支持香港‘一國兩制’長治久安，維護香港法治穩定繁榮發展回執確認書

回執確認書 Confirmation Receipt

致：溫哥華中華會館：

To Chinese Benevolent Association of Vancouver

本團體確認署名登報支持“聯合聲明 — 支持香港‘一國兩制’長治久安，維護香港法治穩定繁榮發展”。

The Group/Individual We hereby confirms our support for the joint statement to support the principle of “one country, two systems" in Hong Kong, maintain long-term stability in Hong Kong and uphold the rule of law, civil liberty and prosperity in Hong Kong.

團體/個人全稱（英文）Full Name of the Group/Individual

中文全稱

負責人簽名 Signature of the person in charge [signature* your-signature]

姓名 Name

日期 Date

地址（英文）Address

電話 Telephone

電郵 Email