*申請人姓名(中文姓名)(必填) Applicant’s name (Chinese name) (required)：

申請人姓名(羅馬拼音) Applicant’s name (Pinyin Romanization)：

*通訊地址(必填) Mailing address(required)：

*聯絡電話(必填) Contact phone number (required)：

電子郵件信箱 E-mail address ：

*土地標示(必填) land description (required) ： 範例說明：地號分別為地號母號、地號子號各4碼，一共為8碼。 例如：地號母子號 427-13，格式應為0427-0013，以此類推。 Example description: A land number consists of eight digits, including the four digits of the main construction number and the four digits of the secondary construction number. For example, the main construction number and secondary number 427-13 shall be written in the format of 0427-0013.

建物標示 Building description： 範例說明：建號分別為建號母號5碼、建號子號3碼，一共為8碼。 例如：建號母子號 427-13，格式應為00427-013，以此類推。 Example description: A building number consists of eight digits, including five digits of the main construction number and three digits of the secondary construction number. For example, the main construction number and secondary number 427-13 shall be written in the format of 00427-013.

房屋門牌 Doorplate of the house：

管理機關 Administrative authority：

是否需定期接收公告通知(以電子郵件信箱方式通知，公告通知以一年為期限) Whether it is necessary to regularly receive announcement notifications (by email, and announcement notifications are limited to one year)：

如有其他說明事項請於此輸入 For any other matters, please specify here：