This Application Form uses the same terms as defined in the prospectus of New Century Healthcare Holding Co. Limited (the “Company”) dated December 30, 2016 (the “Prospectus”). 本申请表格使用新世纪医疗控股有限公司（「本公司」）於二零一六年十二月三十日刊发的招股章程（「招股章 程」）所界定的词语。 Neither this Application Form nor the Prospectus constitutes an offer to sell or the solicitation of an offer to buy any Hong Kong Public Offer Shares in any jurisdiction other than Hong Kong. The Hong Kong Public Offer Shares may not be offered or sold in the United States without registration or an exemption from registration under the U.S. Securities Act. 本申请表格及招股章程概不构成在香港以外司法权区要约出售或游说要约购买香港公开发售股份。若无根据美 国《证券法》登记或豁免登记，香港公开发售股份不得在美国提呈发售或出售。 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. 任何根据当地法例不得发送、派发或复制本申请表格及招股章程的司法权区内概不得发送或派发或复制（不论 方式，也不论全部或部分）本申请表格及招股章程。 Copies of the Prospectus, all related Application Forms and the other documents specified in the “Documents Delivered to the Registrar of Companies and Available for Inspection” section in Appendix V to the Prospectus, have been registered by the Registrar of Companies in Hong Kong as required by section 342C of Companies (Winding Up and Miscellaneous Provisions) Ordinance (Chapter 32 of the Laws of Hong Kong). Hong Kong Exchanges and Clearing Limited, The Stock Exchange of Hong Kong Limited (the “Hong Kong Stock Exchange”), Hong Kong Securities Clearing Company Limited (“HKSCC”), the Securities and Futures Commission of Hong Kong (the “SFC”) and the Registrar of Companies of Hong Kong take no responsibility for the contents of these documents. 招股章程、所有相关申请表格及招股章程附录五「送呈公司注册处处长及备查文件」一节所述其他文件已按香 港法例第32章《公司（清盘及杂项条文）条例》第342C条规定送呈香港公司注册处处长登记。香港交易及结算所 有限公司、香港联合交易所有限公司（「香港联交所」）、香港中央结算有限公司（「香港结算」）、香港证券及期 货事务监察委员会（「证监会」）及香港公司注册处处长对此等文件的内容概不负责。 New Century Healthcare Holding Co. Limited 新世纪医疗控股有限公司 (incorporated in the Cayman Islands with limited liability) （於开曼群岛注册成立的有限公司） Stock code : 1518 股份代号 : 1518 Maximum Offer Price : HK$8.36 per Offer Share plus brokerage of 1.0%, SFC transaction levy of 0.0027% and Hong Kong Stock Exchange trading fee of 0.005% (payable in full on application in Hong Kong dollars and subject to refund) 最高发售价 ： 每股发售股份8.36港元，另加1.0%的 经纪佣金、0.0027%的证监会交易徵费 及0.005%的香港联交所交易费（须於申请时 以港元缴足且可予退还） You should read this Application Form in conjunction with the Prospectus, which contains further information on the application procedures. 招股章程尚有关於申请程序的其他资料，本申请表格应与招股章程一并阅读。 Application Form 申请表格 Please use this form if you want the Hong Kong Public Offer Shares to be issued in your name 如　阁下欲以本身名义登记将获发行的香港公开发售股份，请使用本表格 Staple your payment here 请将股款 紧钉在此 致： 新世纪医疗控股有限公司 联席保荐人 联席全球协调人 香港包销商 申请人声明 本人／吾等同意本申请表格及招股章程的条款及 条件以及申请程序。见本申请表格「填交本申请 表格的效用」一节。 警告：任何人士只限作出一次为其利益而进行的 认购申请。请参阅「填交本申请表格的效用」一节 最後四点。 To: New Century Healthcare Holding Co. Limited Joint Sponsors Joint Global Coordinators The Hong Kong Underwriters Applicants’ declaration I/We agree to the terms and conditions and application procedures in this Application Form and the Prospectus. Please refer to the “Effect of completing and submitting this Application Form” section of this Application Form. Warning: Only one application may be made for the benefit of any person. Please refer to the last four bullets of “Effect of completing and submitting this Application Form” section. Sample hcare Holdin Holdin 疗控股有限 the Cayman Islands with limited e Cayman Islands with limit 开曼群岛注册成立的有限公司） 岛注册成立的有限公司 Stock code : 1518 :1 股份代号 份代号 : 1518 1518 Maximum Offer Price : HK$8.36 per Offer Price : HK SFC trans Stock E on ap ref 最高发售价 ： uld read this Application Form in conju his Application Form pp am application procedures. pp p Sa 股章程尚有关於申请程序的其他资料 股章程尚有关於申请程序的 Ap New Century Healthcare Hold New Century He oint Sponsors t Global Coordinator Global Co ong Kong Unde ong K aration 样版 售股 hole or in part) e or i under the law of that der th 概不得发送或派发或复 得发送或派发或 fied in the “Documents Delivered to the “Documents Deliv e Prospectus, have been registered by th Prospectus, have been register (Winding Up and Miscellaneous Provisions) (Winding Up and Miscellaneous Pr Clearing Limited, The Stock Exchange of Hong earing Limited, The Stock Exchange of Hong aring Company Limited (“HKSCC”), the Securities ompany Limited (“HKSCC”), the Securities ompanies of Hong Kong take no responsibility for the Hong Kong take no responsibilit 注册处处长及备查文件」 册处处长及备查文件」一节所述其他文件已按 一节所述其他文件 定送呈香港公司注册处处长登记。香港交易及结 香港公司注册处处长登记。香港交易及 香港中央结算有限公司 香港中央结算有限公（「香港结算」 香港结算」）、香港证 长对此等文件的内容概不负责。 此等文件的内容概 ing Co. Limited g Co. Limi 限公司 liabil Please use this form if you want the Hong Kong Public Offer Shares to be issued in your name 如　阁下欲以本身名义登记将获发行的香港公开发售股份，请使用本表格 Signed by (all) applicant(s) (all joint applicants must sign): 由（所有）申请人签署（所有联名申请人必须签署）： ........................................................................................................................... Date: 日期：..............................／..............................／.............................. D 日 M 月 Y 年 Number of Hong Kong Public Offer Shares applied for (not more than 6,000,000 shares) 申请香港公开发售股份数目（不超过6,000,000股股份） Total amount 总额 HK$ 港元 Name in English 英文姓名／名称 Family name or company name 姓氏或公司名称 Forename(s) 名字 Name in Chinese 中文姓名／名称 Family name or company name 姓氏或公司名称 Forename(s) 名字 Occupation in English 职业（以英文填写） Names of all other joint applicants in English (if any) 所有其他联名申请人的英文姓名�u名称（如有） 1) 2) 3) Hong Kong address in English and telephone no. (joint applicants should give the address and the telephone number of first-named applicant only)香港地址（以英文填写）及电话号码（联名申请人只须填写排名首位申请人的地址及电话号码） Telephone No. 电话号码 For Nominees: You will be treated as applying for your own benefit if you do not complete this section. Please provide an account number or identification code for each (joint) beneficial owner. 由代名人递 交：代名人若不填写本节，是项认购申请将视作为　阁下利益 提出。请填写每名（联名）实益拥有人的账户号码或识别编 码。 ADDRESS LABEL 地址标贴(Your name(s)and address in Hong Kong in BLOCK letters 请用英文正楷填写姓名�u名称及香港地 址) For Internal use 此栏供内部使用 For Broker use 此栏供经纪填写 Lodged by递交申请的经纪 Broker No. 经纪号码 Broker’s Chop 经纪印章 Cheque/banker’s cashier order number 支票�u银行本票号码 Name of bank on which cheque/Banker’s cashier order is drawn (see “How to make your application” section) 兑现支票�u银行 本票的银行名称（见「申请手续」一节） Hong Kong Identity Card No./Passport No./Hong Kong Business Registration No.* (Please delete as appropriate)香港身份证号码�u 护照号码�u香港商业登记号码*（请删除不适用者） Hong Kong Identity Card No./Passport No./Hong Kong Business Registration No. of all other joint applicants* (Please delete as appropriate) 所有其他联名申请人的香港身份证号码�u护照号码 �u香港商业登记号码*（请删除不适用者） 1) 2) 3) Sample For l ny) （如有） mplpl mp nglish and telephone no. (joint applicants should ephone no. (joint applicants should 英文填写）及电话号码（联名申请人只须填写 及电话号码（联名申请人只须填写 Samp am Nominees: You will be treated as applying for yo ominees: You will be treated as app you do not complete this section. Please provide a u do not complete this section. Ple identification code for each (joint) beneficial entification code for each (joint) 代名人若不填写本节，是项认购申请 代名人若不填写本节，是项 请填写每名（联名）实益拥有 请填写每名（联名 S le L地址标贴 rs请 Hong Kon Registration N gistration 护照号码�u香港 g le p Hong Kong Identity Car Hong Kong Ide Registration No. of a Regi appropriate) ppropria 所有其 �u香港商业登记 香港 pp p pp p1) p2) 3) 样版 ame(s) )名字 样 ename(s) ame(s) 名字 样版版 er 支票�u银行本票 支票�u银行本 样版 heque/Banker que/B ’s cashier order is drawn s cashier order is ur application application”section) 兑现支票�u银行 见「申请手续」一节） 申请手续」一 g Identity Card No./Pas dentity Card No No.* (Please delete .* (Please dele 港商业登记号 港商业登记 样 Please use this form if you want the Hong Kong Public Offer Shares to be issued in your name 如　阁下欲以本身名义登记将获发行的香港公开发售股份，请使用本表格 * (1)An individual must provide his Hong Kong Identity Card number or, if he does not hold a Hong Kong Identity Card, his passport number. A body corporate must provide its Hong Kong Business Registration number. Each joint applicant must provide its or his relevant number. The Hong Kong Identity Card number(s)/passport number(s)/ Hong Kong Business Registration number(s) will be transferred to a third party for checking the Application Form’s validity. 个别人士须填写其香港身份证号码或（如非香港身份证持有人）护照号码。法人团体须填写其香 港商业登记号码。每名联名申请人均须提供其相关号码。该等香港身份证号码�u护照号码�u香 港商业登记号码将转交第三方以核实申请表格的有效性。 (2) Part of the Hong Kong Identity Card number/passport number of you or, for joint applicants, the first-named applicant may be printed on your refund cheque (if any). Your banker may require verification of your Hong Kong Identity Card number/passport number before you can cash your refund cheque. 日後如需退回申请股款，退款支票上或会印有　阁下或（如属联名申请人）排名首位申请人的香 港身份证号码�u护照号码的一部分。银行兑现退款支票前或会要求查证　阁下的香港身份证号 码�u护照号码。 (3) If an application is made by an unlisted company and: the principal business of that company is dealing in securities; and you exercise statutory control over that company, then the application will be treated as being made for your benefit. 倘若申请人是一家非上市公司，而： 该公司主要从事证券买卖业务；及 阁下对该公司可行使法定控制权， 是项申请将视作为　阁下的利益提出。 Sample se y, for your benefit benefit ；及及 制权， 利益提出。 样版 法人团体须 人团 证号码�u护照号码 号码�u护照号 for joint applicants, the first-named or joint applicants, the first-named require verification of your Hong Kong e verification of your Hong Kong nd cheque. d chequ （如属联名申请人） 属联名申请人）排名首位申请人的 排名首位申请人 支票前或会要求查证　阁下的香港身 票前或会要求查证　阁下的香港身 ecurities; and urities; and t This page is intentionally left blank 此乃白页特意留空 Sample le page is intentionally left blank ge is intentionally left blan ple 此乃白页特意留空 白页特意留空 样版 样 Please use this form if you want the Hong Kong Public Offer Shares to be issued in your name How to make your application 1. Use the table below to calculate how much you must pay. Your application must be for a minimum of 500 Hong Kong Public Offer Shares and in one of the numbers set out in the table, or your application will be rejected. * Maximum number of Hong Kong Public Offer Shares you may apply for. 2. Complete the form in English and sign it. Only written signatures will be accepted (and not by way of personal chop). 3. Staple your cheque or banker’s cashier order to the form. Each application for the Hong Kong Public Offer Shares must be accompanied by either one separate cheque or one separate banker’s cashier order. Your application will be rejected if your cheque or banker’s cashier order does not meet all the following requirements: The cheque must: Banker’s cashier order must: be in Hong Kong dollars; not be post-dated; be made payable to “HORSFORD NOMINEES LIMITED-NEW CENTURY HEALTHCARE PUBLIC OFFER”; be crossed “Account Payee Only”; be drawn on your Hong Kong dollar bank account in be issued by a licensed bank in Hong Kong, and have Hong Kong; and your name certified on the back by a person authorised show your account name, which must either be by the bank. The name on the banker’s cashier order pre-printed on the cheque, or be endorsed on the back must correspond with your name. If it is a joint by a person authorised by the bank. This account application, the name on the back of the banker’s cashier name must correspond with your name. If it is a joint order must be the same as the first-named applicant’s application, the account name must be the same as name. the first-named applicant’s name. NUMBER OF HONG KONG PUBLIC OFFER SHARES THAT MAY BE APPLIED FOR AND PAYMENTS Number of Amount payable Number of Amount payable Number of Amount payable Hong Kong Public Offer on application Hong Kong Public Offer on application Hong Kong Public Offer on application Shares applied for HK$ Shares applied for HK$ Shares applied for HK$ 500 4,222.12 1,000 8,444.25 1,500 12,666.37 2,000 16,888.49 2,500 21,110.61 3,000 25,332.73 3,500 29,554.85 4,000 33,776.97 4,500 37,999.10 5,000 42,221.22 6,000 50,665.46 7,000 59,109.71 8,000 67,553.95 9,000 75,998.19 10,000 84,442.44 15,000 126,663.66 20,000 168,884.87 25,000 211,106.09 30,000 253,327.31 35,000 295,548.53 40,000 337,769.75 45,000 379,990.97 50,000 422,212.19 60,000 506,654.62 70,000 591,097.06 80,000 675,539.50 90,000 759,981.93 100,000 844,424.37 200,000 1,688,848.74 300,000 2,533,273.12 400,000 3,377,697.49 500,000 4,222,121.86 600,000 5,066,546.23 700,000 5,910,970.60 800,000 6,755,394.98 900,000 7,599,819.35 1,000,000 8,444,243.72 2,000,000 16,888,487.44 3,000,000 25,332,731.16 4,000,000 33,776,974.88 5,000,000 42,221,218.60 6,000,000 * 50,665,462.32 Sample apply for. y written signatures w ignatures order to the form. Each application fo to the form. Each applicat eparate cheque or one separate banker e or one separate b ’s ker’s cashier order does not meet all the fo er order does not m Sampl mplBanker ank ’s cash rs; to “HORSFORD NOMINEES LIMIT SFORD NOMINEES LIMI Account Payee Only ayee O ”; am wn on your Hong Kong dollar bank acco ur Hong Kong dollar b ng Kong; and g Kong; and show your account name, which must eit how your account name, which pre-printed on the cheque, or be endors pre-printed on the cheque, or b by a person authorised by the bank by a person authorised by name must correspond with you name must corresp plication, the account nam acc rst-named applicant st-named ap ’ ,533, 样版 will be accepte ill be accep 样版 样 62 7.06 ,539.50 539.50 59,981.93 9,981.93 844,424.37 24.37 88,848.74 48.74 版 Am Offer on a ro 版 d for HK r 273.12 273 12 0 3,377,697.49 3,377,697 ,000 4,222,121.86 4,222,121.8 00,000 5,066,546.23 700,000 5,910,970.60 800,000 6,755,394.98 900,000 7,599,819.35 00,000 7,599,819.35 1,000,000 8,444,243.72 000 8,444,243.72 2,000,000 16,888,487.44 3,000,000 25,332,731.16 4,000,000 33,776,974. 4,000,000 33,776,974 5,000,000 42,221,21 5,000,000 42,2 6,000,000 6,000,00 * 50,665 50,6 Please use this form if you want the Hong Kong Public Offer Shares to be issued in your name 4. Tear off the Application Form, fold it once and lodge your completed Application Form (with cheque or banker’s cashier order attached) to one of the collection boxes at any of the following branches of: Standard Chartered Bank (Hong Kong) Limited District Branch Address Hong Kong Island Des Voeux Road Branch Standard Chartered Bank Building, 4-4A, Des Voeux Road Central, Central Hennessy Road Branch 399 Hennessy Road, Wanchai Kowloon Kwun Tong Branch G/F, 414 Kwun Tong Road, Kowloon Mongkok Branch Shop B, G/F, 1/F & 2/F, 617-623 Nathan Road, Mongkok New Territories Metroplaza Branch Shop No. 175, Level 1, Metroplaza, 223 Hing Fong Road, Kwai Chung Tuen Mun Town Plaza Branch Shop No. G047-G052, Tuen Mun Town Plaza Phase I, Tuen Mun 5. Your Application Form can be lodged at these times: Friday, December 30, 2016 ― 9:00 a.m. to 5:00 p.m. Saturday, December 31, 2016 ― 9:00 a.m. to 1:00 p.m. Tuesday, January 3, 2017 ― 9:00 a.m. to 5:00 p.m. Wednesday, January 4, 2017 ― 9:00 a.m. to 5:00 p.m. Thursday, January 5, 2017 ― 9:00 a.m. to 5:00 p.m. Friday, January 6, 2017 ― 9:00 a.m. to 5:00 p.m. Saturday, January 7, 2017 ― 9:00 a.m. to 1:00 p.m. Monday, January 9, 2017 ― 9:00 a.m. to 5:00 p.m. Tuesday, January 10, 2017 ― 9:00 a.m. to 5:00p.m. Wednesday, January 11, 2017 ― 9:00 a.m. to 12:00 noon 6. The latest time for lodging your application is 12:00 noon on Wednesday, January 11, 2017. The application lists will be open between 11:45 a.m. and 12:00 noon on that day, subject only to the weather conditions, as described in “10. Effect of Bad Weather on the Opening of the Application Lists” in the “How to Apply for Hong Kong Public Offer Shares” section of the Prospectus. The application for the Hong Kong Public Offer Shares will commence on Friday, December 30, 2016 through Wednesday, January 11, 2017, being slightly longer than normal market practice of four days. The application monies (including the brokerages, SFC transaction levies and Hong Kong Stock Exchange trading fees) will be held by the receiving bank on behalf of the Company and the refund monies, if any, will be returned to the applicants without interest on Tuesday, January 17, 2017. Investors should be aware that the dealings in the Shares on the Stock Exchange are expected to commence on Wednesday, January 18, 2017. Sample 9:0 ―9:00 a 17 ―9:00 a.m 00 a.m 2017 0 ―9:00 a.m. to 5, 2017 , 2017 ―9:00 a.m. to 5: 9:00 a.m. to ary 6, 2017 , 2017 ―9:00 a.m. to 5:00 9:00 a.m. to nuary 7, 2017 ―9:00 a.m. to 1:00 p 00 a.m. to January 9, 2017 9, 2017 ―9:00 a.m. to 5:00 9:00 a y, January 10, 2017 10, 2017 ―9:00 a.m. to 5 9:00 a day, January 11, 2017 ry 11, 2017 ―9:00 a.m. to 9:0 ging your application is 12:00 noon on W application is 12:00 no en 11:45 a.m. and 12:00 noon on that day . and 12:00 noon on f Bad Weather on the Opening of the Ap ther on the Opening of the A Shares”section of the Prospectus. ction of the Prospectu lication for the Hong Kong Public Offer r the Hong Kong Pub nesday, January 11, 2017, being slightly anuary 11, 2017, bein onies (including the brokerages, SFC tra nies (including the brokerages held by the receiving bank on behalf o held by the receiving bank o applicants without interest on Tuesda applicants without interest on the Stock Exchange are expect on the Stock Exchange ar 样版 uilding, ding Central, Central ntral Wanchai ancha Tong Road, Kowloon ong Road, Kowlo 1/F & 2/F, /F & 2/F, Nathan Road, Mongkok Road, Mongkok No. 175, Level 1, Metroplaza, No. 175, Level 1, Metropla 3 Hing Fong Road, Kwai Chung ng Fong Road, Kwai Chung Shop No. G047-G052, hop No. G047-G Tuen Mun Town Plaza Phase I, Tuen uen Mun Town Plaza Phase I, T 00 a.m. to 5:00 p.m. 0 a.m. to 5:00 p.m. a.m. to 1:00 p.m. . to 1:00 p m. to 5:00 p.m. to 5:00 p.m. o 5:00 p.m. o 5:00 p.m :00 p.m 如　阁下欲以本身名义登记将获发行的香港公开发售股份，请使用本表格 申请手续 1. 使用下表计算　阁下应付的款项。　阁下申请认购的股数须至少为500股香港公开发售股份，并 为下表所列的其中一个数目，否则恕不受理。 * 阁下可申请认购的香港公开发售股份最高数目。 2. 以英文填妥及签署申请表格。只接纳亲笔签名（不得以个人印章代替）。 3. 阁下须将支票或银行本票钉於表格上。每份香港公开发售股份申请须附一张独立开出支票或一 张独立开出银行本票。支票或银行本票必须符合以下所有规定，否则有关的认购申请不获接 纳： 支票必须： 银行本票必须： 为港元； 不得为期票； 注明抬头人为「浩丰代理人有限公司－新世纪医疗公开发售」； 划线注明「只准入抬头人账户」； 从　阁下在香港的港元银行账户中开出；及 须由香港持牌银行开出，并由有关银行授权 显示　阁下的账户名称，而该账户名称必须 的人士在银行本票背面签署核证　阁下姓名 已预印在支票上，或由有关银行授权的人士 ／名称。银行本票所示姓名／名称须与　阁 在支票背书。账户名称必须与　阁下姓名／ 下姓名／名称相同。如属联名申请，银行本 名称相同。如属联名申请，账户名称必须与 票背面所示姓名／名称必须与排名首位申请 排名首位申请人的姓名／名称相同。 人的姓名／名称相同。 可供申请认购的香港公开发售股份数目及应缴款项一览表 申请认购的 申请时 申请认购的 申请时 申请认购的 申请时 香港公开发售 应缴款项 香港公开发售 应缴款项 香港公开发售 应缴款项 股份数目 港元 股份数目 港元 股份数目 港元 500 4,222.12 1,000 8,444.25 1,500 12,666.37 2,000 16,888.49 2,500 21,110.61 3,000 25,332.73 3,500 29,554.85 4,000 33,776.97 4,500 37,999.10 5,000 42,221.22 6,000 50,665.46 7,000 59,109.71 8,000 67,553.95 9,000 75,998.19 10,000 84,442.44 15,000 126,663.66 20,000 168,884.87 25,000 211,106.09 30,000 253,327.31 35,000 295,548.53 40,000 337,769.75 45,000 379,990.97 50,000 422,212.19 60,000 506,654.62 70,000 591,097.06 80,000 675,539.50 90,000 759,981.93 100,000 844,424.37 200,000 1,688,848.74 300,000 2,533,273.12 400,000 3,377,697.49 500,000 4,222,121.86 600,000 5,066,546.23 700,000 5,910,970.60 800,000 6,755,394.98 900,000 7,599,819.35 1,000,000 8,444,243.72 2,000,000 16,888,487.44 3,000,000 25,332,731.16 4,000,000 33,776,974.88 5,000,000 42,221,218.60 6,000,000 * 50,665,462.32 Sample 亲笔签名（不得以个人印 亲笔签名（不得以个人 格上。每份香港公开发售股份申 每份香港公开发售股 或银行本票必须符合以下所有规定 票必须符合以下所 Samp mp银行本票 人为「浩丰代理人有限公司－新世纪 丰代理人有限公司－新世纪 注明「只准入抬头人账户」 准入抬头人账 ； am 从　阁下在香港的港元银行账户中开 阁下在香港的港元银行账 显示　阁下的账户名称，而该账 显示　阁下的账户名称， 已预印在支票上，或由有关银 已预印在支票上，或由 在支票背书。账户名称必须 在支票背书。账 称相同。如属联名申 相同。如属 位申请人的姓 位申 e ,688,8 2,533,273 样版 印章代替 代替 样版版 样 申 售 应缴款 版 目 港元 港 199 4.62 ,097.06 75,539.50 ,539.50 759,981.93 1.93 4,424.37 24.37 848.74 48 74 .12 ,000 3,377,697.49 3,377,697.4 500,000 4,222,121.86 0,000 4,222,121.86 600,000 5,066,546.23 700,000 5,910,970.60 800,000 6,755,394.98 0,000 6,755,394.98 900,000 7,599,819.35 00 7,599,819.35 1,000,000 8,444,243.72 2,000,000 16,888,487.44 ,000,000 16,888,487.44 3,000,000 25,332,731. 3,000,000 25,332,73 4,000,000 33,776,97 4,000,000 33,7 5,000,000 42,221 5,000,000 42,2 6,000,000 * 50,6 5 如　阁下欲以本身名义登记将获发行的香港公开发售股份，请使用本表格 4. 请撕下申请表格，对摺一次，然後将填妥的申请表格（连同支票或银行本票）投入下列任何一家 分行特设的收集箱： 渣打银行（香港）有限公司 地区 分行 分行地址 港岛区 德辅道分行 中环德辅道中4-4A号渣打银行大厦 轩尼诗道分行 湾仔轩尼诗道399号 九龙区 观塘分行 九龙观塘道414号地下 旺角分行 旺角弥敦道617-623号地下B�m，一楼及二楼 新界区 新都会广场分行 葵涌兴芳路223号新都会广场一楼175号�m 屯门市广场分行 屯门屯门市广场第一期地下G047 - G052号�m 5. 阁下可於下列时间递交申请表格： 二零一六年十二月三十日（星期五）―上午九时正至下午五时正 二零一六年十二月三十一日（星期六）―上午九时正至下午一时正 二零一七年一月三日（星期二）―上午九时正至下午五时正 二零一七年一月四日（星期三）―上午九时正至下午五时正 二零一七年一月五日（星期四）―上午九时正至下午五时正 二零一七年一月六日（星期五）―上午九时正至下午五时正 二零一七年一月七日（星期六）―上午九时正至下午一时正 二零一七年一月九日（星期一）―上午九时正至下午五时正 二零一七年一月十日（星期二）―上午九时正至下午五时正 二零一七年一月十一日（星期三）―上午九时正至中午十二时正 6. 截止递交申请的时间为二零一七年一月十一日（星期三）中午十二时正。本公司将於当日上午十 一时四十五分至中午十二时正期间登记认购申请，唯一会影响此时间的变化因素为当日的天气 情况（详见招股章程「如何申请香港公开发售股份」一节「10.恶劣天气对办理申请登记的影响」）。 香港公开发售股份申请将会自二零一六年十二月三十日（星期五）起直至二零一七年一月十一日 （星期三）止，较一般市场惯例四天略长。申请款项（包括经纪佣金、证监会交易徵费及香港联交 所交易费）将由收款银行代表本公司持有，且退款金额（如有）将於二零一七年一月十七日（星期 二）不计利息退还予申请人。投资者务请注意，预期股份将於二零一七年一月十八日（星期三）於 联交所开始买卖。 Sample ―上午 ）―上午九 午九 期二） 期二 ―上午九时正 星期三） 期三）―上午九时正至 上午九时正 日（星期四） ）―上午九时正至下 上午九时正 六日（星期五） 期五）―上午九时正至下 上 一月七日（星期六）―上午九时正 上午 年一月九日（星期一） 日（星期 ―上午九时 一七年一月十日（星期二） 月十日（星期二）―上午九 一七年一月十一日（星期三） 月十一日（星期三）―上 申请的时间为二零一七年一月十一 间为二零一七年一月十一 十五分至中午十二时正期间登记认 至中午十二时正期间 况（详见招股章程 股章程「如何申请香港公开 「如何申请 香港公开发售股份申请将会自二 香港公开发售股份申请将 （星期三）止，较一般市场惯例 止，较一般市 所交易费）将由收款银行代 所交易费）将由收 不计利息退还予申请 计利息退 开始买卖。 开始 样版 渣打银行大厦 打银行大厦 号 14号地下 道617-6233号地下 号地 B�m，一楼及二楼 �m，一楼及 涌兴芳路 兴芳路223号新都会广场一楼175 17 号 屯门屯门市广场第一期地下 屯门市广场第一期地下G047 - G G047 - 午九时正至下午五时正 时正至下午五时正 九时正至下午一时正 正至下午一 正至下午五 正至下午 至下午 Please use this form if you want the Hong Kong Public Offer Shares to be issued in your name New Century Healthcare Holding Co. Limited 新世纪医疗控股有限公司 (incorporated in the Cayman Islands with limited liability) GLOBAL OFFERING Conditions of your application A. Who can apply 1. You and any person(s) for whose benefit you are applying must be 18 years of age or older and must have a Hong Kong address. 2. If you are a firm, the application must be in the individual members’ names. 3. The number of joint applicants may not exceed 4. 4. If you are a body corporate, the application must be signed by a duly authorised officer, who must state his representative capacity, and stamped with your corporation’s chop. 5. You must be outside the United States, not be a United States Person (as defined in Regulation S under the U.S. Securities Act) and not be a legal or natural person of the PRC. 6. Unless permitted by the Listing Rules, you cannot apply for any Hong Kong Public Offer Shares if you are: an existing beneficial owner of shares in the Company and/or any of its subsidiaries; a Director or chief executive officer of the Company and/ or any of its subsidiaries; a connected person of the Company or will become a connected person of the Company immediately upon completion of the Global Offering; an associate of any of the above; or have been allocated or have applied for or indicated an interest in any Offer Shares under the International Offering. B. If you are a nominee You, as a nominee, may make more than one application for the Hong Kong Public Offer Shares by: (i) giving electronic instructions to HKSCC via Central Clearing and Settlement System (“CCASS”) (if you are a CCASS Participant); or (ii) using a WHITE or YELLOW Application Form, and lodge more than one application in your own name on behalf of different beneficial owners. C. Effect of completing and submitting this Application Form By completing and submitting this Application Form, you (and if you are joint applicants, each of you jointly and severally) for yourself or as an agent or a nominee on behalf of each person for whom you act: undertake to execute all relevant documents and instruct and authorise the Company, the Joint Sponsors and/or the Joint Global Coordinators (or their agents or nominees), as agents of the Company, to execute any documents for you and to do on your behalf all things necessary to register any Hong Kong Public Offer Shares allocated to you in your name as required by the Articles of Association; agree to comply with the Companies Ordinance, the Companies (Winding Up and Miscellaneous Provisions) Ordinance and the Articles of Association; confirm that you have read the terms and conditions and application procedures set out in the Prospectus and in this Application Form and agree to be bound by them; confirm that you have received and read the Prospectus and have only relied on the information and representations contained in the Prospectus in making your application and will not rely on any other information or representations except those in any supplement to the Prospectus; confirm that you are aware of the restrictions on the Global Offering in the Prospectus; agree that none of the Company, the Joint Sponsors, the Joint Global Coordinators, the Underwriters, their respective directors, officers, employees, partners, agents, advisers and any other parties involved in the Global Offering is or will be liable for any information and representations not in the Prospectus (and any supplement to it); undertake and confirm that you or the person(s) for whose benefit you have made the application have not applied for or taken up, or indicated an interest for, and will not apply for or take up, or indicate an interest for, any Offer Shares under the International Offering nor participated in the International Offering; agree to disclose to the Company, our Hong Kong Share Registrar, receiving banks, the Joint Sponsors, the Joint Global Coordinators, the Underwriters and/or their respective advisers and agents any personal data which they may require about you and the person(s) for whose benefit you have made the application; if the laws of any place outside Hong Kong apply to your application, agree and warrant that you have complied with all such laws and none of the Company, the Joint Sponsors, the Joint Global Coordinators and the Underwriters nor any of their respective officers or advisers will breach any law outside Hong Kong as a result of the acceptance of your offer to purchase, or any action arising from your rights and obligations under the terms and conditions contained in the Prospectus and this Application Form; agree that once your application has been accepted, you may not rescind it because of an innocent misrepresentation; agree that your application will be governed by the laws of Hong Kong; represent, warrant and undertake that (i) you understand that the Hong Kong Public Offer Shares have not been and will not be registered under the U.S. Securities Act; and (ii) you and any person for whose benefit you are applying for the Hong Kong Public Offer Shares are outside the United States (as defined in Regulation S) or are a person described in paragraph (h)(3) of Rule 902 of Regulation S; warrant that the information you have provided is true and accurate; agree to accept the Hong Kong Public Offer Shares applied for, or any lesser number allocated to you under the application; authorise the Company to place your name(s) on the Company’s register of members as the holder(s) of any Hong Kong Public Offer Shares allocated to you, and the Company and/or its agents to send any share certificate(s) and/or any refund cheque(s) to you or the first-named applicant for joint application by ordinary post at your own risk to the address stated on the application, unless you are eligible to collect the share certificate(s) and/or refund cheque(s) in person; Sample for Company omp Company and/ and/ any or will become a becom pany immediately upon iately upon fering; above; or r have applied for or indicated an ed for or indicat fer Shares under the International under the International inee may make more than one application for the Hong re than one application for the Hong er Shares by: (i) giving electronic instructions (i) giving electronic in entral Clearing and Settlement System ( ng and Settlement System “CCASS CASS Participant); or (ii) using a WHITE or YE cipant); or (ii) using a WH ion Form, and lodge more than one application i n Form, and lodge more than one ap on behalf of different beneficial owners. on behalf of different beneficial ow . Effect of completing and submitting this Effect of completing and subm completing and submitting this Applicati ompleting and submitting this re joint applicants, each of you jointly a e joint applicants, each agent or a nominee on behalf of nee e to execute all rel e to exec e Company, e ators ( und you h or indica or indic indicate an i ndicate an Offering nor p Offering no agree to disclose agree to di Registrar, receiving Registrar, Coordinators, the and agents any and and the pe applicati if the ap 样版 ve received and read the Prospectus and e received and read the Prospe on the information and representations n the information and representations e Prospectus in making your application and will tus in making your application and will ny other information or representations except those y other information or representations exce pplement to the Prospectus; lement to the Prospectus; m that you are aware of the restrictions on the G t you are aware of the restrictions on th fering in the Prospectus; ring in the Prospectu agree that none of the Company, the Joint Sponso that none of the Company, the Joint Spon Global Coordinators, the Underwriters, their resp Global Coordinators, the Underwriters, their officers, employees, partners, agents, advis officers, employees, partners, agents, adv parties involved in the Global Offering i arties involved in the Global Offerin any information and representations no any information and representat any supplement to it); ny supplement to it) dertake and confirm that you or ke and confirm that you o ave made the application made the applic ted an interest for ed an interest f nterest for, a for articip Please use this form if you want the Hong Kong Public Offer Shares to be issued in your name declare and represent that this is the only application made and the only application intended by me/us to be made to benefit me/us or the person for whose benefit I am/we are applying; understand that the Company and the Joint Global Coordinators will rely on your declarations and representations in deciding whether or not to make any allotment of any of the Hong Kong Public Offer Shares to you and that you may be prosecuted for making a false declaration; (if the application is made for your own benefit) warrant that no other application has been or will be made for your benefit on a WHITE or YELLOW Application Form or by giving electronic application instructions to HKSCC or to the White Form eIPO Service Provider by you or by any one as your agent or by any other person; and (if you are making the application as an agent for the benefit of another person) warrant that (i) no other application has been or will be made by you as agent for or for the benefit of that person or by that person or by any other person as agent for that person on a WHITE or YELLOW Application Form or by giving electronic application instructions to HKSCC and (ii) you have due authority to sign the Application Form or give electronic application instructions on behalf of that other person as their agent. D. Power of attorney If your application is made through an authorised attorney, the Company and the Joint Global Coordinators may accept or reject your application at their discretion, and on any conditions they think fit, including evidence of the attorney’s authority. Determination of Offer Price and Allocation of Hong Kong Public Offer Shares The Offer Price is expected to be fixed on or around Wednesday, January 11, 2017. Applicants are required to pay the maximum Offer Price of HK$8.36 for each Hong Kong Public Offer Share together with 1% brokerage, 0.0027% SFC transaction levy and 0.005% Hong Kong Stock Exchange trading fee. If the Offer Price is not agreed between the Company and the Joint Global Coordinators (on behalf of the underwriters) on or before Tuesday, January 17, 2017, the Global Offering will not proceed. Applications for Hong Kong Public Offer Shares will not be processed and no allotment of any Hong Kong Public Offer Shares will be made until the application lists close. The Company expects to announce the fixed offer price, the indication of the level of interest in the International Offering, the level of applications under the Hong Kong Public Offer and the basis of allocation of the Hong Kong Public Offer on Tuesday, January 17, 2017 in South China Morning Post (in English), Hong Kong Economic Times (in Chinese), the website of the Hong Kong Stock Exchange at www.hkexnews.hk and the Company’s website at www.ncich.com.cn. Results of allocations in Hong Kong Public Offer, and the Hong Kong Identity Card/passport/Hong Kong business registration numbers of successful applicants (where applicable) will be available on the above websites. If your application for Hong Kong Public Offer Shares is successful (in whole or in part) If you apply for 1,000,000 or more Hong Kong Public Offer Shares, you may collect your share certificate(s) and/or refund cheque(s) in person from the Hong Kong Share Registrar, Computershare Hong Kong Investor Services Limited at Shops 1712-1716, 17th Floor, Hopewell Centre, 183 Queens Road East, Wanchai, Hong Kong, from 9:00 a.m. to 1:00 p.m. on Tuesday, January 17, 2017 or such other date as notified by us in the newspapers. If you are an individual who is eligible for personal collection, you must not authorise any other person to collect for you. If you are a corporate applicant which is eligible for personal collection, your authorised representative must bear a letter of authorisation from your corporation stamped with your corporation’s chop. Both individuals and authorised representatives must produce, at the time of collection, evidence of identity acceptable to the Hong Kong Share Registrar. If you do not collect your Share certificate(s) and/or refund cheque(s) personally within the time period specified for collection, they will be dispatched promptly to the address as specified on this Application Form by ordinary post at your own risk. If you apply for less than 1,000,000 Hong Kong Public Offer Shares, your refund cheque(s) and/or share certificate(s) will be sent to the address on the relevant Application Form on or before Tuesday, January 17, 2017, by ordinary post and at your own risk. Refund of your money If you do not receive any Hong Kong Public Offer Shares or if your application is accepted only in part, the Company will refund to you your application monies (including the related 1% brokerage, 0.0027% SFC transaction levy and 0.005% Hong Kong Stock Exchange trading fee) without interest. If the offer price is less than the maximum Offer Price, the Company will refund to you the surplus application monies (including the related 1% brokerage, 0.0027% SFC transaction levy and 0.005% Hong Kong Stock Exchange trading fee) without interest. The refund procedures are stated in the “14. Dispatch/Collection of share certificates and refund monies” in the “How to Apply for Hong Kong Public Offer Shares” section of the Prospectus. Application by HKSCC Nominees Limited (“HKSCC Nominees”) Where this Application Form is signed by HKSCC Nominees on behalf of persons who have given electronic application instructions to apply for the Hong Kong Public Offer Shares, the provisions of this Application Form which are inconsistent with those set out in the Prospectus shall not apply and provisions in the Prospectus shall prevail. Without limiting the generality of this paragraph, the following sections of this Application Form are inapplicable where this form is signed by HKSCC Nominees: “Applicants’ declaration” on the first page; “Warning” on the first page; “If you are a nominee”; All representations and warranties under the “10. Effect of completing and submitting this Application Form” section, except the first one regarding registration of Hong Kong Public Offer Shares in the applicant’s name and the signing of documents to enable the applicant to be registered as the holder of the Hong Kong Public Offer Shares; “If your application for Hong Kong Public Offer Shares is successful (in whole or in part)”; and “Refund of your money”. The following sections in the “How to Apply for Hong Kong Public Offer Share” section of the Prospectus are inapplicable where this form is signed by HKSCC Nominees “How many applications can you make”; and “Circumstances in which you will not be allotted offer shares”. Sample ect think Kong Public ng Public round Wednesday, y ay the maximum Offer mum Off blic Offer Share together are together action levy and 0.005% Hong d 0.005% Hong If the Offer Price is not agreed ice is not int Global Coordinators (on behalf Coordinators (on behalf e Tuesday, January 17, 2017, the Global uary 17, 2017, the Global Kong Public Offer Shares will not be processed Offer Shares will not be processed any Hong Kong Public Offer Shares will be made ng Public Offer Shares will be made ion lists close. y expects to announce the fixed offer price, the ind announce the fixed offer p vel of interest in the International Offering, th l of interest in the International O ations under the Hong Kong Public Offer and tions under the Hong Kong Public ocation of the Hong Kong Public Offer on Tues ation of the Hong Kong Public Offe 017 in South China Morning Post (in English), H in South China Morning Post (in mes (in Chinese), the website of the Hong K es (in Chinese), the website of t hkexnews.hk and the Company hkexnews.hk and the C ’s web allocations in Hong Kong Pub Hon /passport/Hong Kong b passport/Ho ants (where appli ants ( Ho fee) w Price, the (including th uding t and 0.005% Ho nd 0.005% H The refund procedu he refund proce share certificates and re are certificates Kong Public Offer Share Kong Public Off Application by HKS Applicat Where this App here behalf of pers to apply fo this Ap Pro 样版 ong ate(s) and/or refun s) an pecified for collection, t ified for collecti dress as specified on this Applic as specified on this A r own risk. own n 1,000,000 Hong Kong Public Offer Shares, 000,000 Hong Kong Public Offer Shares, s) and/or share certificate(s) will be sent to the share certificate(s) will be sent to the levant Application Form on or before Tuesday evant Application Form on or before T 17, by ordinary post and at your own risk. by ordinary post and at your own risk of your money your money u do not receive any Hong Kong Public Offer Sh u do not receive any Hong Kong Public Of pplication is accepted only in part, the Company w lication is accepted only in part, the Compan your application monies (including the related 1% pplication monies (including the related FC transaction levy and 0.005% Hong Kong ansaction levy and 0.005% Hon without interest. If the offer price is le ithout interest. If the offer price i e Company will refund to you mpany will refund to you he related 1% brokerag related 1% brok ng Kong Stock E ng Kong Stock ures are f 如　阁下欲以本身名义登记将获发行的香港公开发售股份，请使用本表格 New Century Healthcare Holding Co. Limited 新世纪医疗控股有限公司 （於开曼群岛注册成立的有限公司） 全球发售 申请条件 甲、可提出申请的人士 1. 阁下及　阁下为其利益提出申请的人士必须年满18岁 并有香港地址。 2. 如　阁下为商号，申请须以个别成员名义提出。 3. 联名申请人不得超过四名。 4. 如　阁下为法人团体，申请须经获正式授权人员签 署，并注明其所属代表身份及盖上公司印监。 5. 阁下必须身处美国境外，并非美国籍人士（定义见美 国《证券法》S规例），亦非中国法人或自然人。 6. 除《上市规则》批准外，下列人士概不得申请认购任何 香港公开发售股份： 本公司及�u或其任何附属公司股份的现有实益拥 有人； 本公司及／或其任何附属公司的董事或最高行政 人员； 本公司关连人士或紧随全球发售完成後成为本公 司关连人士的人士； 上述任何人士的联系人；或 已获分配或已申请或表示有意申请国际发售的任 何发售股份。 乙、 如　阁下为代名人 阁下作为代名人可提交超过一份香港公开发售股份申请， 方法是：(i)透过中央结算及交收系统（「中央结算系统」）向 香港结算发出电子认购指示（如　阁下为中央结算系统参 与者）；或(ii)使用白色或黄色申请表格，并以自身名义代 表不同的实益拥有人提交超过一份申请。 丙、 填交本申请表格的效用 阁下填妥并递交本申请表格，即表示　阁下（如属联名申 请人，即各人共同及个别）代表　阁下本身，或作为　阁 下代其行事的每位人士的代理或代名人： 承诺促使所有相关文件生效，并指示及授权本公司、 作为本公司代理的联席保荐人及／或联席全球协调人 （或彼等的代理或代名人），代表　阁下促使任何文件 生效，并为按照组织章程细则的规定将　阁下获分配 的任何香港公开发售股份以　阁下名义登记； 同意遵守《公司条例》、公司（清盘及杂项条文）条例及 组织章程细则； 确认　阁下已细阅招股章程及本申请表格所载的条款 及条件以及申请程序，并同意受其约束； 确认　阁下已接获及细阅招股章程，提出申请时也仅 依据招股章程载列的资料及陈述，而除招股章程任何 补充文件外，不会依赖任何其他资料或陈述； 确认　阁下知悉招股章程内有关全球发售的限制； 同意本公司、联席保荐人、联席全球协调人、包销 商、彼等各自的董事、高级职员、雇员、合夥人、代 理、顾问及参与全球发售的任何其他人士现时及日後 均毋须对并非载於招股章程（及其任何补充文件）的任 何资料及陈述负责； 承诺及确认　阁下或　阁下为其利益提出申请的人士 并无申请或接纳或表示有意认购（亦不会申请或接纳 或表示有意认购）国际发售的任何发售股份，也没有 参与国际发售； 同意在本公司、香港证券登记处、收款银行、联席保 荐人、联席全球协调人、包销商及／或彼等各自的顾 问及代理提出要求时，向彼等披露其所要求提供有 关　阁下及　阁下为其利益提出申请的人士的个人资 料； 若如香港境外任何地方的法例适用於　阁下的申请， 则同意及保证　阁下已遵守所有有关法例，且本公 司、联席保荐人、联席全球协调人及包销商和彼等各 自的高级职员或顾问概不会因接纳　阁下的购买要 约，或　阁下在招股章程及本申请表格所载的条款及 条件项下的权利及责任所引致的任何行动，而违反香 港境外的任何法例； 同意　阁下的申请一经接纳，即不得因无意的失实陈 述而撤销； 同意　阁下的申请受香港法例规管； 声明、保证及承诺：(i)　阁下明白香港公开发售股份 不曾亦不会根据美国《证券法》登记；及(ii)　阁下 及　阁下为其利益申请香港公开发售股份的人士均身 处美国境外（定义见S规例），或属S规例第902条第 (h)(3)段所述的人士； 保证　阁下提供的资料真实及准确； 同意接纳所申请数目或根据申请分配予　阁下但数目 较少的香港公开发售股份； Sample 购任何 的现有实益拥 益拥 司的董事或最高行政 或最高行政 随全球发售完成後成为本公 完成後成为本公 士； 的联系人；或或 或已申请或表示有意申请国际发售的任 表示有意申请国际发售的任 股份。 阁下为代名人 名人 为代名人可提交超过一份香港公开发售股 代名人可提交超过一份香港公 法是： 是：(i) ( 透过中央结算及交收系统（「中央结 香港结算发出电子认购指示 港结算发出电子认购指示（如　阁下为 （如 者） ）；或(ii)使用白色或黄色申请表格 的实益拥有人提交超过一份 的实益拥有人提交 申请表格的效用 申请表 本申请表 及 理、 均毋须 何资料及陈 何资料及 承诺及确认　 承诺及确认 并无申请或接纳 并无申请 或表示有意认购 参与国际发 参 同意在本 荐人 问 样版 例》、公司 公司（清盘及杂项条文） 清盘及杂项条文）条例及 ； 下已细阅招股章程及本申请表格所载的条款 细阅招股章程及本申请表格所载 以及申请程序，并同意受其约束； 及申请程序，并同意受其约束； 　阁下已接获及细阅招股章程，提出申请 阁下已接获及细阅招股章程，提出申请 依据招股章程载列的资料及陈述，而除招股 招股章程载列的资料及陈述，而除招 补充文件外，不会依赖任何其他资料或 补充文件外，不会依赖任何其他资料 确认　阁下知悉招股章程内有关全球 确认　阁下知悉招股章程内有关 同意本公司、联席保荐人、联席 同意本公司、联席保荐人 商、彼等各自的董事、高级职 彼等各自的董事、高级 顾问及参与全球发售的 问及参与全球发 对并非载於招股 对并非载於招 陈述负责责 阁 如　阁下欲以本身名义登记将获发行的香港公开发售股份，请使用本表格 授权本公司将　阁下的姓名／名称列入本公司股东名 册，作为　阁下获分配的任何香港公开发售股份的持 有人，并授权本公司及�u或其代理以普通邮递方式按 申请所示地址向　阁下或联名申请的首名申请人发送 任何股票及�u或退款支票，邮误风险由　阁下承担， 除非　阁下已符合亲身领取股票及／或退款支票； 声明及表示此乃本人／吾等为本身或本人／吾等为其 利益提出申请的人士提出及拟提出的唯一申请； 明白本公司及联席全球协调人将依据　阁下的声明及 陈述而决定是否向　阁下分配任何香港公开发售股 份，　阁下如作出虚假声明，可能会被检控； （如本申请是为　阁下本身的利益提出）保证　阁下或 作为　阁下代理的任何人士或任何其他人士不曾亦不 会为　阁下的利益而以白色或黄色申请表格或向香港 结算或白表eIPO服务供应商发出电子认购指示而提出 其他申请；及 （如　阁下作为代理为另一人士的利益提出申请）保证 (i)　阁下（作为代理或为该人士利益）或该人士或任何 其他作为该人士代理的人士不曾亦不会以白色或黄色 申请表格或向香港结算发出电子认购指示而提出其他 申请；及(ii)　阁下获正式授权作为该人士的代理代 为签署申请表格或发出电子认购指示。 丁、 授权书 如　阁下透过授权人士提出申请，本公司及联席全球协调 人可按其认为合适的条件（包括出示获授权证明）酌情接纳 或拒绝　阁下的申请。 厘定发售价及香港公开发售股份的分配 预期发售价於二零一七年一月十一日（星期三）或前後厘 定。申请人须缴付每股香港公开发售股份8.36港元的最高 发售价，另加1%经纪佣金、0.0027%证监会交易徵费及 0.005%香港联交所交易费。倘若本公司与联席全球协调人 （代表包销商）并无於二零一七年一月十七日（星期二）或之 前协定发售价，全球发售将不会进行。 截止登记认购申请前，概不处理香港公开发售股份的申请 或配发任何香港公开发售股份。 本公司预期於二零一七年一月十七日（星期二）在南华早报 （英文）、香港经济日报（中文）、香港联交所网站 (www.hkexnews.hk)及本公司网站www.ncich.com.cn公布 协定发售价、国际发售踊跃程度、香港公开发售认购水平 及香港公开发售分配基准。香港公开发售的分配结果以及 成功申请人的香港身份证�u护照�u香港商业登记号码（如 适用）亦同於上述网站公布。 如　阁下成功申请认购香港公开发售股份（全部或部分） 如　阁下申请认购1,000,000股或以上香港公开发售股 份，　阁下可於二零一七年一月十七日（星期二）或本公司 在报章上公布的其他日期上午九时正至下午一时正，亲身 前往香港证券登记处，即香港中央证券登记有限公司（地 址为香港湾仔皇后大道东183号合和中心17楼1712-1716 室）领取　阁下的股票及／或退款支票。 如　阁下为个人申请人并合资格亲身领取，　阁下不得授 权任何其他人士代领。如　阁下为公司申请人并合资格派 人领取，　阁下的授权代表须携同盖上公司印监的授权书 领取。个人申请人及授权代表领取股票及／或退款支票时 均须出示香港证券登记处接纳的身份证明文件。 如　阁下并无在指定领取时间内亲身领取股票及／或退款 支票，有关股票及／或退款支票将会立刻寄往本申请表格 所示地址，邮误风险由　阁下承担。 如　阁下申请认购1,000,000股以下香港公开发售股份，　阁 下的退款支票及／或股票将於二零一七年一月十七日（星 期二）或之前以普通邮递方式寄往本申请表格所示地址， 邮误风险由　阁下承担。 退回款项 若　阁下未获分配任何香港公开发售股份或申请仅部分获 接纳，本公司将不计利息退回　阁下的申请股款（包括相 关的1%经纪佣金、0.0027%证监会交易徵费及0.005%香港 联交所交易费）。如最终厘定的发售价低於最高发售价， 本公司将不计利息退回多收申请股款（包括相关的1%经纪 佣金、0.0027%证监会交易徵费及0.005%香港联交所交易 费）。 有关退款程序载於招股章程「如何申请香港公开发售股份」 一节「14.发送�u领取股票及退回股款」一段。 香港中央结算（代理人）有限公司（「香港结算代理人」）提出 的申请 如本申请表格由香港结算代理人代表发出电子认购指示申 请香港公开发售股份的人士签署，本申请表格与招股章程 不符的条文将不适用，且以招股章程所述者为准。 在不限制此段一般应用的前提下，本申请表格的以下部分 在香港结算代理人作签署人的情况下并不适用： 第一页的「申请人声明」； 第一页的「警告」； 「如　阁下为代名人」； 「10.填交本申请表格的效用」一节项下的所有陈述及 保证，惟首项有关以申请人名义登记香港公开发售股 份及签署使申请人登记成为香港公开发售股份持有人 的文件除外； 「如　阁下成功申请认购香港公开发售股份（全部或部 分）」； 「退回款项」。 招股章程「如何申请香港公开发售股份」一节的以下部分在 香港结算代理人作签署人的情况下并不适用： 「阁下可提交的申请数目」；及 「阁下不获配发发售股份的情况」。 Sample 席全球协调 全球协调 证明）酌情接纳 接纳 分配 十一日（星期三） 三）或前後厘 公开发售股份份8.36港元的最高 港元的 金、0.0027% %证监会交易徵费及 费。倘若本公司与联席全球协调人 本公司与联席全球协调人 於二零一七年一月十七日 年一月十七（星期二） 星期二或之之 全球发售将不会进行。 不会进 购申请前，概不处理香港公开发售股份的 ，概不处理香港公开发 任何香港公开发售股份。 何香港公开发售股份 公司预期於二零一七年一月十七日 司预期於二零一七年一月十七（星期二 英文）、香港经济日报（中文）、香 文）、香港经济日报（中 ww.hkexnews.hk) w.hkexnews.hk)及本公司网站 及本公司 ww 发售价、国际发售踊跃程度、香 售价、国际发售踊 开发售分配基准。香港 发售分配基 的香港身份证�u护 的香港身 述网站公布 述 联交 本公司将 佣金、 金、0.00 费）。 有关退款程序载於招 关退款程序载 一节「14.发送�u领取 发送 香港中央结算 港中 的申请 如本申请 请香 不 样版 身领取股票 领取股 将会立刻寄往本申 会立刻寄往本 下承担。 承担 ,000 00股以下香港公开发售股份，　阁 股以下香港公开发售股份 或股票将於二零一七年一月十七日 票将於二零一七年一月十七日（星 普通邮递方式寄往本申请表格所示地址， 邮递方式寄往本申请表格所示地 阁下承担。 阁下承担 项 阁下未获分配任何香港公开发售股份或申 阁下未获分配任何香港公开发售股份 接纳，本公司将不计利息退回　阁下的申 ，本公司将不计利息退回　阁下的申 关的1% %经纪佣金、 经纪佣金 0.0027%证监会交易 证监会 所交易费）。如最终厘定的发售 如最终厘定的发 将不计利息退回多收申请 计利息退回多收 27% %证监会交易徵 监会交易 Please use this form if you want the Hong Kong Public Offer Shares to be issued in your name Personal Data Personal Information Collection Statement This Personal Information Collection Statement informs the applicant for, and holder of, Hong Kong Public 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 correct personal data to the Company or its agents and the Hong Kong Share 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 Public Offer Shares which you have successfully applied for and/or the dispatch of share certificate(s) 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 used, held, processed, and/or stored (by whatever means) for the following purposes: processing your application 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 Public 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; verifying securities holders’ identities; establishing benefit entitlements of securities’ holders of the Company, such as dividends, rights issues, 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 or transfer (whether within or outside Hong Kong) the personal data to, from or with any of the following: the Company’s appointed agents such as financial advisers, receiving bankers 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 their respective business operation; the Hong Kong 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 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. The Company and the Hong Kong Share Registrar have the right to charge a reasonable fee for the processing of such 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 our Hong Kong Share Registrar for the attention of the privacy compliance officer. By signing an Application Form or by giving electronic application instructions to HKSCC, you agree to all of the above. Sample nd/ Company ompany diately of any any s holders may be used, may be used, by whatever means) for the means) for the lication and refund cheque, where refund cheque, where cation of compliance with the terms ompliance with the terms n procedures set out in this Application res set out in this Application the Prospectus and announcing results o tus and announcing on of the Hong Kong Public Offer Shares Hong Kong Public Off pliance with applicable laws and regulat th applicable laws an ong Kong and elsewhere; ng Kong and elsewhere; registering new issues or transfers into registering new issues or tran names of securities’holders inc ho applicable, HKSCC Nominees; applicable, HKSCC Nom maintaining or updating the r maintaining or up ders of the Company; s of the Com ng securities hold ng securit ng benefit en ng pany, w comp com or the H or the their respe their resp the Hong Kon the Hong K statutory regul statutory otherwise as requ otherwi any persons o any holders ha h bankers 4. Re The C the th 样版版 any and its Ho y an e securities holders ecurities hold mpany and its Hong Kong S ny and its Hong Ko nt necessary for achieving any o nt necessary for achievin isclose, obtain or transfer (whether sclose, obtain or transfer (w Hong Kong) the personal data to, from g Kong) the personal data to, from he following: ng: mpany pan’s appointed agents such as financi s appointed agents such as fin ers, receiving bankers and overseas princ eceiving bankers and overseas pr are registrar; e registrar; where applicants for securities request a d e applicants for securities request a CCASS, HKSCC or HKSCC Nomine CCASS, HKSCC or HKSCC Nom use the personal data for the purpos use the personal data for the pu CCASS; CASS; any agents, contractors or third-p any agents, contractors or thi who offer administrative offer administrative puter, payment or oth ter, payment o Hong Kong Sha ong Kong Sh ective bus bus ng S 如　阁下欲以本身名义登记将获发行的香港公开发售股份，请使用本表格 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公开发售股份的 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香港证券登记处 提供准确个人资料。 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公开发售股份及 �u或寄发　阁下应得的股票及�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被采用及以任何方式持 有，处理及�u或保存，以作下列用途： 处理　阁下的申请及退款支票（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公开发售股份的 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； 核实证券持有人的身份； 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， 向下列任何人士披露，获取或转交（无论在香港 境内或境外）有关个人资料： 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； 香港联交所、证监会及任何其他法定监管机 关或政府部门或遵照其他法例、规则或法 规；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 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。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。 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，或向本公司的香港证券登记 处的个人资料私隐事务主任提出。 阁下签署申请表格或向香港结算发出电子认购指 示，即表示同意上述各项。 Sample 及 票。 票 何错误，须 误，须 处。 可被采用及以任何方式持 及以任何方 ，以作下列用途： 列用途： 的申请及退款支票 退款支票（如适用） 适用）、核核 合本申请表格及招股章程载列的条 表格及招股章程载列的条 申请程序以及公布香港公开发售股份 以及公布香港公开发 配结果； 配结 遵守香港及其他地区的适用法律及 遵守香港及其他地区的适 以证券持有人 以证券持有人（包括香港结算 包括香 用））的名义登记新发行证券 的名义登记 更新本公司证 更新 持有人 他 供应商 香港联交 关或政府部 关或政府 规；及 证券持有人 证 士或机构 士 或股票 4. 个 本 样版版 所持有关证 持有 本公司及其香港证 公司及其香 任何目的之必要情况下 何目的之必要情 露，获取或转交（无论在香港 （无论在 关个人资料： 个人资料： 任的代理人，例如财务顾问、收款 的代理人，例如财务顾问、 和主要海外证券登记处； 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 证券申请人要求将证券存於中央结 统）香港结算或香港结算代理人；彼 香港结算或香港结算代理人； 就中央结算系统的运作使用有关 就中央结算系统的运作使用有 向本公司或香港证券登记处提 向本公司或香港证券登记处 务营运有关的行政、电讯 务营运有关的行政、电 他服务的任何代理人、 务的任何代理人、 商；； 交所、证证 部门