弘和仁爱医疗集团有限公司 Hospital Corporation of China Limited (Incorporated in the Cayman Islands with limited liability) （於开曼群岛注册成立的有限公司） GLOBAL OFFERING Number of Offer Shares under the Global Offering : 33,334,000 Shares (subject to Over-allotment Option) Number of Hong Kong Offer Shares : 3,333,600 Shares (subject to adjustment) Number of International Offer Shares : 30,000,400 Shares (subject to adjustment and the Over-allotment Option) Maximum Offer Price : HK$15.00 per Offer Share, plus brokerage of 1%, SFC transaction levy of 0.0027% and Stock Exchange trading fee of 0.005% (payable in full on application in Hong Kong dollars and subject to refund) Nominal value : HK$0.001 per Share Stock code : 3869 全球发售 全球发售的发售股份数目 ： 33,334,000股股份（视乎超额配股权行使与否而定） 香港发售股份数目 ： 3,333,600股股份（可予调整） 国际发售股份数目 ： 30,000,400股股份（可予调整及视乎超额配股权行使与否而定） 最高发售价 ： 每股发售股份15.00港元另加1%经纪佣金、0.0027%证监会交易徵费及 0.005%联交所交易费（须於申请时以港元缴足，可予退款） 面值 ： 每股股份0.001港元 股份代号 ： 3869 Please read carefully the prospectus of Hospital Corporation of China Limited (the “Company”) dated Tuesday, February 28, 2017 (the “Prospectus”) (in particular, the section “How to Apply for the Hong Kong Offer Shares” in the Prospectus) and the guide on the back of this Application Form before completing this Application Form. Terms defined in the Prospectus together with any supplement thereto have the same meanings when used in this Application Form unless defined herein. Hong Kong Exchanges and Clearing Limited, The Stock Exchange of Hong Kong Limited (the “Stock Exchange”) and Hong Kong Securities Clearing Company Limited (“HKSCC”) take no responsibility for the contents of this Application Form, make no representation as to its accuracy or completeness and expressly disclaim any liability whatsoever for any loss howsoever arising from or in reliance upon the whole or any part of this Application Form. A copy of this Application Form, together with a copy of each of the WHITEand YELLOW Application Forms, the Prospectus and the other documents specified in the section headed “Documents Delivered to the Registrar of Companies and Available for Inspection” in Appendix V to the Prospectus, have been registered by the Registrar of Companies in Hong Kong as required by Section 342C of the Companies (Winding Up and Miscellaneous Provisions) Ordinance. The Securities and Futures Commission (the “SFC”) and the Registrar of Companies in Hong Kong take no responsibility as to the contents of any of these documents. Your attention is drawn to the paragraph headed “Personal Data” in the section “How to Apply for the Hong Kong Offer Shares” in the Prospectus which sets out the policies and practices of the Company and its Hong Kong Share Registrar in relation to personal data and compliance with the Personal Data (Privacy) Ordinance. Nothing in this Application Form or the Prospectus constitutes an offer to sell or the solicitation of an offer to buy nor shall there be any sale of Hong Kong Offer Shares in any jurisdiction in which such offer, solicitation or sales would be unlawful. This Application Form and the Prospectus are not for distribution, directly or indirectly, in or into the United States, nor is this application an offer of Shares for sale in the United States. The Offer Shares have not been and will not be registered under the U.S. Securities Act or any state securities law in the United States and may not be offered, sold, pledged or transferred within the United States, except pursuant to an exemption from, or in a transaction not subject to, the registration requirements of the U.S. Securities Act and applicable U.S. state securities laws. The Offer Shares may only be offered and sold outside the United States in offshore transactions in reliance on Regulation S under the U.S. Securities Act and the applicable laws of each jurisdiction where those offers and sales occur. No public offering of the Offer Shares will be made in the United States. This Application Form and the Prospectus may not be forwarded or distributed or reproduced (in whole or in part) in any manner whatsoever in any jurisdiction where such forwarding, distribution or reproduction is not permitted under the law of that jurisdiction. This Application Form and the Prospectus are addressed to you personally. Any forwarding or distribution or reproduction of this Application Form or the Prospectus in whole or in part is unauthorized. Failure to comply with this directive may result in a violation of the U.S. Securities Act or the applicable laws of other jurisdictions. To: Hospital Corporation of China Limited Sole Sponsor Sole Global Coodinator Sole Bookrunner Hong Kong Underwriter 在填写本申请表格前，请仔细阅读弘和仁爱医疗集团有限公司（「本公司」）於二零一七年二月 二十八日（星期二）刊发的招股章程（「招股章程」）（尤其是招股章程「如何申请香港发售股份」 一节）及刊於本申请表格背面的指引。除另有说明外，本申请表格所使用词汇与招股章程连 同其任何增补所界定者具相同涵义。 香港交易及结算所有限公司、香港联合交易所有限公司（「联交所」）及香港中央结算有限公司 （「香港结算」）对本申请表格内容概不负责，对其准确性或完整性亦不发表任何声明，并明确 表示不会就因本申请表格全部或任何部分内容而产生或因依赖该等内容而引致的任何损失承 担任何责任。 本申请表格连同白色及黄色申请表格、招股章程及招股章程附录五「送呈公司注册处处长及 备查文件」一节所列的其他文件，已遵照公司（清盘及杂项条文）条例第342C条的规定，送呈 香港公司注册处处长登记。证券及期货事务监察委员会（「证监会」）和香港公司注册处处长对 此等文件的内容概不负责。 敬请　阁下留意招股章程「如何申请香港发售股份」一节内的「个人资料」一段，当中载有本公 司及本公司的香港证券登记处有关个人资料及遵守《个人资料（私隐）条例》的政策及实际应用 条文。 本申请表格或招股章程所载者概不构成出售要约或要约购买的游说，而在任何作出有关要 约、游说或出售即属违法的司法权区内，概不得出售任何香港发售股份。本申请表格及招股 章程不得在美国境内直接或间接派发，而此项申请亦并非在美国出售股份的要约。发售股份 并无亦将不会根据美国证券法或美国任何州证券法登记，且不得在美国境内发售、出售、抵 押或转让，惟根据美国证券法及适用美国州证券法获豁免登记规定或并非受该等登记规定规 限的交易除外。发售股份只可依据美国证券法S规例以及进行发售及出售的各司法权区适用 法例於离岸交易中在美国境外提呈发售及出售。将不会於美国进行发售股份的公开发售。 在任何根据有关司法权区法律不得发送、派发或复制本申请表格及招股章程之司法权区内， 本申请表格及招股章程概不得以任何方式发送或派发或复制（全部或部分）。本申请表格及招 股章程仅致予　阁下本人。概不得发送或派发或复制本申请表格或招股章程的全部或部分。 如未能遵守此项指令，可能违反美国证券法或其他司法权区的适用法律。 致： 弘和仁爱医疗集团有限公司 独家保荐人 独家全球协调人 独家账簿管理人 香港承销商 2 We, on behalf of the Total number of Hong Kong Offer Shares Hong Kong Offer Shares on behalf of the underlying applicants whose details are contained in underlying applicants, 香港发售股份总数 the read-only CD-ROM submitted with this Application Form. offer to purchase 代表相关申请人提出认购的香港发售股份（申请人的详细资料载於连同本申请表格递 我们（代表相关 交的唯读光碟内）。 申请人）提出认购 3 A total of cheque(s) Cheque number(s) 随附合共 张支票 支票编号 are enclosed for HK$ Name of bank a total sum of 银行名称 其总金额为 港元 Please use BLOCKletters 请用正楷填写 4 Name of White Form eIPO Service Provider 白表eIPO服务供应商名称 Chinese Name White Form eIPO Service Provider ID 中文名称 白表eIPO服务供应商编号 Name of contact person Contact number Fax number 联络人士姓名 联络电话号码 传真号码 Address For Broker use 此栏供经纪填写 地址 Lodged by 申请由以下经纪递交 Broker No. 经纪号码 Broker’s Chop 经纪印章 For Bank use 此栏供银行填写 Hong Kong Public Offering ― White Form eIPO Service Provider Application Form 香港公开发售－白表eIPO服务供应商申请表格 Please use this Application Form if you are a White Form eIPO Service Provider and are applying for Hong Kong Offer Shares on behalf of underlying applicants. 倘　阁下为白表eIPO服务供应商，并代表相关申请人申请认购香港发售股份，请使用本申请表格。 我们确认已(i)遵照电子公开发售指引及透过银行�u股票经纪递交电子首次公开发售 申请的运作程序以及我们就香港公开发售提供白表eIPO服务的所有适用法例及规例 （无论法定与否）；及(ii)阅读招股章程及本申请表格所载的条款和条件及申请手续， 并同意受其约束。为代表与本申请有关的相关申请人作出申请，我们： 按招股章程及本申请表格所载条款及条件，并在遵守组织章程大纲及组织章程细 则的情况下，申请以下数目的香港发售股份； 随附申请香港发售股份所需的全数款项（包括1%经纪佣金、0.0027%证监会交易 徵费及0.005%联交所交易费）； 确认相关申请人已承诺及同意接纳彼等根据本申请所申请的香港发售股份，或任 何较少数目的香港发售股份； 承诺及确认相关申请人及相关申请人为其利益而提出申请的人士并无申请或已申 请或承购或表示有意认购或收取或获配售或分配（包括有条件及�u或暂定），亦将 不会申请或承购或表示有意认购国际发售的任何发售股份，亦不会参与国际发 售； 明白　贵公司与独家全球协调人将依赖此等声明及陈述，以决定是否就本申请配 发香港发售股份，及相关申请人如作出虚假声明，可能会遭受检控； 授权　贵公司将相关申请人的姓名�u名称列入　贵公司股东名册内，作为配发予 彼等的香港发售股份的持有人，而　贵公司及／或其代理（在符合本申请表格所 载条款及条件的规限下）根据本申请表格及招股章程所载程序向相关申请人寄发 股票及／或任何退款支票及／或电子退款指示（如适用），除非相关申请人申请 1,000,000股或以上香港发售股份，并按本申请表格及招股章程所载程序亲身领 取任何股票； 要求把任何电子退款指示发送到相关申请人以单一银行账户缴交申请股款的付款 账户； 要求任何以多个银行账户缴交申请股款之相关申请人的退款支票以相关申请人为 抬头人，并根据本申请表格及招股章程所述程序将任何有关退款支票以普通邮递 方式寄发到申请所列的地址，邮误风险概由相关申请人承担； 确认各相关申请人已细阅本申请表格及招股章程所载条款及条件以及申请手续， 并同意受其约束； 声明、保证及承诺向相关申请人或由相关申请人或为其利益而提出本申请的人士 配发或由该等人士申请香港发售股份，不会引致　贵公司须遵从香港以外任何地 区的法例或规例的任何规定（不论是否具法律效力）； 同意本申请、申请获接纳及因而产生的合约，均受香港法例管辖，并按其诠释； 及 同意　贵公司、独家全球协调人、独家保荐人、独家账簿管理人、独家牵头经办 人、承销商、彼等各自的董事、顾问、代理及参与全球发售的任何其他人士有权 依赖於吾等或相关申请人作出的任何保证、声明或陈述。 Date 日期 Capacity 身份 1 We confirm that we have (i) complied with the Guidelines for Electronic Public Offerings and the Operational Procedures for eIPO Applications submitted via banks/stockbrokers and all applicable laws and regulations (whether statutory or otherwise) in relation to the provision of our White Form eIPO services in connection with the Hong Kong Public Offering; and (ii) read the terms and conditions and application procedures set out in the Prospectus and this Application Form and agree to be bound by them. Applying on behalf of each of the underlying applicants to whom this application relates, we: apply for the number of Hong Kong Offer Shares set out below, on the terms and conditions of the Prospectus and this Application Form, and subject to the Memorandum of Association and the Articles of Association; enclosepayment in full for the Hong Kong Offer Shares applied for, including 1% brokerage, 0.0027% SFC transaction levy and 0.005% Stock Exchange trading fee; confirmthat the underlying applicants have undertaken and agreed to accept the Hong Kong Offer Shares applied for, or any lesser number allocated to such underlying applicants on this application; undertake and confirm that the underlying applicant(s) and the person for whose benefit the underlying applicant(s) is/are applying; or has/have not applied for or taken up, or indicated an interest for, or received or been placed or allocated (including conditionally and/or provisionally), and will not apply for or take up, or indicate an interest for, any Offer Shares under the International Offering nor participate in the International Offering; understandthat these declarations and representations will be relied upon by the Company and the Sole Global Coordinator in deciding whether or not to make any allotment of Hong Kong Offer Shares in response to this application, and that the underlying applicants may be prosecuted if they made a false declaration; authorise the Company to place the name(s) of the underlying applicant(s) on the register of members of the Company as the holder(s) of any Hong Kong Offer Shares to be allotted to them, and our Company and/or its agent (subject to the terms and conditions set out in this Application Form) to send any share certificate(s) and/or any refund cheque and/or e-Refund payment instruction(s) (where applicable) to the that underlying applicant in accordance with the procedures prescribed in this Application Form and in the Prospectus except where the underlying applicant has applied for 1,000,000 or more Hong Kong Offer Shares and that underlying applicant has collected any Share certificate(s) in person in accordance with the procedures prescribed in this Application and in the Prospectus; request that any e-Refund payment instructions be despatched to the application payment account where the underlying applicants had paid the application monies from a single bank account; requestthat any refund cheque(s) be made payable to the underlying applicant(s) who had used multiple bank accounts to pay the application monies and to send any such refund cheque(s) by ordinary post at that underlying applicant’s own risk to the address stated on the application in accordance with the procedures prescribed in this Application Form and in the Prospectus; confirm that each underlying applicant has readthe terms and conditions and application procedures set out in this Application Form and in the Prospectus and agrees to be bound by them; represent, warrant and undertake that the allotment of or application for the Hong Kong Offer Shares to the underlying applicant or by underlying applicant or for whose benefit this application is made would not require the Company to comply with any requirements under any law or regulation (whether or not having the force of law) of any territory outside Hong Kong; agree that this application, any acceptance of it and the resulting contract, will be governed by and construed in accordance with the laws of Hong Kong; and agree that the Company, the Sole Global Coordinator, the Sole Sponsor, the Sole Bookrunner, the Sole Lead Manager, the Underwriters and their respective directors, advisors, agents and any other parties involved in the Global Offering are entitle to rely on any warranty, representation and declaration made by us or the underlying applicants. Signature 签名 Name of signatory 签署人姓名�u名称 Sample 随附 徵费及 确认认相关申 何较少数目的 何较少数目 承诺及确认 承诺及确 相关申 关申 请或承购或表示有意 请或承购或表示有 不会申请或承购或表示 不会申请或承购或 售； 明白 明 　贵公司与独家全球 发香港发售股份，及相 发香港发 授权 授 　贵公司将 彼等的香港 载条款及 股票及 1,00 取 Hong erlying whose benefit hose ben r or taken up, or taken up, o uding conditionally ionally te an interest for, any any he International Offering; g; will be relied upon by the g whether or not to make any ot to make an to this application, and that the on, and that the ade a false declaration; aration; he underlying applicant(s) on the register icant(s) on the register s) of any Hong Kong Offer Shares to be ng Offer S its agent (subject to the terms and conditions ms and co end any share certificate(s) and/or any refund ertificate(s) and/or any refund ruction(s) (where applicable) to the that underlying applicable) to the that underlying rocedures prescribed in this Application Form and in d in this Application Form and in underlying applicant has applied for 1,000,000 or more licant has applied for 1,000,000 or more nd that underlying applicant has collected any Share ing applicant has collected any Share ccordance with the procedures prescribed in this Application procedures prescribed in this Application efund payment instructions be despatched to the application paym ructions be despatched to the ap e underlying applicants had paid the application monies from a ts had paid the application m at any refund cheque(s) be made payable to the underlying appli eque(s) be made payable to the un d multiple bank accounts to pay the application monies and to multiple bank accounts to pay the application m d cheque(s) by ordinary post at that underlying applicant’s own r heque(s) by ordinary post at that underlying app ed on the application in accordance with the procedures prescribe d on the application in accordance with the proc Form and in the Prospectus; rm and in the Pro confirm that each underlying applicant has read onfirm that each underlying applicant the t application procedures set out in this Application Form and pplication procedures set out in this Applica o be bound by them; be bound by them; resent esent, warrant warra and undertake ndert that the allotm Offer Shares to the underlying applicant or erly his application is made would not re made s under any law or regulation ( under any law o utside Hong Kong; utside Hong plication, any acc plic strued in acco y, the M 样版 行发 美国进行 美国进 或复制本申请表格及招股章程之 复制本申请表格及招股章 送或派发或复制 或派发或 （全部或部分） 全部或部分）。本申 派发或复制本申请表格或招股章程的全部 复制本申请表格或招股章程 证券法或其他司法权区的适用法律。 券法或其他司法权区的适用法律。 公司 )遵照电子公开发售指引及透过银行�u股票经纪递交电子首 程序以及我们就香港公开发售提供 程序以及我们就香港公开 白表表eIPO eIP 服务的所有适 的所有 定与否）；及(ii) i)阅读招股章程及本申请表格所载的条款和条 阅读招股章程及本申请表格所载的条款和 意受其约束。为代表与本申请有关的相关申请人作出申请， 束。为代表与本申请有关的相关申请人作出 按招股章程及本申请表格所载条款及条件，并在遵守 章程及本申请表格所载条款及条件，并在 则的情况下， 情况下，申请以下数目的香港发售股份； 以下数目的香港发售股 申请香港发售股份所需的全数款项 港发售股份所需的全数款项（包 .005% %联交所交易费） 联交所交 ； 请人已承诺及同意接纳彼等 人已承诺及同意接纳 香港发售股份； 香港发售股份 请人及相关 认购或 有 样版 Hong Kong Public Offering ― White Form eIPO Service Provider Application Form 香港公开发售－白表eIPO服务供应商申请表格 Please use this Application Form if you are a White Form eIPO Service Provider and are applying for Hong Kong Offer Shares on behalf of underlying applicants. 倘　阁下为白表eIPO服务供应商，并代表相关申请人申请认购香港发售股份，请使用本申请表格。 GUIDE TO COMPLETING THIS APPLICATION FORM References to boxes below are to the numbered boxes on the Application Form. 1 Sign and date the Application Form in Box 1. Only a written signature will be accepted. The name and the representative capacity of the signatory should also be stated. To apply for Hong Kong Offer Shares using this Application Form, you must be named in the list of eIPO Service Providers who may provide White Form eIPO services in relation to the Hong Kong Public Offering, which was released by the SFC. 2 Put in Box 2 (in figures) the total number of Hong Kong Offer Shares for which you wish to apply on behalf of the underlying applicants. Applicant details of the underlying applicants on whose behalf you are applying must be contained in one data file in read-only CD-ROM format submitted together with this Application Form. 3 Complete your payment details in Box 3. You must state in this box the number of cheque(s) you are enclosing together with this Application Form; and you must state on the reverse of each of those cheque(s) (i) your White Form eIPO Service Provider ID and (ii) the file number of the data file containing application details of the underlying applicant(s). The dollar amount(s) stated in this box must be equal to the amount payable for the total number of Hong Kong Offer Shares applied for in Box 2. All cheque(s) and this Application Form together with a sealed envelope containing the CD-ROM, if any, must be placed in the envelope bearing your company chop. For payments by cheque, the cheque must: be in Hong Kong dollars; be drawn on a Hong Kong dollar bank account in Hong Kong; show your (or your nominee’s) account name; be made payable to “Wing Lung Bank (Nominees) Limited �C Hospital Corporation Public Offer”; be crossed “Account Payee Only”; not be post-dated; and be signed by the authorised signatories of the White Form eIPO Service Provider. Your application may be rejected if any of these requirements is not met or if the cheque is dishonoured on its first presentation. It is your responsibility to ensure that details on the cheque(s) submitted correspond with the application details contained in the CD-ROM or data file submitted in respect of this application. The Company and the Sole Global Coordinator have full discretion to reject any applications in the case of discrepancies. No receipt will be issued for sums paid on application. 4 Insert your details in Box 4 (using BLOCK letters). You should write your name, White Form eIPO Service Provider ID and address in this box. You should also include the name and telephone number of the contact person at your place of business and where applicable, the Broker No. and Broker’s Chop. Personal Data Personal Information Collection Statement This Personal Information Collection Statement informs the applicant for, and holder of, Hong Kong Offer Shares, of the policies and practices of the Company and its Hong Kong Share Registrar in relation to personal data and the Personal Data (Privacy) Ordinance (Chapter 486 of the Laws of Hong Kong) (the “Ordinance”). 1. Reasons for the collection of your personal data It is necessary for applicants and registered holders of securities to supply their latest correct personal data to the Company or its agents and/or the Hong KongShare Registrar when applying for securities or transferring securities into or out of their names or in procuring the services of the Hong Kong Share Registrar. Failure to supply the requested data may result in your application for securities being rejected, or in delay or the inability of the Company or its Hong Kong Share Registrar to effect transfers or otherwise render their services. It may also prevent or delay registration or transfers of the Hong Kong Offer Shares which you have successfully applied for and/or the despatch of share certificate(s) and/or e-Refund payment instructions and/or refund cheque(s) to which you are entitled. It is important that securities holders inform the Company and the Hong Kong Share Registrar immediately of any inaccuracies in the personal data supplied. 2. Purposes The personal data of the securities holders may be held and processed for the following purposes: processing your application and e-Refund payment instructions and refund cheque, where applicable, verification of compliance with the terms and application procedures set out in this Application Form and the Prospectus and announcing results of allocation of the Hong Kong Offer Shares; compliance with applicable laws and regulations in Hong Kong and elsewhere; registering new issues or transfers into or out of the names of securities holders including, where applicable, HKSCC Nominees; maintaining or updating the register of securities holders of the Company; conducting or assisting to conduct signature verifications, any other verifications or exchange of information; establishing benefit entitlements of securities holders of the Company, such as dividends, rights issues and bonus issues, etc; distributing communications from the Company and its subsidiaries; compiling statistical information and securities holder profiles; disclosing relevant information to facilitate claims on entitlements; and any other incidental or associated purposes relating to the above and/or to enable the Company and the Hong Kong Share Registrar to discharge their obligations to securities holders and/or regulators and/or any other purposes to which the securities holders may from time to time agree. 3. Transfer of personal data Personal data held by the Company and its Hong Kong Share Registrar relating to the securities holders will be kept confidential but the Company and its Hong Kong Share Registrar may, to the extent necessary for achieving any of the above purposes, disclose, obtain, transfer (whether within or outside Hong Kong) the personal data of the applicants and the holders of securities to, from or with any and all of the following persons and entities: the Company’s appointed agents such as financial advisers, receiving bank and overseas principal share registrar; where applicants for securities request a deposit into CCASS, HKSCC or HKSCC Nominees, who will use the personal data for the purposes of operating CCASS; any agents, contractors or third-party service providers who offer administrative, telecommunications, computer, payment or other services to the Company or the Hong Kong Share Registrar in connection with the operation of their respective business; the Stock Exchange, the SFC and any other statutory regulatory or governmental bodies or otherwise as required by laws, rules or regulations; and any persons or institutions with which the securities holders have or propose to have dealings, such as their bankers, solicitors, accountants or stockbrokers etc. 4. Retention of personal data The Company and its Hong Kong Share Registrar will keep the personal data of the applicants and holders of securities for as long as necessary to fulfil the purposes for which the personal data were collected. Personal data which is no longer required will be destroyed or dealt with in accordance with the Ordinance. 5. Access to and correction of personal data The Ordinance provides the Securities holders have the right to ascertain whether the Company or the Hong Kong Share Registrar hold their personal data, to obtain a copy of that data, and to correct any data that is inaccurate. In accordance with the Ordinance, the Company and the Hong Kong Share Registrar have the right to charge a reasonable fee for the processing of any data access requests. All requests for access to data or correction of data should be addressed to us, at our registered address disclosed in the “Corporate Information” section of the Prospectus or as notified from time to time, for the attention of the company secretary, or to the Hong Kong Share Registrar for the attention of the privacy compliance officer for the purposes of the Ordinance. By signing an Application Form, you agree to all of the above. 填写本申请表格的指引 下列号码指申请表格中各栏的编号。 1 在申请表格栏1签署及填上日期。只接受亲笔签名。 签署人的姓名�u名称及代表身份亦必须注明。 使用本申请表格申请香港发售股份，　阁下必须为名列於证监会公布的电 子首次公开发售服务供应商名单内可以就香港公开发售提供白表eIPO服 务的人士。 2 在栏2填上　阁下欲代表相关申请人申请认购的香港发售股份总数（以数字 填写）。 阁下代表相关申请人作出申请的申请人资料必须放置於一个连同本申请表 格递交的唯读光碟格式的资料档案内。 3 在栏3填上　阁下的付款详情。 阁下必须在本栏注明　阁下连同本申请表格随附的支票数目；及　阁下必 须在每张支票的背面注明(i)　阁下的白表eIPO服务供应商编号及(ii)载有 相关申请人申请详细资料的资料档案的档案编号。 本栏所注明的金额必须与栏2所申请认购的香港发售股份总数对应金额相 同。 所有支票及本申请表格，连同装有该光碟的密封信封（如有）必须放进加 盖　阁下公司印章的信封内。 倘以支票付款，该支票必须： 为港元支票； 由在香港的港元银行账户开出； 显示　阁下（或　阁下的代名人）的账户名称； 注明抬头人为「永隆银行受托代管有限公司－弘和仁爱公开发售」； 划线注明「只准入抬头人账户」； 不得为期票；及 由白表eIPO服务供应商的授权签署人签署。 倘支票不符合上述任何规定；或支票首次过户不获兑现，则　阁下的申请 可遭拒绝受理。 阁下须确保所递交的支票的详细资料，与就本申请递交的光碟或资料档案 所载的申请详细资料相同。倘有差异，本公司及独家全球协调人有绝对酌 情权拒绝接受任何申请。 申请所缴付的金额不会获发收据。 4 在栏4填上　阁下的详细资料（用正楷）。 阁下必须在本栏填上　阁下的名称、白表eIPO服务供应商编号及地 址。　阁下亦必须填写　阁下办公地点的联络人士的姓名及电话号码及 （如适用）经纪号码及盖上经纪印章。 个人资料 个人资料收集声明 此项个人资料收集声明是向香港发售股份的申请人和持有人说明有关本公司及其 香港证券登记处有关个人资料和香港法例第486章《个人资料（私隐）条例》（「条 例」）方面的政策和惯例。 1. 收集　阁下个人资料的原因 证券申请人及登记持有人以本身名义申请证券或转让或受让证券时或寻求 香港证券登记处的服务时，必须向本公司或其代理人及�u或香港证券登记 处提供其最新的准确个人资料。 未能提供所要求的资料可能导致　阁下申请证券被拒或延迟，或本公司或 其香港证券登记处无法落实转让或提供服务。此举也可能妨碍或延迟登记 或转让　阁下成功申请的香港发售股份及�u或寄发　阁下应得的股票及／ 或电子退款指示及�u或退款支票。 证券持有人所提供的个人资料如有任何错误，须立即通知本公司及香港证 券登记处。 2. 目的 证券持有人的个人资料可作以下目的持有及处理： 处理　阁下的申请及电子退款指示及退款支票（如适用）、核实是否 符合本申请表格及招股章程载列的条款和申请程序以及公布香港发 售股份的分配结果； 遵守香港及其他地区的适用法律及法规； 以证券持有人（包括香港结算代理人（如适用））的名义登记新发行证 券或转让或受让证券； 存置或更新本公司证券持有人的名册； 进行或协助进行签名核对、任何其他核对或交换资料； 确定本公司证券持有人的受益权利，例如股息、供股和红股等； 分发本公司及其附属公司的通讯； 编制统计数据和证券持有人资料； 披露有关资料以便就权益索偿；及 与上述有关的任何其他附带或相关目的及�u或使本公司及香港证券 登记处能履行对证券持有人及�u或监管机构承担的责任及�u或证券 持有人不时同意的任何其他目的。 3. 转交个人资料 本公司及其香港证券登记处所持有关证券持有人的个人资料将会保密，但 本公司及其香港证券登记处可以在为达到上述任何目的之必要情况下，向 下列任何及所有人士及实体披露、索取或转交证券申请人及持有人的个人 资料（无论在香港境内或境外）： 本公司委任的代理人，例如财务顾问、收款银行和主要海外证券登 记处； 如证券申请人要求将证券存於中央结算系统、香港结算或香港结算 代理人；彼等将会就中央结算系统的运作使用有关个人资料； 向本公司或香港证券登记处提供与其各自业务营运有关的行政、电 讯、电脑、付款或其他服务的任何代理人、承包商或第三方服务供 应商； 联交所、证监会及任何其他法定监管机关或政府部门或其他法例、 规则或法规所要求的机构；及 证券持有人与其进行或拟进行交易的任何人士或机构，例如彼等的 银行、律师、会计师或股票经纪等。 4. 个人资料的保留 本公司及其香港证券登记处将按收集个人资料所需的用途保留证券申请人 及持有人的个人资料。无需保留的个人资料将会根据条例销毁或处理。 5. 查阅和更正个人资料 条例赋予证券持有人有权确定本公司或香港证券登记处是否持有其个人资 料，并有权索取有关该资料的副本并更正任何不准确资料。根据条例规 定，本公司和香港证券登记处有权就处理任何查阅资料的要求收取合理费 用。 根据条例，所有查阅资料或更正资料的要求应按招股章程「公司资料」一 节所披露或不时通知的本公司注册地址送交公司秘书，或向香港证券登 记处的个人资料私隐事务主任提出。 阁下签署申请表格，即表示同意上述各项。 DELIVERY OF THIS APPLICATION FORM This completed Application Form, together with the appropriate cheque(s) must be submitted to the following receiving bank by 4:00 p.m. on Thursday, March 9, 2017 together with a sealed envelope containing the CD-ROM: Room 1503, 15/F Wing Lung Bank Centre 636 Nathan Road Kowloon Hong Kong 递交本申请表格 填妥的申请表格，连同有关支票以及载有相关光碟的密封信封，必须於二零一七 年三月九日（星期四）下午四时正之前，送达下列地址： 香港九龙 旺角弥敦道636号 永隆银行中心 十五楼三室 Sample e fund Kong Share Kong S ied. and processed for the ayment instructions and refund ons and refund of compliance with the terms and with the terms and Application Form and the Prospectus m and the Prospectus n of the Hong Kong Offer Shares; Offer Shar e laws and regulations in Hong Kong and ulations in Hong Kong and s or transfers into or out of the names of securities nto or out of the names of securities where applicable, HKSCC Nominees; , HKSCC No r updating the register of securities holders of the Company gister of securities holders of the Company ng or assisting to conduct signature verifications, any o conduct signature verific ations or exchange of information; nge of information; tablishing benefit entitlements of securities holders of the Co ablishing benefit entitlements of securities hol as dividends, rights issues and bonus issues, etc; dividends, rights issues and bonus issues, e distributing communications from the Company and it distributing communications from the C compiling statistical information and securities ho istical information an disclosing relevant information to facilitate c disclosing relevant information t any other incidental or associated purpos any other incidental or a nable the Company and the Hong Ko y an gations to securities holders and tions to securitie h the securities holders m h the securi nal data al e Com 或 或电 证券持有人所 券登记处。 券 2. 目的 证券持有人的个人资料 证券持有人 处理　阁 符合本 售股 样版 、白表eIPO服务供 公地点的联络人士的姓名及 点的联络人士的姓 印章。。 是向香港发售股份的申请人和持有人说明有关本公司及其 发售股份的申请人和持有人说明有关 个人资料和香港法例第 资料和香港法例 486章《个人资料（私隐） 《个人资料（私隐条例》 惯例。 惯例 阁下个人资料的原因 证券申请人及登记持有人以本身名义申请证券或转让或受 请人及登记持有人以本身名义申请证券或转让或 香港证券登记处的服务时，必须向本公司或其代理人及 香港证券登记处的服务时，必须向本公司或其代 处提供其最新的准确个人资料。 处提供其最新的准确个人资 未能提供所要求的资料可能导致　阁下申请 未能提供所要求的资料可能导致　 其香港证券登记处无法落实转让或提供服 其香港证券登记处无法落实转让或提 或转让　阁下成功申请的香港发售股份 阁下成功申请的香港发售股 电子退款指示及�u或退款支票。 退款指示及�u或退款 提供的个人资 个人