意大利雲石（俗稱[有窿石] ）製造。

It must be of Travertino marble.
(ii) 將靈灰甕存放入靈灰龕後，必須立即加上石匾。
The plaque must be affixed to the niche immediately following the deposit of the urn or casket inside the niche.

FEHB 136 (3/2015) 5

 8. 在可行情况下，每個標準及大型靈灰龕位可分別安放多過兩位及四位先人靈灰，但加放靈灰在靈灰龕的先人必須
是最早安放在靈灰龕內的先人的近親或與其有密切關係的。近親指配偶、父母、祖父母、外祖父母、兄弟、姊妹、
配偶的父親、配偶的母親、媳婦、女婿，或父系或母系的直系後裔。
Each standard niche and large niche can be used for the deposit of more than 2 and 4 sets of cremated human ashes
respectively as far as situation warrants. Provided that the subsequent set of cremated human ashes deposited in a niche
shall be those of a close relative of or in close relationship with the deceased first deposited in that niche. Close relative
means the spouse, parent, grandparent, grandparent-in-law, brother, sister, father-in-law, mother-in-law, daughter-in-law,
son-in-law or a direct descendant of either the male or female line.

9. 石匾上所載的先人姓名必須與有關「領取骨灰許可證」或「火葬證明書」相符。一般而言，除籍貫、相片、生死
日期或經署方批准外，其餘一律不准刻列在石匾上。
The name of the deceased stated on the plaque should be equivalent to those stated in the relevant “Permit to Take Away
Cremated Ashes” or “Certificate of Cremation”. In general, only the native place, photo, birth and death dates of the
deceased and other items as approved by the Department are allowed to be shown on the plaque.

# 在遞交申請時須一併付上相關文件的正本。
It must be provided with relevant original documents upon application.
## 有關費用會不時調整，以付款當日的規定收費為準。詳情可向本署職員查詢。
The respective fees may be adjusted from time to time and charged according to the prevailing prescribed fee on the day of payment.
More information and details for the charges (fees) can be obtained from the staff of this office.

FEHB 136 (3/2015) 6