[Applicant Name]
[Applicant Address]
[Applicant Email Address]
[Applicant Telephone Number]

Via Fax (+852 2509 0580) & Registered Mail:

Date: [Insert Date]

Hong Kong Immigration Department Ref: [Insert Your File Reference Number]

The Chief Executive,
Government House,
Hong Kong.

Request for the Direct Intervention of the Chief Executive on Grounds of Significant Public Interest

Dear Sir,

I would respectfully request  the direct intervention of the Chief Executive in a decision of the Director of Immigration who has recently refused my immigration application for [State Type of Application] on [Date] under the captioned Hong Kong Immigration Department reference.

I believe there is a matter of significant public issue at stake which requires the intervention of the Chief Executive, for the following reasons:

•	 [Insert Your Reasons]
•	 Etc
•	 
•	 
•	

I can be contacted at the address and via details above until further notice.

Yours, most faithfully

[Your Name]