APPLICATION FORM - EMPLOYER

申 請表格 - 僱主
Principal MPF Scheme Series 800 信安強積金計劃 800系列
This Application Form forms part of the Participation Agreement and shall only be used in conjunction with the MPF Scheme Brochure. The details
specified in this form shall apply for the purposes of the Scheme. 本申請表將連同信安的強積金計劃說明書一併使用，並為參與協議書之一部份。申
請表內的資料，將用於此計劃之事宜上。

Note 注意:
1. As the Inland Revenue (Amendment) (No.2) Ordinance 2019 will effect on 1 January 2020, please submit the “Self-Certification Form”
with this application form to us. For details, please refer to the guidelines on completing Self-certification Form which can be
downloaded from our website. . 因應於 2020 年 1 月 1 日生效之《2019 年稅務(修訂)(第 2 號)條例》，遞交此申請表格時，請連同「自我證明表
格」一併交回本公司。詳情可從本公司網址下載自我證明表格填寫指引以作參考。
2. Please tick and complete the appropriate sections. 請於適當位置及部份加上✓號。

(1) Information of Employer 僱主資料

Scheme effective date Number of employees
0 1
計劃生效日期 |___|___| D日 |___|___| M月 |___|___|___|___| Y年 僱員人數 |__________|

Employer Legal Name English 英文

____________________________________________________________________________________
僱主法定名稱
Chinese 中文
____________________________________________________________________________________

Registered Address ___________ _ _________ __________ __________________________________________________________

(P.O. Box Address is not accepted) Room/Flat 室 Floor 樓層 Block 座 Name of Building 大廈名稱
註冊地址
(不接納郵箱地址) ___________________ ________________________________________________________ _________________________
Street No.街/道號碼 Name of Street 街/道名稱 City 城市

❑Hong Kong 香港 ❑Kowloon 九龍 ❑N.T. 新界 ________________________ _________________________

Country 國家 Post Code/Zip Code
郵政編碼/郵遞區號碼

Current Business Address ____________ __________ __________ __________________________________________________________

(If different from Registered Room/Flat 室 Floor 樓層 Block 座 Name of Building 大廈名稱
Address)
現時營業地址 _____________________ ___________________________________________________ _________________________
(如與註冊地址不同) Street No.街/道號碼 Name of Street 街/道名稱 City 城市

❑Hong Kong 香港 ❑Kowloon 九龍 ❑N.T. 新界 __________________________________________________

Country 國家 Post Code/Zip Code
郵政編碼/郵遞區號碼

Mailing Address ___________ _________ __________ __________________________________________________________

(If different from Registered/ Room/Flat 室 Floor 樓層 Block 座 Name of Building 大廈名稱
Business Address)
通訊地址 _____________________ ___________________________________________________ _________________________
(如與註冊/營業地址不同) Street No.街/道號碼 Name of Street 街/道名稱 City 城市

❑Hong Kong 香港 ❑Kowloon 九龍 ❑N.T. 新界 _______________________ _________________________

Country 國家 Post Code/Zip Code
郵政編碼/郵遞區號碼
Contact Person ❑Mr 先生 Name Job Title
聯絡人 ❑Ms 女士 姓名 _______________________________________ 職銜 _____________________________

Contact details Daytime contact no. Fax no.

聯絡資料 日間聯絡號碼 |___|___|___|___|___|___|___|___| 傳真號碼 |___|___|___|___|___|___|___|___|

E-mail address
電子郵箱 ___________________________________________________________________

(2) Government registration type 政府登記類別 (please provide a certified true copy of the registration document 請附上註冊證明文件之認證副本)

❑ (BR) Business Registration ❑ (TU) Registry of Trade Union ❑ (SO) Society Office of Hong Kong Police (in respect of societies)
商業登記 職工會登記局 香港警務處社團事務處 (社團)
❑ (ED) Education Department ❑ (IR) Inland Revenue Department (in respect of charitable organizations) ❑ Others
教育署 稅務局部(慈善團體) 其他 ____________________
(please specify 請說明)
Registration no.登記號碼 |___|___|___|___|___|___|___|___|___|___|___|

*CASE-SEPARATOR* *DEFKBC-NBER* *OBJTNBAPPFORM*

*CASE-SEPARATOR* *DEFKBC-NBER* *OBJTNBAPPFORM* P01_ERAPP_v.1.May 23

Page 1 of 8
(3) Nature of Business 業務性質

❑ (01) Catering ❑ (02) Construction ❑ (03) Manufacturing

飲食業 建造業 製造業
❑ (04) Financing/Banking Services ❑ (05) Community/Social/Personal Services ❑ (06) Wholesale/Retail/Import & Export
銀行及金融業 社會服務業 批發/零售/出入口
❑ (07) Transport ❑ (08) Cleaning ❑ (09) Security Guard
運輸業 清潔業 保安業
❑ (10) Hairdressing & Beauty ❑ (88) Others
髮型及美容 其他 ______________________
(please specify 請說明)

(4) Particulars of MPF Plan 強積金計劃詳情 (To be completed if applicable 於適用時填寫)

❑ Employer’s Voluntary Contributions (Please complete the Principal MPF Scheme Voluntary Contribution Application Form (Employer))
僱主自願性供款(請填妥信安強積金計劃自願性供款申請表格(僱主))
❑ Transfer benefits from other scheme (Please complete the Participating Employer’s Request For Fund Transfer Form (Form MPF(S)-P(E))
從其他計劃轉入權益(請填妥參與僱主資金轉移申請表(第 MPF(S)-P(E)號表格)

(5) Contribution Arrangement 供款安排(No indication will default to "Monthly" 如沒指示將預設為"每月")

Monthly (i.e. first day of each calendar month Weekly

❑ to the last day of the calendar month) ❑ 每週
每月(即每曆月的首日至最後一日)
❑ Semi-monthly
每半個曆月 ❑ Others (Please specify)
其他 (請說明) _______________________________

(6) Method of Payment 付款方法(No indication will default to "Cheque". However, Direct Debit Authorization is enclosed but no indication will default
to “Autopay” 如沒指示將預設為"支票"，然而附上直接付款授權書但沒指示則預設為"自動轉帳")

Autopay 自動轉帳 Cheque 支票

❑ (Please attach Direct Debit Authorization 請遞交直接付款授權書) ❑

(7) Arrangement of Remittance Statement 供款報表安排

Please select ONE of the following. If election is not made option(a) below will be applied automatically.
請選擇以下其中一項。 如沒有註明選擇，下列(a)項將自動採用。

❑ (a) Pre-printed Contribution Listing with relevant income of previous contribution period & contribution records listed
詳列上個供款期之有關入息及供款額的成員供款資料
❑ (b) e-Contribution on Principal Retirement Service Centre or submit the contribution file via electronic means to [email protected],
and no Pre-printed Contribution is required
信安退休服務中心提供的網上易供款或以電子方式遞交供款檔案至 [email protected]，不需要預印成員供款資料

❑ (c) Others 其他___________________________________________________________________________________________________

(please specify 請說明)
(8) Official Receipt 正式收據 (No indication will default to “No Official Receipt is required” 如沒指示將預設為“不需要正式收據”)

❑ Official Receipt is required 需要正式收據 ❑ No Official Receipt is required 不需要正式收據

Optional 選擇性 (To be completed if applicable 於適用時填寫)

The authorized officer shall provide his/her HKID/Passport copy, which shall be certified as true copy by a MPF Intermediary, an
accounting professional, an estate agent, a legal professional or a Trust or Company Service Provider licensee. If the nationality
reported does not match with the information shown on the copy of identity proof, client must also provide copy of nationalit y proof
bearing photograph. 授權代表須提供香港身份證/護照副本，而該文件須經由強積金中介人、會計專業人士、地產代理、法律專業人士或信託或公
司服務持牌人核實為真實副本。如所申報之國籍與提交的身份證明文件上之資料不相符，客戶必須另外附上附有相片的國籍證明副本。

(9) Authorized officer 授權代表

(a)Full Name 全名____________________________________________ Email address 電子郵箱 __________________________________

Job Title 職銜 ____________________________________________

Nationality 國籍____________________________________________ Signature 簽署 X

__________________________________

(b)Full Name 全名____________________________________________ Email address 電子郵箱 __________________________________

Job Title 職銜 ____________________________________________

Nationality 國籍____________________________________________ Signature 簽署 X

__________________________________

Page 2 of 8
(10) Beneficial owners 實益擁有人

(a) In relation to a corporation 關於法團

- means an individual who : (i) owns or controls, directly or indirectly, including through a trust or bearer share holding, more than 25% of the
issued share capital of the corporation; or (ii) is, directly or indirectly, entitled to exercise or control the exercise of more than 25% of the voting
rights at general meetings of the corporation; or (iii) exercises ultimate control over the management of the corporation; or 所指的個人 : (i) 直
接或間接有權攤分或控制該法團己發行股本 25%或以上; 或; (ii) 直接或間接有權行使該法團的成員大會的投票權 25%或以上; 或 (iii) 行使對該
法團的管理最終控制權; 或
- if the corporation is acting on behalf of another person, means the other person 如該法團是代表另一人行事，所指該另一人
(b) In relation to a partnership 關於合夥人
- means an individual who : (i) is entitled to or controls, directly or indirectly, more than a 25% share of the capital or profits of the partnership; or
(ii) is, directly or indirectly, entitled to exercise or control the exercise of more than 25% of the voting rights in the partnership; or (iii) exercises
ultimate control over the management of the partnership; or 所指的個人 : (i) 直接或間接有權攤分或控制該合夥的資本或利潤 25%或以上; 或
(ii) 直接或間接有權行使該合夥的投票權 25%或以上; 或 (iii) 行使對該合夥的管理最終的控制權; 或
- if the partnership is acting on behalf of another person, means the other person 如該合夥人是代表另一人行事，所指該另一人
(c) In relation to a trust 關於信託
- means an individual who is entitled to a vested interest in more than 25% of the capital of the trust property, whether the interest is in
possession or in remainder or reversion and whether it is defeasible or not; or 所指的個人享有信託財產的資本的既得權益 25%或以上，而不
論該人是享有該權益的管有權、利餘權或復歸權，亦不論該權益是否可予廢除; 或
- the settlor of the trust; or 該信託的財產授予人; 或
- a protector or enforcer of the trust; or 該信託的保護人或執行人; 或
- an individual who has ultimate control over the trust 對該信託擁有最終控制權的個人
(d) In relation to a person not falling within paragraph (a), (b) or (c) 關於不屬(a)至(c)段所指的個人
- means an individual who ultimately owns or controls the person; or 所指的個人最終擁有或控制該人; 或
- if the person is acting on behalf of another person, means the other person; 如該個人代表另一人行事，所指該另一人
- Please enclose a photocopy of HKID Card/ Passport for verification. If the nationality reported does not match with the information shown on the
copy of identity proof, client must also provide copy of nationality proof bearing photograph. 請附上香港身份證/護照副本，以作核實。如所申報之
國籍與提交的身份證明文件上之資料不相符，客戶必須另外附上附有相片的國籍證明副本。
- Please note we may request for further information of the Beneficial Owner(s) with less shareholding/ownership/voting right described in the above.
請注意我們可能會要求提供少於上列所述股份/擁有權/投票權的實益擁有人資料。
- If the space is insufficient, please photocopy this page and attach for submission. 如空格不敷應用，請另行影印此頁補充並一併遞交。
- If the Beneficial Owner(s) list need to update in the future, please submit “Change Request of Employer Particulars” form within 30 days. 若未來
需要更改實益擁有人名單，請於 30 天內遞交”僱主資料更改”表格。

1 (a) Owner Name 擁有人姓名 (same as HKID card or passport 必須與身份證或護照相同)

English 英文
_______________________________________________________________________________________________________________

Chinese 中文
_______________________________________________________________________________________________________________

(b) Ownership 擁有權 (c) Date of Birth 出生日期 (d) Nationality 國籍 (Country 國家/Region 地區)

_______________ % |___|___| D 日|___|___| M 月|___|___|___|___|Y 年 _____________________________________

2 (a) Owner Name 擁有人姓名 (same as HKID card or passport 必須與身份證或護照相同)

English 英文
_______________________________________________________________________________________________________________

Chinese 中文
_______________________________________________________________________________________________________________

(b) Ownership 擁有權 (c) Date of Birth 出生日期 (d) Nationality 國籍 (Country 國家/Region 地區)

_______________ % |___|___| D 日|___|___| M 月|___|___|___|___|Y 年 _____________________________________

3 (a) Owner Name 擁有人姓名 (same as HKID card or passport 必須與身份證或護照相同)

English 英文
_______________________________________________________________________________________________________________

Chinese 中文
_______________________________________________________________________________________________________________

(b) Ownership 擁有權 (c) Date of Birth 出生日期 (d) Nationality 國籍 (Country 國家/Region 地區)

_______________ % |___|___| D 日|___|___| M 月|___|___|___|___|Y 年 _____________________________________

4 (a) Owner Name 擁有人姓名 (same as HKID card or passport 必須與身份證或護照相同)

English 英文
_______________________________________________________________________________________________________________

Chinese 中文
_______________________________________________________________________________________________________________

(b) Ownership 擁有權 (c) Date of Birth 出生日期 (d) Nationality 國籍 (Country 國家/Region 地區)

_______________ % |___|___| D 日|___|___| M 月|___|___|___|___|Y 年 _____________________________________

Page 3 of 8
Personal Information Collection Statement 個人資料收集說明書

The provision of information and other personal data by you is on a voluntary basis. However, failure to provide us with the information and other
personal data as requested may result in your application/instruction not being able to be processed. The information and other personal data
provided by you will only be accessed and handled by Principal Trust Company (Asia) Limited (“the Trustee and Administrator”) and its affiliate(s),
Principal Insurance Company (Hong Kong) Limited (“the sponsor”), Principal Investment & Retirement Services Limited (“the promoter”) (collectively,
“the Companies”) and the relevant persons stated herein below.

The information and other personal data collected from you from time to time will be used for the purposes of: (1) processing your application for
participation under Principal MPF Scheme Series 800 (“the Scheme”); (2) administering and managing your contributions and accrued benefits under
the Scheme; (3) carrying out your instructions or responding to any enquiries given or purporting to be given by you or on your behalf; (4) direct
marketing of mandatory provident fund (“MPF”), retirement schemes, MPF and retirement schemes related services and products of Principal Trust
Company (Asia) Limited and its member company(ies); (5) providing MPF and retirement schemes related services; (6) maintaining statistical data
and providing a database for product and market research; (7) compliance with applicable laws, regulations, guidelines or guidance given or issued
by any legal, regulatory, governmental, tax, law enforcement or other authorities, or self-regulatory or industry bodies or associations of financial
services providers within or outside the Hong Kong Special Administrative Region (“Hong Kong”), including but not limited to the Foreign Account Tax
Compliance Act and the Common Reporting Standard; and (8) any other purposes relating or incidental to the above.

Furthermore, for the purpose of automatic exchange of financial account information, such information and information regarding the account holder
and any reportable account(s) may be reported by the Trustee and its member company(ies) to the Inland Revenue Department of the Government
of Hong Kong (“IRD”) and exchanged with the tax authorities of another jurisdiction or jurisdictions in which the account holder may be resident for
tax purposes, pursuant to the legal provisions for exchange of financial account information provided under the Inland Revenue Ordinance (Cap.112
of the Laws of Hong Kong). You shall advise us of any change in circumstances which affects the tax residency status of the account holder, and to
provide us with a suitably updated self-certification form within 30 days of such change in circumstances.

You may visit the IRD website that sets out information relating to the implementation of automatic exchange of financial account information in Hong
Kong: http://www.ird.gov.hk/eng/tax/dta_aeoi.htm.

Your personal data (name, contact details and account records) may be used for direct marketing of MPF products, retirement schemes, MPF and
retirement schemes related services and products of the Trustee and its member company(ies) only with your consent.

Your personal data may be transferred/disclosed to the following parties (whether within or outside Hong Kong) for any of the purposes stated above:
(1) any agent, contractor, third party service provider, or any company(ies) within the same group of companies to which the Trustee belongs which
provides administrative, telecommunications, computer, data processing or storage, marketing, professional or other services to the Trustee in
connection with their business operations; (2) any person to whom the Trustee is under an obligation to make disclosure under the requirements of
any laws and regulations binding on the Trustee or any of its member company(ies) or under and for the purposes of any guidelines issued by
regulatory, tax or other authorities with which the Trustee or its member companies are expected to comply; and (3) any actual or proposed assignee
of the Trustee or participant or sub-participant or transferee of the rights of the Trustee in respect of you.

Under the Personal Data (Privacy) Ordinance (Cap.486 of the Laws of Hong Kong), you have a right to request access to and correction of any of
your personal information held by the Companies and to request not to use your personal data for direct marketing purpose as stated above. The
aforesaid requests can be made in writing to: Data Protection Officer, Principal Trust Company (Asia) Limited, 30/F, Millennium City 6, 392 Kwun
Tong Road, Kwun Tong, Kowloon, Hong Kong. If you have any questions or wish to know more about our privacy policy, please send your enquiry
to the above address or contact us at (852) 2827 1233.

閣下提供的資料及其他個人資料純屬自願性質。然而，如未能提供所需資料及其他個人資料，可能導致閣下的申請/指示不獲處理。閣下提供的資料及
其他個人資料僅供信安信託(亞洲)有限公司(「受託人及管理人」)、美國信安保險有限公司(「保薦人」)及信安投資及退休金服務有限公司（「推銷
商」）（統稱「公司」）及以下所指的相關人士/機構使用及處理。

向閣下所收集的資料及其他個人資料將會用作下列用途：(1) 處理閣下參與信安強積金計劃800系列 (「該計劃」)的申請； (2) 處理及管理閣下於該計

劃的供款及累算權益；(3) 執行閣下的指示或答覆閣下或閣下代表的查詢；(4) 直接促銷信安信託(亞洲)有限公司及其成員公司的強制性公積金(「強積
金」)產品、退休計劃、強積金及退休計劃的相關服務及產品；(5) 提供強積金及退休計劃的相關服務；(6) 維持統計數據及用作產品及市場研究資料庫；
(7) 遵守有關不論於香港特別行政區境内或境外的任何法律、監管、政府、税務、執法或其他機關,或金融服務供應商的自律監管或行業組織或協會作
出或發出的任何適用的法律、規則、指引或指導, 包括但不限於《外國帳戶稅務合規法案》及共同匯報標準；及 (8) 用作與任何上述有關的用途。

除上述以外，受託人及其成員公司可根據<税務條例>（香港法例第112章)有關交換財務賬户資料的法律條文，及作自動交換財務賬户資料用途，把
該等資料和關於賬户持有人及任何須申報賬户的資料向香港特別行政區政府税務局(「税務局」)申報，從而把資料轉交到賬户持有人的税務管轄區的
税務當局。如情況有所改變，以致影響賬户持有人的税務居民身分，閣下會通知本公司，並會在情況發生改變後30日内，向本公司提交一份已適當更
新的自我證明表格。

閣下可參閱税務局網站 http://www.ird.gov.hk/chi/tax/dta_aeoi.htm 以了解香港實施自動交換財務賬户資料的詳情。

只有在閣下的同意下，閣下的個人資料（姓名，聯絡資料和戶口記錄）或會用於直接促銷本公司及其成員公司的強制性公積金的產品，退休計劃，強
積金相關的服務和產品。

閣下的個人資料可能轉移/披露予以下的人士 (不論在香港特別行政區內外) 作為上述所載的任何用途：(1) 在業務上向受託人提供行政、電訊、電腦、

數據處理或儲存、市場推廣、專業或其他任何服務的代理、承包商、第三方服務供應商或本公司所屬公司集團旗下的任何公司；(2) 就受託人或其成員
公司所需遵守的法律及規則要求，或按監管機構、税務或其他主管機構要求受託人或其成員公司需遵守的指引，受託人因而有責任要向其披露的任何
人士；及 (3) 允許任何受託人的實際或建議承讓人或受託人所持客戶權益的分享者、再分享者、受讓人擁有有關客戶資料的權利。

根據個人資料(私隱)條例（香港法例第486章），閣下有權要求查閱及更正該公司所持有閣下的個人資料及要求閣下的個人資料不被用作上述的直接促
銷用途。上述要求可以書面形式通知保障資料主任，信安信託(亞洲)有限公司，香港九龍觀塘觀塘道392號創紀之城6期30樓，閣下如有任何疑問或欲
進一步了解本公司的私隱政策，請致函到上述地址或致電（852）2827 1233與本公司聯絡。

Page 4 of 8
 Signed by Employer 僱主簽署

For and on behalf of the Scheme Participant

代表計劃參與者

Employer’s signature (with company chop)

僱主簽署(蓋上公司印鑑)
X Date日期
Full Name全名
(in BLOCK LETTERS以正楷填寫） Title職銜

Nationality國籍

This Application Form/Participation Agreement must be signed by: (a) if the Employer is a Corporation, a director, the compan y
secretary or such other *duly authorized person of such Corporation; (b) if the Employer is a Sole Proprietorship, the Sole Proprietor;
or (c) if the Employer is a Partnership, any one of its partners. The signer/authorized officer shall provide his/her HKID/P assport copy,
which shall be certified as true copy by a MPF Intermediary, an accounting professional, an estate agent, a le gal professional or a
Trust or Company Service Provider licensee. If the nationality reported does not match with the information shown on the copy of
identity proof, client must also provide copy of nationality proof bearing photograph.

此申請表格或同意書必須由以下人士簽署：(甲) 倘僱主為法團公司，該公司董事、公司秘書或*經公司正式授權人士；(乙)倘僱主為獨資經營，該獨資
經營者；或(丙)倘僱主為合夥，任何一位合夥人。簽署人/授權代表須提供香港身份證/護照副本，而該文件須經由強積金中介人、會計專業人士、地
產代理、法律專業人士或信託或公司服務持牌人核實為真實副本。如所申報之國籍與提交的身份證明文件上之資料不相符，客戶必須另外附上附有相
片的國籍證明副本。
* "Duly authorized person” –requires proof of proper written authorization by the corporation (such as authorization letter signed by company
directors/company secretary /partners, resolutions or minutes of the corporation) provided that the duly authorized person is only allowed to carry
out general administration of the scheme. For the avoidance of doubt, such duly authorized person is not allowed to authorize another "Duly
authorized person”. "正式授權人士"需要提供組織發出的適當書面授權 (例如：由公司董事/公司秘書/合伙人簽署的授權書、組織決議或會議記錄)。
該等授權只允許正式授權人士為該計劃作一般行政管理。為免疑問，該正式授權人士不得授權另一人士為"正式授權人士"。

To be completed by MPF Intermediary 由強積金中介人填寫

 Agent代理人
Signature of Licensed MPF Intermediary MPF Intermediaries Reg. No.
強積金中介人簽署 X 強積金中介人註冊號碼
MPF Intermediary Name Contact Tel. No.
強積金中介人姓名 聯絡電話
Name of Principal Intermediary Agent/Consultant Code (if any)
主事中介人名稱 營業員/顧問編號(如有)

 Agent代理人
Signature of Licensed MPF Intermediary MPF Intermediaries Reg. No.
強積金中介人簽署 X 強積金中介人註冊號碼
MPF Intermediary Name Contact Tel. No.
強積金中介人姓名 聯絡電話
Name of Principal Intermediary Agent/Consultant Code (if any)
主事中介人名稱 營業員/顧問編號(如有)

Trustee & Administrator: Principal Trust Company (Asia) Limited 受託人及管理人: 信安信託(亞洲)有限公司
Sponsor: Principal Insurance Company (Hong Kong) Limited 保薦人: 美國信安保險有限公司
Promoter: Principal Investment & Retirement Services Limited 推銷商: 信安投資及退休金服務有限公司
30/F, Millennium City 6, 392 Kwun Tong Road, Kwun Tong, Kowloon, Hong Kong 香港九龍觀塘觀塘道 392 號創紀之城 6 期 30 樓
Customer Service Hotline 客戶服務熱線: (852) 2827 1233 Employer Hotline 僱主專線: (852)2251 9322 Fax 傳真: (852)2827 1707 Website 網址: www.principal.com.hk

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 PARTICIPATION AGREEMENT

THIS PARTICIPATION AGREEMENT is made on

BETWEEN:

(1) PRINCIPAL TRUST COMPANY (ASIA) LIMITED whose registered office is at 30/F, Millennium City 6, 392 Kwun Tong Road, Kwun Tong,
Kowloon, Hong Kong (the “Trustee”); and

(2) The applicant, whose name and address are given in the Application Form attached hereto (the “Scheme Participant”).

RECITALS:
(A) The Trustee is the Trustee of the Principal MPF Scheme selected in the Application Form (the “Master Trust Scheme”).

(B) The Scheme Participant wishes to join the Master Trust Scheme for the benefit of the Scheme Participant and/or his/her employees.

(C) The participation of the Scheme Participant shall be governed by the trust deed of the Master Trust Scheme as amended from time to
time (the “Deed”) and this Participation Agreement.

PROVISIONS
1. Unless otherwise stated, words and expressions used in this Participation Agreement shall have the meanings given to them in the Deed.

2. The Scheme Participant hereby participates in the Master Trust Scheme with effect from the Plan Effective Date as specified in Section 2
of the Application Form, the participation is to be governed by the terms of the Deed and this Participation Agreement.

3. The Scheme Participant hereby covenants with the Trustee to comply with and be bound by the provisions of the Deed and this Participation
Agreement and all applicable laws and regulations.

4. The Scheme Participant warrants that he/she has read and fully understood the content of the MPF Scheme Brochure and the Application
Form (including the Personal Information Collection Statement) and that the information contained in the Application Form and other
information from time to time to be provided by the Scheme Participant in relation to contributions and as to the age, salary, length of service,
benefits, Investment Elections, Switching Instruction Forms are correct in all respects.

5. Subject to the provisions of the Deed and this Participation Agreement, the Scheme Participant undertakes and agrees to hold the Trustee
indemnified against any and all proceedings, costs, charges, liabilities and expenses occasioned by any and all actions, claims, demands
or proceedings in connection with the Master Trust Scheme and his/her participation either:

(a) arising out of the breach by the Scheme Participant of the warranty referred to in paragraph 4; or

(b) as a result of any failure or omission on the part of the Scheme Participant to duly and punctually perform or observe any
obligations pursuant to the Deed and this Participation Agreement or otherwise so far as they relate to the Scheme Participant
and his/her Employee Members (where applicable) (whether they relate to the Scheme Participant and such Employee Members
alone or together with another Scheme Participant and the Employee Members).

6. The Scheme Participant undertakes and agrees to pay all fees and expenses which are payable by it under the terms of the Deed and this
Participation Agreement.

7. This Participation Agreement shall be terminated in accordance with Rule 20 of the Deed.

8. This Participation Agreement shall be governed by the laws of Hong Kong.

IN WITNESS whereof this Participation Agreement has been entered into the day and year first above written.

For and on behalf of the Scheme Participant For and on behalf of

PRINCIPAL TRUST COMPANY (ASIA) LIMITED

X
Authorized Signature(s) with company chop Authorized Signature(s)

Full Name & Title in print

Nationality

The Application Form/Participation Agreement must be signed by director(s), company secretary or such other duly authorized person(s)
of the Employer. For Sole Proprietorship Company, need to be signed by the Sole Proprietor and for Partnership Company, need to be
signed by any one of the partners. The signer / authorized officer shall provide the HKID/Passport copy, which shall be certified as true
copy by a MPF Intermediary, an accounting professional, an estate agent, a legal professional or a Trust or Company Service Provider
licensee.

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 參與協議書

本參與協議書是於 由以下雙方所簽訂

(一) 信安信託﹝亞洲﹞有限公司﹝“受託人”﹞，香港九龍觀塘觀塘道 392 號創紀之城 6 期 30 樓及

(二) [申請人] ﹝ “計劃參與者”﹞，其名稱/姓名及註冊地址填寫在計劃之申請表格內。

引述

(甲) 受託人乃計劃參與者於申請表內所選擇的信安強積金計劃﹝“集成信託計劃”﹞ 的信託人。

(乙) 計劃參與者現欲參與集成信託計劃，為計劃參與者或其僱員成立退休保障。

(丙) 計劃參與者的參與是由集成信託計劃所不時修改的信託契據﹝統稱“契據”﹞及本參與協議書所管限。

條款

一. 除另有所指外，本參與協議書所用字詞的意思均以契據為準。

二. 計劃參與者現參與集成信託計劃，其生效日期﹝計劃生效日期﹞己填寫在計劃之申請表格的第二部份內，並由契據及本參與協議書的條款
所管限。

三. 計劃參與者現與受託人立約承諾遵從並受制於契據及本參與協議書的條款及適用的法律和規例。

四. 計劃參與者已閱畢並完全明白信安強積金計劃說明書及申請表(包括個人資料收集說明書)之內容，並保證申請表所載的資料及所有由其提供
的供款資料，包括年齡、薪酬、服務年資、褔利、投資選擇、更改投資選擇通知書及其他相關資料均為確實毋誤。

五. 計劃參與者除受制於契據及本參與協議書的限制條款外，亦同意承擔補償受託人任何及所有由於以下原由而引致與集成信託計劃或有關計
劃參與者參與集成信託計劃的訴訟、索償或要求所帶來的訴訟費、費用、收費、責任及花費：

甲. 計劃參與者違反條款四所承諾的保證；或

乙. 任何由於計劃參與者疏忽或遺忘依時履行或遵守契據及本參與協議書訂定的責任或其他與計劃參與者及僱員成員相關的責任﹝不論
單與計劃參與者及其僱員成員相關，或與其他計劃參與者及其僱員成員相關﹞。

六. 計劃參與者同意承擔支付所有按契據及本參與協議書條款而需其支付的費用及花費。

七. 本參與協議書可按契據內第二十條條款而終止。

八. 本參與協議書是受香港法律所管限。

代表計劃參與者 信安信託(亞洲)有限公司

X
授權人簽署及公司蓋章 授權人簽署

簽署人姓名及職銜

國籍

此申請表格或同意書必須由董事、公司秘書或經僱主正式授權人士簽署，倘為獨資經營公司，必須由獨資經營者簽署及倘為合伙經營公司，必須由任
何一位合伙人簽署。簽署人/授權代表須提供香港身份證/護照副本，而該文件須經由強積金中介人、會計專業人士、地產代理、法律專業人士或信託
或公司服務持牌人核實為真實副本。

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