Declaration

I, the undersigned applicant, guarantee that 1. I do not have overseas Chinese status, nor have the nationality of Hong Kong, Macau or the Peoples Republic of China. 2. I do not hold the Republic of China nationality, as defined in the Article 2 of Law of Nationality. According to the Article 2 of Law of Nationality, A person who meets one of the following requirements acquires the nationality of the Republic of China: (1) A person whose father or mother is, at the time of his (her) birth, a citizen of the Republic of China. (2) A person born after the death of his (her) father or mother who was, at the time of his (her) death, a citizen of the Republic of China. (3) A person born in the territory of the Republic of China and whose parents are both unknown or are stateless. (4) A naturalized person. The provisions specified in sub-paragraphs (1) and (2) of the preceding Paragraph shall apply to minor children on the date of the promulgation of the amendment of this Law. 3. The highest level diploma which I present (senior high school or technical junior college for under-graduates, bachelors or masters for graduate students) is recognized as legal and valid within the country where the school is located and is equivalent to the comparable diploma offered in R.O.C. I have not used overseas Chinese status to apply for any other college or university in R.O.C. 4. I have NOT been dropped out of or expelled from any university or college in the R. O. C. due to unsatisfactory conduct grade, failure in academic achievement or confirmed sentence in criminal cases. 5. I authorize this school to check on all of the above information, and if any of it is found to be false, I will accept the consequences set forth in NTUST School Regulation No. 9. I also understand that a false declaration would result in the immediate cancellation of my admission or the deprivation of my status as a National Taiwan University of Science and Technology registered student. Note: NTUST School Regulation No.9 states: If the documents submitted by new students for admission are found to be forged, fraudulent or altered, etc., the students acceptance for admission or student status will be revoked. No other documentation of this will be provided beyond notification of the students parent or guardian. I, the undersigned, declare that Signature (Full Name) Print Full Name Date of birth: Date:

AUTHORIZATION
I, the undersigned, authorize National Taiwan University of Science and Technology to undertake a verification of the information I have provided and I authorize all corporations, companies, educational institutions, persons and former employers to release information they may have about me, and release them from any liability for doing so.

Signature (Full Name) Print Full Name Social Security Number (if available) University (Graduate School) Student ID Number (if applicable)

Date of Birth Date