Leisure and Cultural Services Department’s Civic Centres
Application for Hire Charges Reduction Scheme          Sha Tin Town Hall
This application will only be considered if the booking has been approved

Confirmed Booking Ref. No.	
Details of Applicant
Name of Organization		

Nature of Organization	
�Y	Registered non-profit-making organization	
�Y	Subsidized / grant-in-aid school	
	�Y	Non-profit district organization	�Y	Registered charitable organization	
	�Y	Others (please specify)		

Details of Booking

Venue		Date		Time		

Nature of Function			
	
Admission of this function is   open to the general public 	 not open	

Admission Fees：     free admission     as the following price schedule 
Price								Estimated total ticket receipts:	
No. of seats								(on a 50% ticket sales basis)	

Financial Information

The function is / will apply for / is applying for / is not* in receipt of subsidy / sponsorship* from the following organization:
 Community Chest    Jockey Club    Government Lottery Fund
 Other Government Department (Please specify)
 Other Charitable Organization (please specify)

A detailed breakdown of the estimated income and expenditure for the function is as follows (including donations and sponsorship from various sources):	

	

	

	

Submission of Documentary Proof

If the applicant organization has, during the past 12 months, applied for and been granted the same kind of rental subsidy / hire charges reduction at an LCSD cultural venue (i.e. civic centre / town hall / theatre, Queen Elizabeth Stadium, museum or the Hong Kong Central Library) and has submitted valid and subsisting documentary proof (such as Constitution / Memorandum and Articles of Association or tax exemption document issued by the Inland Revenue Department) which are still valid to be applicable to the present application, the applicant organization may declare the same below to save the effort of re-submission. However, as different cultural venues may have different levels / forms of rental subsidy / hire charges reduction, the applicant organization may be requested to submit the relevant documents when necessary.

This applicant organization is/is not* an arts organization (whose aim is to promote arts as stated in its Constitution or Memorandum and Articles of Association*). Approval was given to the application made for rental subsidy / hire charges reduction at __________________________________ (name of the venue) in ______________ / _______ (month / year) with the required documentary proof submitted.

*Please delete where inappropriate

The undersigned hereby certifies that all the information furnished on this form is complete and accurate. (To be signed by a responsible officer of the organization, such as the Chairman, Director or General Secretary, etc.)

Name (in block letters)	Mr. / Ms.*	

Post		Tel No.		Fax No.		

Chop of Organization Represented:

Signature of Applicant			

		Date			
 tick if appropriate     *delete where inapplicable
Notes:	(1)	Please read the “Guidelines on Hire Charges Reduction Scheme” overleaf before filling in this form.	
	(2)	This form must be submitted with the following documents:
(i)	Registration of Societies / Companies,
(ii)	Constitution / Ordinance / Articles of Association; and
(iii)	Documentary proof from the Inland Revenue Department approving “Claim for Exemption under Section 88 as of the Inland Revenue Ordinance (Cap.112)” and / or “Approved Charitable Donations”.	
	(3)	The completed form should be returned to Sha Tin Town Hall, 1 Yuen Wo Road, Sha Tin, N.T., Hong Kong.	
	(4)	Enquiries:  (852) 2694 2550-1