Application Form for NHRI Parking Card
Application Date:___________ 1. Vehicle Type: ? Car ? Motorcycle
2. Basic Data of the Applicant:
? NHRI Staff: Affiliation: _____________________(Institute/Division/Center/Dept/Units)
staff ?family dependent ?others Parking Cards: ?
? Non-NHRI staff: Affiliation: ___________________ (Organization/Dept/Company/Office)
Guest ? Supplier/Vendor ?others Parking Cards: ?
TEL& Cell phone NHRI Employee ID Name
Vehicle registered No. (a
photo copy of the vehicle Name of Vehicle Vehicle color license is required in this owner
Application No.; ( ) 1. New applicant:
1.1.?Parking Permit 1.2.?Sensor card 1.3.?Both
( ) 2. re-apply: (Previous receipt No.: )
2.1.?Parking Permit 2.2.?Sensor card 2.3.?Both
2.4.?Reason for re-application:
2.4.1.?Card lost 2.4.2.?Out of order 2.4.3.?others:
( ) 3. Change of Vehicle information: (Previous receipt No. )
3.1.?Parking Permit 3.2.?Sensor card 3.3.?Both
3.4.?Reason for change (Please specify):
( ) 4. Payment of the Sensor Card (NT$1,500).
Signature(Unit chief); Signature (the unit chief of non-NHRI );
I agree to follow the regulation regarding proper usage of the Parking Card with due care.
Signature of Applicant: _______________________________ Date: ________________
Regulation for proper usage of the Parking Card:
1. The Parking Card is to be used by the applicant only. Do not lend to other people. 2. Please place the Parking Permit in the left side of the windscreen of your vehicle for easy identification. 3. You need to return the Parking badge and Parking Sensor Card when you resign from your position. Before you leave NHRI,
please return the parking permit and sensor card to the General Affairs Office, Department of Administration 4. Fee Rate for the sensor card is NT$1500. Upon application, please remit also the fee 5. In case your Parking Permit or sensor card is lost, please inform the General Affairs Office, Department of Administration
6. Please follow the parking sign and rules given by the NHRI.