OFFICE USE ONLY Client no.: Date received: / / Application no.

INZ 1015

Work Visa
Application
based on qualifications, employment or humanitarian reasons

INZ 1016 Refer to the Work Visa Guide

Work Visa
Guide
A guide to applying for a work visa The Work Visa Guide (INZ 1016) contains important information about the
OFFICE USE ONLY Client no.:
Information about this guide
Date received: / / Application no.:
This guide will help you to
Do you need a visa to work in New Zealand?
You do not need a work visa to work in New Zealand if one of
the following applies to you.
• You are a New Zealand citizen.
requirements for a work visa and how to complete the form. It can be downloaded
from www.immigration.govt.nz/forms.
complete the form Work
INZ 1015

Work Visa
Application
for a temporary stay in New Zealand
Visa Application (INZ 1015). • You hold a New Zealand residence class visa.
Information about this guide
Work Visa
Guide
INZ 1016

A guide to applying for a work visa

Do you need a visa to work in New Zealand?

You do not need a work visa to work in New Zealand if one of
the following applies to you.
Use the guide to help you complete the application form
Read the Work Visa Guide (INZ 1016) before you complete this application form.
The guide will help you decide which visa you should apply for and contains helpful
It will give you information • You hold a special temporary (diplomatic, consular or
about coming to New Zealand
OFFICE USE ONLY Client no.: Date received: / / Application no.:
This guide will help you to
• You are a New Zealand citizen.

information about how to complete the application form. The guide also gives
INZ 1015

complete the form Work

Work Visa
Application
for a temporary stay in New Zealand
Visa Application (INZ 1015). • You hold a New Zealand residence class visa.
Use the guide to help you complete the application form
Read the Work Visa Guide (INZ 1016) before you complete this application form.
The guide will help you decide which visa you should apply for and contains helpful
It will give you information • You hold a special temporary (diplomatic, consular or
information about how to complete the application form. The guide also gives
detailed information about the evidence and documents you need to send.
Do not use this form to apply for a visa under a working holiday scheme. Use the form Working
Holiday Schemes Work Visa Application (INZ 1085), or go to our website
www.immigration.govt.nz/whs to see if you can apply online.
about coming to New Zealand official) visa.
Do not use this form to apply for a long-term business visa. Use the form Long-Term Business
Visa Application (INZ 1058).
Do not use this form to apply to work for a recognised seasonal employer. Use the form
to work and help you to
• You hold a military visa.

official) visa.
Application to Work for a Recognised Seasonal Employer (INZ 1142).
Do not use this form to apply for a visa under one of the China skilled work instructions. Use the form Work Visa
Application for China Skilled Work Instructions (INZ 1158).
Do not use this form if you intend to work as a performing artist or entertainer; or work on any film or video production in

understand the requirements

detailed information about the evidence and documents you need to send.
New Zealand. Use the form Performing Artists, Entertainers and Entertainment Industry Personnel Work Visa Application (INZ 1187).
When you have completed the form, use the checklist at the end to make sure you have sent all the documents and

• You are intending to undertake work in New Zealand that is

information we need. We will process your application only when we receive all the information and documents we need. If
you do not send all the required information, we will return your application.
Your partner or other family members cannot apply on this application form. They must lodge separate applications for
the type of visa they need.

VisaView you need to meet if you want

It is an offence to employ a person who is not entitled to work in New Zealand. One way for employers to avoid committing
this offence is to check a person’s entitlement to work with Immigration New Zealand’s online VisaView system. Disclosure
of information through VisaView is authorised by legislation.
If you believe that an employer has been given the wrong entitlement information about you via VisaView, you may contact
the Immigration Contact Centre (0508 558 855) to request correction of that information. to work in New Zealand. not considered to be employment (see ‘What work is not
Immigration Advisers Licensing Act 2007
Under the Immigration Advisers Licensing Act 2007 it is an offence to provide immigration advice without being licensed or
exempt. If your immigration adviser is not licensed when they should be, Immigration New Zealand will return your application.
For more information and to view the register of licensed advisers, go to the Immigration Advisers Authority website
considered to be employment?’ on page 3).
www.iaa.govt.nz or email [email protected].
Lawyers provide immigration advice and are exempt from licensing under the Immigration Advisers Licensing Act 2007. For more
information and to view the register of immigration lawyers, go to the New Zealand Law Society website www.lawsociety.org.nz.
You should read this guide
When filling in this form, print clearly in English using CAPITAL LETTERS.

If you are the holder of a current Australian permanent

For further information on immigration
visit www.immigration.govt.nz
before completing the
residence visa or a current Australian resident return visa, you
application form. The guide
do not need a visa to travel to New Zealand. You must apply
gives you information about:
for a resident visa on arrival. You will do this by completing an

Do not use this form to apply for a visa under a working holiday scheme. Use the form Working
• how to decide which visa you need to apply for arrival card on the aircraft/ship on your way to New Zealand.
• what evidence you need to provide with your
application form Where do you send your application
• what to do if you want to later apply for residence in
New Zealand.
and documents?

Applicants who are overseas

Send your completed application form and documents to
your nearest Immigration New Zealand office, New Zealand
Embassy, or New Zealand High Commission.
Holiday Schemes Work Visa Application (INZ 1085), or go to our website
Applicants who are in New Zealand
Send your completed application form and documents to your
nearest Immigration New Zealand office.
www.immigration.govt.nz/whs to see if you can apply online.
For office addresses, see www.immigration.govt.nz/contactus.

Do not use this form to apply for a long-term business visa. Use the form Long-Term Business

For further information on immigration

visit www.immigration.govt.nz

Do not use this form to apply for a visa under one of the China skilled work instructions. Use the form Work Visa
Application for China Skilled Work Instructions (INZ 1158).
November 2011
Visa Application (INZ 1058).
Do not use this form to apply to work for a recognised seasonal employer. Use the form
Application to Work for a Recognised Seasonal Employer (INZ 1142). to work and help you to • You hold a military visa.
Do not use this form if you intend to work as a performing artist or entertainer; or work on any film or video production in
New Zealand. Use the form Performing Artists, Entertainers and Entertainment Industry Personnel Work Visa Application (INZ 1187).
When you have completed the form, use the checklist at the end to make sure you have sent all the documents and understand the requirements
• You are intending to undertake work in New Zealand that is
information we need. We will process your application only when we receive all the information and documents we need. If
you do not send all the required information, we will return your application.
Your partner or other family members cannot apply on this application form. They must lodge separate applications for
the type of visa they need.

VisaView you need to meet if you want

It is an offence to employ a person who is not entitled to work in New Zealand. One way for employers to avoid committing
this offence is to check a person’s entitlement to work with Immigration New Zealand’s online VisaView system. Disclosure
of information through VisaView is authorised by legislation.
If you believe that an employer has been given the wrong entitlement information about you via VisaView, you may contact
the Immigration Contact Centre (0508 558 855) to request correction of that information. to work in New Zealand. not considered to be employment (see ‘What work is not
Immigration Advisers Licensing Act 2007
Under the Immigration Advisers Licensing Act 2007 it is an offence to provide immigration advice without being licensed or
exempt. If your immigration adviser is not licensed when they should be, Immigration New Zealand will return your application.
For more information and to view the register of licensed advisers, go to the Immigration Advisers Authority website
considered to be employment?’ on page 2).
www.iaa.govt.nz or email [email protected].
Lawyers provide immigration advice and are exempt from licensing under the Immigration Advisers Licensing Act 2007. For more
information and to view the register of immigration lawyers, go to the New Zealand Law Society website www.lawsociety.org.nz.
You should read this guide

Documents required
When filling in this form, print clearly in English using CAPITAL LETTERS.

If you are the holder of a current Australian permanent

For further information on immigration
visit www.immigration.govt.nz
21 November 2011
before completing the residence visa or a current Australian resident return visa, you
application form. The guide do not need a visa to travel to New Zealand. You must apply
gives you information about: for a resident visa on arrival. You will do this by completing an
• how to decide which visa you need to apply for arrival card on the aircraft/ship on your way to New Zealand.
• what evidence you need to provide with your
application form Where do you send your application
• what to do if you want to later apply for residence in
New Zealand.
and documents?

Applicants who are overseas

Send your completed application form and documents to
your nearest Immigration New Zealand office, New Zealand
Embassy, or New Zealand High Commission.
Use the checklist on page 2 of this form to find out which documents you must provide. If you
Applicants who are in New Zealand
Send your completed application form and documents to your
nearest Immigration New Zealand office.
have not provided the correct documents, we will return your application.
For office addresses, see www.immigration.govt.nz/contactus.

Including your family

For further information on immigration

21 November 2011
You cannot include family members on this form. Your partner must use the Partnership Visa
visit www.immigration.govt.nz

Application (INZ 1198). Dependent children must use the Student Visa Application (INZ 1012) if
they have reached school age or the Visitor Visa Application (INZ 1017) otherwise.

Who cannot use this form

This form cannot be used for some types of work visa. These work visas have separate forms that can be found at
www.immigration.govt.nz/forms. Do not use this form to apply for a visa under the following categories:
• Partnership
• Working holiday scheme
• Recognised seasonal employer
• China Skilled Work
• Performing Artists, Entertainers and Entertainment Industry Personnel.

Immigration Advisers Licensing Act 2007

Under the Immigration Advisers Licensing Act 2007 it is an offence to provide immigration advice without being licensed or
exempt. If your immigration adviser is not licensed when they should be, Immigration New Zealand will return your application.
For more information and to view the register of licensed advisers, go to the Immigration Advisers Authority website
www.iaa.govt.nz or email [email protected].
Lawyers provide immigration advice and are exempt from licensing under the Immigration Advisers Licensing Act 2007.
For more information and to view the register of immigration lawyers, go to the New Zealand Law Society website
www.lawsociety.org.nz.
When filling in this form, write clearly in English using CAPITAL LETTERS.

For further information on immigration July 2012

visit www.immigration.govt.nz
 When filling in this form, please write clearly using CAPITAL LETTERS.

Application checklist Specific Description of the specific

purpose or purpose or event for which I
All applicants must provide: event work visa am coming to New Zealand.

Completed, signed application form. Evidence of the specific

purpose or event.
Appropriate application fee.
Religious worker Completed Sponsorship Form
Two passport-sized colour photographs. visa for Religious Workers (INZ 1190)
and associated documents.
Passport or travel document.
Work exchange Evidence of acceptance to
Medical and chest X-ray certificates if required by visa approved work exchange.
Section C: Your health. Evidence of medical and
Police certificates if required by Section D: Your dental insurance.
character. Evidence I hold (or can
purchase) outward travel
Applications for visas based on employment from New Zealand.
A job offer, including a job description and the details Graduate job Evidence I have completed a
of pay and conditions of the proposed employment. search visa New Zealand qualification that
Evidence of qualifications relevant to my job offer. would qualify for points under
the Skilled Migrant Category.
Evidence of work experience relevant to my job offer.
Evidence I have a minimum of
Evidence that I have met or am able to meet any NZ$4200 in funds available to
necessary New Zealand registration requirements. maintain myself.
Visas based on employment include the following types: Graduate work Evidence I have completed a
experience visa New Zealand qualification that
• Essential Skills
would qualify for points under
• Work to Residence: Accredited Employer the Skilled Migrant Category.
• Work to Residence: Arts Culture and Sports
Completed Employer
• Work to Residence: Long Term Skill Shortage List Supplementary Form (INZ 1113)
• Approved in Principle and associated documents.
• Specific Purpose or Event
Note: Detailed information about the type of documents you
• Free Trade Agreement special work
should provide in support of your application is available from
• Work exchange the Immigration New Zealand branch where you will submit
• Religious Worker your application. Go to www.immigration.govt.nz/contactus
and select the appropriate branch.
Unless listed below, applications for these types of visas
do not require additional documents. If your circumstances are not covered in the
above list, refer to the Immigration New Zealand
If you are applying for... You must also provide...
website, www.immigration.govt.nz/work, or the
an Essential Completed Employer Immigration New Zealand Operational Manual,
skills work visa Supplementary Form (INZ 1113) www.immigration.govt.nz/opsmanual, for information about
and associated documents. the documents you must provide.
a Work to Completed Talent (Arts,
Residence: Arts, Culture and Sports) Returning your documents
culture and Sponsorship Form (INZ 1091) Please tick one of the following options
sport work visa and associated documents.
Please return all documents to me by secure post
Evidence of my international
at the address given at B3 .
reputation in my declared
field and evidence I am still I wish to collect my documents when ready.
prominent in that field. Note: This option is not available in all branches, see your branch
website at www.immigration.govt.nz/contactus to check if you
Silver Fern Completed Employer can collect your documents.
Practical Supplementary Form (INZ 1113)
Experience visa and associated documents.

2 – Work Visa Application - July 2012

OFFICE USE ONLY Client no.: Date received: / / Application no.:

What type of work visa are you applying for?

Visas based on employment Religious Worker

Essential Skills Other (specify)
Work to Residence: Accredited Employer
Visas based on qualifications gained in New Zealand
Work to Residence: Arts Culture and Sports
Graduate job search
Work to Residence: Long Term Skill Shortage List
Graduate work experience
Approved in Principle
Visas based on humanitarian reasons
Specific Purpose or Event
Free Trade Agreement special work Refugee or protection status claimant

Work exchange Other (specify)

Section A Personal details

For more information about the questions in this section, see ‘Completing Section A: Personal details’ in the Work Visa Guide.

Attach two colour passport-size photographs of yourself here.

The photographs must be less than six months old.
Write your full name on the back of both photographs.

A1 Name as shown in passport

Family/last name 4.5cm 4.5cm

Given/first name(s)
3.5cm 3.5cm

A2 Preferred title Mr Mrs Ms Miss Dr

Other (specify)

A3 Other names you are known by or have ever been known by

A4 Gender Male Female A5 Date of birth

A6 Town/city of birth

Country of birth

A7 Passport details

Number

Country Expiry date

A8 Other citizenships you hold

A9 Partnership status Single Separated Partner Divorced

Married/in civil union Engaged Widowed

Work Visa Application - July 2012 – 3

 When filling in this form, please write clearly using CAPITAL LETTERS.

Section B Contact details

B1 Your current residential address:

Address

Telephone (landline) Telephone (mobile)

Email

B2 If you are currently in New Zealand, your most recent overseas address:

Address

B3 Name and address for communication about this application.

Same as address at B1 , or as below

Name

Company name (if applicable) and address

Telephone (daytime) Telephone (evening)

Email

B4 Do you authorise the person stated at B3 to act on your behalf? Yes No

B5 Have you received immigration advice on this application?

You can find a definition of immigration advice at www.immigration.govt.nz/advice.

Yes Make sure that your immigration adviser completes ‘Section H: Immigration adviser’s details’.

No

B6 Names and addresses of any friends, relatives, or contacts you have in New Zealand (if applicable).

Name

Address

Relationship Date of birth (if known)

Name

Address

Relationship Date of birth (if known)

4 – Work Visa Application - July 2012

 Section C Your health
For more information about the questions in this section, see ‘Completing Section C: Your health’ in the Work Visa Guide.

C1 Do you have tuberculosis (TB)? Yes No

C2 Do you have any medical condition that requires, or may require, one of the following during your stay in New Zealand?
• Renal dialysis Yes No
• Hospital care Yes No
• Residential care Yes No
Residential care is long-term care provided in live-in facilities for the aged or for people with physical, sensory,
intellectual, or psychiatric disabilities.

C3 If you have answered Yes to any of the questions in C1 and C2 , provide details.

C4 Are you pregnant?

Yes Date you are due to give birth D D M M Y Y Y Y Go to C5

No Go to C6

C5 If you intend to give birth in New Zealand, please indicate how the cost of maternity health services will be paid for
and provide the relevant evidence.
Not applicable as I do not intend to give birth in New Zealand.
I am, or will be eligible for publicly-funded maternity health services and have provided evidence of my eligibility.
I will cover the cost myself and have attached copies (not originals) that I have at least NZ$9000 of funds available.
My sponsor has guaranteed to cover the cost and I have attached a completed Sponsorship Form for Temporary
Entry (INZ 1025).

Medical certificates you must provide

C6 Will you be in New Zealand for more than six months in total?
No You do not have to provide a chest X-ray certificate or a medical certificate. Go to Section D: Your character.

Yes You may have to provide a chest X-ray certificate and a medical certificate if indicated at C7 .

C7 How long do you intend to stay in New Zealand? If you are in New Zealand, this includes time you have already spent here.
More than six months but not more than 12 months. You must provide a Chest X-ray Certificate (INZ 1096) if you are from, or
have visited for more than three months, a place that is not listed as having a low incidence of tuberculosis. See notes below, then go to C8 .

More than 12 months. You must provide a Chest X-ray Certificate (INZ 1096) and a General Medical Certificate (INZ 1007). See notes
below, then go to C8 .
Notes:
• Refer to ‘Completing Section C: Your health’ in the Work Visa Guide (INZ 1016) for the ‘List of countries, areas and territories with a low
incidence of tuberculosis’.
• Pregnant women are not required to have an X-ray, unless a special report is required.
• You do not need to provide a chest X-ray certificate if you have provided one which was issued less than 36 months ago, with a previous
Immigration New Zealand application, unless your health has deteriorated since your previous certificate was issued, or unless you have spent
six consecutive months since your previous application, in a place not listed as having a low incidence of tuberculosis.
• You do not need to provide a medical certificate if you have provided one which was issued less than 36 months ago, with a previous Immigration
New Zealand application, unless your health has deteriorated since your previous certificate was issued.

Work Visa Application - July 2012 – 5

 When filling in this form, please write clearly using CAPITAL LETTERS.

C8 Tick the option below which applies to you:

I attach both a Chest X-ray Certificate (INZ 1096) and a General Medical Certificate (INZ 1007). Go to Section D: Your character

I have attached only a Chest X-ray Certificate (INZ 1096) because:

I am staying between six to 12 months and I am from, or have visited for more than three months, a place
that is not listed as having a low incidence of tuberculosis, go to Section D: Your character; or
I have previously provided a chest X-ray certificate; however:
it was dated by the radiologist more than 36 months ago, or
my health has deteriorated since my last certificate was issued, or
I have spent six consecutive months since my previous application, in a place not listed as having a low
incidence of tuberculosis. Go to Section D: Your character.

I am required to provide a Chest X-ray Certificate (INZ 1096), however, as I am pregnant I am not required to
have an X-ray; and:
I am not required to provide a General Medical Certificate (INZ 1007) at this stage; or
I have therefore provided only a General Medical Certificate (INZ 1007). Go to Section D: Your character.

I attach only a General Medical Certificate (INZ 1007) because I have previously provided a medical certificate, however:
it was dated by the medical examiner more than 36 months ago; or
my health has deteriorated since my last certificate was issued. Go to Section D: Your character.

I do not have to provide a Chest X-ray Certificate (INZ 1096) or a General Medical Certificate (INZ 1007) at this
stage because:
• I have provided a medical certificate and chest X-ray certificate which were issued less than 36 months ago,
with a previous Immigration New Zealand application; and
• my health has not deteriorated; and
• I have not spent six consecutive months in a place which is not listed as having a low incidence of tuberculosis
since my previous application. Go to Section D: Your character.

Section D Your character

All applicants must complete this section. If your application is declined for character reasons, Immigration
New Zealand may place a notation in your passport indicating that you applied for a visa for New Zealand.

For more information about the questions in this section, see ‘Completing Section D: Your character’ in the Work Visa Guide.

D1 Have you been:

• convicted Yes No
• charged Yes No
• under investigation Yes No
for any offence(s) against the law in any country, including New Zealand?

D2 Have you been:

• excluded (refused entry) from Yes No
• refused a visa by Yes No
• removed or deported from Yes No
any country, including New Zealand?
If you have answered Yes to any of the questions in D1 and D2 , provide details below.

6 – Work Visa Application - July 2012

Police certificates you must provide
Select the appropriate option to indicate whether you are required to provide a police certificate with this application.
Police certificates must be less than six months old when you submit them to Immigration New Zealand.

D3 You must provide police certificates from your country of citizenship and any country you have lived in for five years
or more since the age of 17 if:
you are applying for a work to residence visa, or
you plan to be in New Zealand for 24 months or longer (including any time you have already spent in New Zealand),
and, either
you have not provided police certificates to Immigration New Zealand with a previous visa application, or
you have provided police certificates to Immigration New Zealand but those certificates were issued more
than 24 months ago.

D4 You do not have to provide police certificates if:

you are not planning to be in New Zealand for more than 24 months, or
you have already provided police certificates to Immigration New Zealand with a previous visa application and
those police certificates were issued less than 24 months ago.

Section E Employment and qualifications

Applicants who hold a current New Zealand work visa may go to Section F: Job offer. All other applicants must
complete this section.

E1 If you are currently employed, provide details

Employer’s name

Employer’s address

Telephone Email

Your position:

E2 List all periods of previous employment, including self-employment and employment outside New Zealand.

Date from Date to Name of employer Location Type of work/occupation/job title

(DD/MM/YY) (DD/MM/YY)
/ / / /
/ / / /
/ / / /
/ / / /

E3 Give details of all qualifications you hold. If you have no qualifications, write ‘No qualifications’.

Name of qualification Date obtained Institution where gained

(DD/MM/YY)
/ /
/ /
/ /
/ /

Work Visa Application - July 2012 – 7

 When filling in this form, please write clearly using CAPITAL LETTERS.

Section F Job offer

F1 Do you have a job offer in New Zealand?
Yes No Go to ‘Section G: Declaration by applicant’.

F2 Name and address of employer who has offered you a job.

Employer’s name

Employer’s address

Telephone Email

F3 Name of position offered

Write your ANZSCO occupation code (eg 321212 Diesel Motor Mechanic) if known.

ANZSCO is the Australian and New Zealand Standard Classification of Occupations. You can search the ANZSCO by going to
www.immigration.govt.nz/anzsco.

Section G Declaration by applicant

I have provided true and correct answers to the questions in this form.
I agree to tell Immigration New Zealand about any changes to my circumstances (including a change in my employment or
partnership status) that occur after making this application.
I agree to leave New Zealand before my visa expires. If I remain in New Zealand after my visa has expired, I may be
deported by Immigration New Zealand.
I agree that if I am not entitled to free health care in New Zealand, I will pay for any health care or medical assistance
I may require in New Zealand.
I understand that if I have received immigration advice from an immigration adviser and if that immigration adviser
is not licensed under the Immigration Advisers Licensing Act 2007 when they should be, Immigration New Zealand will
return my application.
I understand that Immigration New Zealand may provide information about my entitlement to work to potential employers via
the online VisaView system. VisaView is authorised by legislation.
I authorise Immigration New Zealand to provide information about my health and my immigration status to any health service
agency. I authorise any health service agency to provide information about my health to Immigration New Zealand.
I authorise Immigration New Zealand to make any necessary enquiries about information on this form and/or accompanying
documentation. I authorise any agency whether in New Zealand or overseas, including but not limited to border or
immigration agencies, education providers, financial institutions, foreign embassies, government authorities, healthcare
providers, police or other law enforcement agencies, that holds information (including personal information) related to
information on this application form and/or accompanying documentation to disclose that information to Immigration
New Zealand so that they can:
• make a decision on this application
• answer enquiries about my immigration status once my application has been decided.
I authorise any agency that holds information (including personal information) related to those matters to disclose that
information to Immigration New Zealand.
I have provided all the documents required by the checklist on page 2.

Signature of principal applicant Date

A parent or guardian may sign on behalf of a child under 18 years.

8 – Work Visa Application - July 2012 This form has been approved under section 381 of the Immigration Act 2009
 Section H Immigration adviser’s details
This section must be completed by the applicant’s immigration adviser. If the applicant does not have an immigration
adviser, this section does not have to be completed.

H1 If you are a licensed adviser, please provide your licence details.

Licence type full provisional limited List conditions specified in the register

Licence number 2 0 Go to Section I: Declaration by person assisting the applicant

H2 If you are exempt from licensing, tick one box below to show why you are exempt from licensing then go to
Section I: Declaration by person assisting the applicant.
I provided immigration advice in an informal or family context only, and I did not provide the advice systematically
or for a fee.
I have provided immigration advice in the course of my work (employed or volunteer) and that work exempts me
from the requirement to be licensed. Indicate the reason for your exemption below.
Lawyer with current New Zealand practicing certificate Community Law Centre Citizens Advice Bureau
New Zealand Member of Parliament or staff New Zealand public servant Foreign Diplomatic/Consular
See www.immigration.govt.nz/adviserlicensing for more information about who is exempt from licensing.

Section I Declaration by person assisting the applicant

This section must be completed and signed by the applicant’s immigration adviser, or by any person who has assisted
the applicant by providing immigration advice, explaining, translating, or recording information on the form for the
applicant. If the applicant does not have an immigration adviser, and no one helped the applicant to fill in this form, this
section does not have to be completed.
If you are not exempt under the Immigration Advisers Licensing Act 2007, it is an offence for you to provide immigration advice without holding a license,
and Immigration New Zealand will refuse to accept your client’s application. More information about immigration adviser licensing can be obtained from
the Immigration Advisers Authority website www.iaa.govt.nz, via email [email protected] or by telephone on 0508 422 422.

Name and address of person assisting applicant. Same as address given at B3 , or as below.
Family/last name Given/first name(s)

Company name (if applicable) and address

Telephone Email
I understand that after the applicant has signed this form it is an offence for me to change or add further information,
change any documents attached to the form, or attach any further documents to the form. However, if changes are
needed, the person making the changes must state on the form what information or documents have been changed and
give reasons for the changes.
I note that the maximum penalty for this offence is a fine of up to NZ$100,000 and/or a term of imprisonment of up to
seven years.
I certify that the applicant asked me to help them complete this form and any additional forms. I certify that the applicant
agreed that the information provided was correct before signing the declaration.
I have assisted the applicant as an interpreter/translator
I have assisted the applicant with recording information on the form
I have assisted the applicant in another way. Specify
I have provided immigration advice (as defined in the Immigration Advisers Licensing Act 2007) and my details in
Section H: Immigration adviser’s details are correct.

Signature of person assisting Date D D M M Y Y Y Y

Work Visa Application - July 2012 – 9

 When filling in this form, please write clearly using CAPITAL LETTERS.

10 – Work Visa Application - July 2012

 Section J Paying your application fee
Deciding whether you are eligible
for a visa To find out how much the fee is and where to send
your application, use our office and fees finder at
Immigration New Zealand collects the www.immigration.govt.nz/fees.
information about you on this form to decide whether Note: some offshore branches do not accept credit cards.
you are eligible for a work visa. We may also use the The office and fees finder contains information about
information to contact you for research purposes or to alternative methods of payment.
advise you on immigration matters.
Collecting the information is authorised by the Your application fee
Immigration Act 2009 and the Immigration Regulations
made under that Act. You do not have to provide the Amount you are paying:
information, but if you do not we are likely to decline
your application. Currency
Deciding whether you are eligible to board a Application number
flight to New Zealand (office use only)
The information we collect may also be used to
determine whether you are allowed to board a flight to Preferred methods of payment
New Zealand. We will not share your personal information
with airline check-in agents; however, we will send a We recommend that you use one of the following methods
boarding message to the airline check-in agent based on of payment for better security and faster processing:
the information you have provided in this form. Bank cheque/bank draft
Immigration New Zealand may also share the Credit card (choose one)
information you have provided with other government
agencies that are entitled to it by law, or with other Mastercard Visa
agencies (as you have agreed in the declaration). SWITCH card Issue number
SWITCH card (UK only)
You are able to ask for the information we hold about
you and have any of it corrected if you think it is Name of cardholder
necessary. The address of Immigration New Zealand
is PO Box 3705, Wellington, New Zealand. This is not
where your application should be sent. Card number

Other documents we may need

Sometimes we may ask for additional documents
CVC/CVV number
or information so that we can consider it with
this application. Note: your CVC/CVV number is the three-digit number found on the
Other documents you may wish to send signature strip on the back of your credit card.

You may wish to send other documents or Expiry date

information so that we can consider it with this
Signature of cardholder
application. Send photocopies only (not original
documents), as these documents will not be returned
to you. If we need to see an original document, you will
be asked to produce it later. Date

VisaView
Other methods of payment
It is an offence to employ a person who is not entitled
to work in New Zealand. One way for employers to Personal cheque. Note that we will hold your application for
avoid committing this offence is to check a person’s 10 working days to allow the cheque to be cleared.
entitlement to work with Immigration New Zealand’s Cash. Our New Zealand branches do not accept cash. Most of our
online VisaView system. Disclosure of information branches outside New Zealand do not accept cash.
through VisaView is authorised by legislation. EFTPOS. Note this option is only available for applications lodged in
person in one of our New Zealand offices.
If you believe that an employer has been given
the wrong entitlement information about you via We do not accept money orders.
VisaView, you may contact the Immigration Contact
Centre (0508 558 855) to request correction of that
information.

Work Visa Application - July 2012 – 11

 When filling in this form, please write clearly using CAPITAL LETTERS.

12 – Work Visa Application - July 2012