Visitor Visa: Application
Visitor Visa: Application
Visitor Visa: Application
Date received:
Application no.:
INZ 1017
INZ 1017
Section A
All principal applicants must complete this section. Attach one passport-size photograph of yourself here. The photograph must be less than six months old. Write your full name on the back of the photograph. Name as shown in passport Family/last name Given/first name(s)
Preferred title Mr
Mrs
Ms
Miss
Dr
other
This guide will help you to complete the form Visitors Visa/ Permit Application (INZ 1017) or the Visitors Permit Application for Auckland Region Applicants (INZ 1111). It will give you information about coming to New Zealand as a visitor and help you to understand the requirements you need to meet if you want to visit New Zealand. You should read this guide before completing the application form. The guide gives you information about: how to decide which visa or permit you need to apply for what evidence you need to provide with your application form what a visitors visa/permit allows you to do.
INZ 1111
Section A
All principal applicants must complete this section. Attach one passport-size photograph of yourself here. The photograph must be less than six months old. Write your full name on the back of the photograph. Name as shown in passport Family/last name Given/first name(s)
August 2010
Section A
All principal applicants must complete this section. Attach two 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
3.5cm 3.5cm 4.5cm 4.5cm
Given/first name(s)
A2 Preferred title
Mr
Mrs
Ms
Miss
Dr
other (specify)
November 2010
This guide will help you to complete the form Visitor Visa Application (INZ 1017) or the Visitor Visa Application for Auckland Region Applicants (INZ 1111). It will give you information about coming to New Zealand as a visitor and help you to understand the requirements you need to meet if you want to visit New Zealand. You should read this guide before completing the application form. The guide gives you information about: how to decide which visa you need to apply for what evidence you need to provide with your application form what a visitor visa allows you to do.
Date received:
Application no.:
INZ 1111
Application
Section A
This guide will help you to complete the form Visitors Visa/ Permit Application (INZ 1017) or the Visitors Permit Application for Auckland Region Applicants (INZ 1111). It will give you information about coming to New Zealand as a visitor and help you to understand the requirements you need to meet if you want to visit New Zealand. You should read this guide before completing the application form. The guide gives you information about: how to decide which visa or permit you need to apply for what evidence you need to provide with your application form what a visitors visa/permit allows you to do.
INZ 1111
August 2010
We will process your application only when we have received all the information and documents we need. If you do not send all the required information, we will return your application. You can use this form to apply for a visa for a single applicant or for a family. A family may include a principal applicant, partner, and dependent children aged under 20 years.
November 2010
April 2011
You can use this form to apply for a visa for a single applicant or for a family. A family may include a principal applicant, partner, and dependent children under 20.
Section A
All principal applicants must complete this section. Attach two 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
3.5cm 3.5cm 4.5cm 4.5cm
Given/first name(s)
A2 Preferred title
Mr
Mrs
Ms
Miss
Dr
other (specify)
April 2011
When filling in this form, please print clearly using CAPITAL LETTERS.
For more information about this question, see Completing Sections A, C, and D: Personal details in the Visitor Visa Guide.
For more information about this question, see Completing Sections A, C, and D: Personal details in the Visitor Visa Guide.
A5 Gender
Male
Female
A6 Date of birth
A7 Town/city of birth Country of birth A8 Passport details Number Country Expiry date
For more information about this question, see Completing Sections A, C, and D: Personal details in the Visitor Visa Guide.
A9 Country of citizenship A10 Other citizenships you hold A11 Partnership status Married/in civil union Separated Never married/never in civil union Engaged Widowed Partner Divorced
For more information about this question, see Completing Sections A, C, and D: Personal details in the Visitor Visa Guide.
Yes
No
Section B
Contact details
All principal applicants must complete this section. B1 Your residential address and telephone number in your home country Address
Telephone (evening)
B2 Your New Zealand residential address and telephone number (if you are already in New Zealand) Address
Telephone (evening)
B3 Name and address for communication about this application Same as address at Family/last name
B1
, or
Same as address at
B2
, or
as below
Given/first name(s)
Yes No
Make sure that your immigration adviser completes Section O: Immigration advisers details.
B6 Would you like us to email you instructions for registering to check online how your application is progressing? Yes No
B7 Names and addresses of any friends, relatives, or contacts you have in New Zealand (if applicable) Name Address Relationship Name Address Relationship B8 List all periods of employment, including self-employment
Date from (DD/MM/YY) / / / / / / / / / / / / / / / / / / / / / / Date to (DD/MM/YY) / / / / / / / / / / / / / / / / / / / / / / Name of employer Location Type of work/occupation/job title
When filling in this form, please print clearly using CAPITAL LETTERS.
Section C
All principal applicants who have ticked Married/in civil union, Partner or Engaged at A11 must complete this section with their partners personal details, whether or not the partner is included in this application. Attach two photographs of your partner only if they are included in this application. If applicable, attach two passport-size photographs of your partner here. The photographs must be less than six months old. Write your partners full name on the back of both photographs. C1 Partners name as shown in passport Family/last name
4.5cm 4.5cm
3.5cm
3.5cm
Given/first name(s)
Mrs
Ms
Miss
Dr
other (specify)
For more information about this question, see Completing Sections A, C, and D: Personal details in the Visitor Visa Guide.
C5 Partners gender
Male
Female
C7 Partners town/city of birth Partners country of birth C8 Partners passport details Number Country Expiry date
For more information about this question, see Completing Sections A, C, and D: Personal details in the Visitor Visa Guide.
C9 Partners country of citizenship C10 Other citizenships your partner holds C11 Is your partner included in this application? Yes No
Section D
You must complete this section with the details of each dependent child included in this application. Dependent child one Attach two recent passport-size photographs of the child here. The photographs must be less than six months old. Write the childs full name on the back of both photographs. D1 Childs name as shown in passport Family/last name
3.5cm 3.5cm 4.5cm 4.5cm
Given/first name(s)
D2 Childs gender
Male
Female
D4 Childs country of birth D5 Childs passport details Number Country Expiry date
For more information about this question, see Completing Sections A, C, and D: Personal details in the Visitor Visa Guide.
D6 Childs country of citizenship D7 Other citizenships child holds Dependent child two Attach two recent passport-size photographs of the child here. The photograph must be less than six months old. Write the childs full name on the back of both photographs. D8 Childs name as shown in passport Family/last name
4.5cm 4.5cm
Given/first name(s)
3.5cm 3.5cm
D9 Childs gender
Male
D10 Childs date of birth D12 Childs passport details Number Country Expiry date
D D M M Y Y Y Y
When filling in this form, please print clearly using CAPITAL LETTERS.
D13 Childs country of citizenship D14 Other citizenships child holds Dependent child three Attach two recent passport-size photographs of the child here. The photographs must be less than six months old. Write the childs full name on the back of both photographs. D15 Childs name as shown in passport Family/last name
4.5cm 4.5cm
Given/first name(s)
3.5cm 3.5cm
Male
D17 Childs date of birth D19 Childs passport details Number Country D20 Childs country of citizenship D21 Other citizenships child holds Dependent child four
Expiry date
Attach two recent passport-size photographs of the child here. The photographs must be less than six months old. Write the childs full name on the back of both photographs. D22 Childs name as shown in passport Family/last name
4.5cm 4.5cm
Given/first name(s)
3.5cm 3.5cm
Male
D24 Childs date of birth D26 Childs passport details Number Country D27 Childs country of citizenship D28 Other citizenships child holds
Expiry date
Section E
Health
E1
Do you or any person included in this application have pulmonary tuberculosis (TB)?
Yes
Provide details
No
E2 Do you or any person included in this application have any medical condition that requires, or may require, one of the following during your stay in New Zealand? Yes No Renal dialysis 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. E3 If you have answered Yes to any of the questions in
E2
Yes
No
If you have answered Yes, please provide details (who is pregnant and when are they due to give birth).
No
Go to E6
E6 Have you or any person included in this application submitted medical certificates that were completed and dated by a medical practitioner within the last 24 months with another Immigration New Zealand application? Yes
Provide details
No
Full name
Type of application
1. 2. 3. 4. 5. 6.
If everyone included in the application has submitted medical certificates in the last 24 months you do not need to provide further medical certificates now. We will tell you if we need any further medical information. Go to E10 If not everyone included in the application has submitted medical certificates that were completed and dated by a medical practitioner within the last 24 months, they may have to provide certificates now. Go to E7
When filling in this form, please print clearly using CAPITAL LETTERS.
E7
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. Go to
E8 E10
More than 12 months. You must provide a Medical and Chest X-ray Certificate (INZ 1007). Go to
E8 See the list Countries, areas, and territories with a low incidence of tuberculosis in Completing Section E: Health of the Visitor Visa Guide. Please tick one of the options below. Everyone included in this application is from a place that is on the list. Go to
E9
One or more people included in this application are from a place that is not on the list. Provide details below.
You must provide a completed X-Ray Certificate for Temporary Entry (INZ 1096) for each of these people with your application. If everyone included in your application is included above, go to E10 . If not everyone is included, go to E9 and complete it for the
people not included above.
E9 Please tick one of the options below. No one included in this application has spent three months or more in the past five years in a place that is not on the list. You do not have to provide any medical certificates at this stage. Go to E10 One or more people included in this application has spent three months or more in the past five years in a place that is not on the list. Provide details
You must provide a completed X-Ray Certificate for Temporary Entry (INZ 1096) for each of these people with your application. Go to E10 E10 Please tick below to show the evidence you are providing. I do not have to provide any medical certificates at this stage. I attach a X-ray Certificate for Temporary Entry (INZ 1096) for: Principal applicant Dependent child two Principal applicant Dependent child two Partner Dependent child three Partner Dependent child three Dependent child one Dependent child four Dependent child one Dependent child four
Note that children under the age of 11 years and pregnant women are not required to have an X-ray, unless a special report is needed
Section F
Visa type
All principal applicants must complete this section. F1 Please tick one of the boxes below to show the type of visa(s) you are applying for, and provide the details required.
For more information, see Completing Section F: Visa type in the Visitor Visa Guide.
Applying for a visitor visa while outside New Zealand. Provide details. Go to Date you will arrive in New Zealand Date you will finally depart New Zealand
F2
Applying for a visitor visa while inside New Zealand. Provide details. Go to Date you arrived in New Zealand Date you want your visitor visa to be valid to Date you will finally depart New Zealand
F2
Applying for a limited visa while outside New Zealand. Provide details. Go to Date you will enter New Zealand Date you will finally depart New Zealand
F3
Applying for a further limited visa while inside New Zealand. Provide details. Go to Date you arrived in New Zealand on a limited visa Date you will finally depart New Zealand F2 Only answer these questions if you are applying for a visitor visa. What is the purpose of your visit to New Zealand?
F3
F3 Only answer this question if you are applying for a limited visa or a further limited visa. What is your express purpose for visiting New Zealand? If you are applying for a further limited visa, also list the reasons why you require a further limited visa.
Date your express purpose starts/started Date your express purpose will be completed
Section G
Character
All applicants must complete this section. Note: 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 G: Character in the Visitor Visa Guide.
G1 Have you or any other person included in this application been: Yes No convicted charged Yes No under investigation Yes No for any offence(s) against the law in any country? G2 Have you or any other person included in this application been: excluded (refused entry) from refused a visa by removed or deported from any country? Yes Yes Yes No No No
When filling in this form, please print clearly using CAPITAL LETTERS.
If you have answered Yes to any of the questions in piece of paper if necessary.
G1
and
G2
Section H
Additional details
Complete this section for everyone included in the application aged 17 years or over. H1 Do you or any other person included in this application have a national identity number, or other unique identifier that was issued to you by any government? Yes Provide details No
Name of applicant 1. 2. 3. 4. 5. 6. National identity number/Unique identifier
H2 Have you or any other person included in this application completed military service in any country? Yes No
Date from (DD/MM/YY) / / / / / / / / / / / / / / Date to (DD/MM/YY) / / / / / / / / / / / / / / Rank Unit name or number Role Provide information about your/their military service including the dates of your/their military service, your/their position and rank, the unit or units that you/they served in, and your/their role within each unit.
H3 Are you or any other person included in this application presently subject to military service obligations in any country? Yes
Go to H4
No
If you/they are a citizen of a country in which compulsory military service exists, provide details.
H4 Have you or any other person included in this application been associated with any intelligence agency or group, or law enforcement agency? Yes Describe how you/they were involved No
H5 Have you or any other person included in this application been associated with any group or organisation that has used or promoted violence to further their aims? Yes Describe how you/they were involved No
H6 Have you or any other person included in this application ever committed or been involved in war crimes, crimes against humanity, and/or human rights abuses? Yes Describe how you/they were involved No
Section I
Principal applicants applying under the parent and grandparent multiple entry visitor visa instructions must complete All other applicants must complete I1 and I2 .
For more information about the questions in this section, see Completing Section I: Financial support while you are in New Zealand in the Visitor Visa Guide.
I1
Please tick one of the options below to show what evidence you are providing of financial support in New Zealand. I have attached copies (not originals) of evidence that I have NZ$1000 per month for each person included in this application. I have attached copies (not originals) of evidence that I have NZ$400 per month for each person included in this application for maintenance, and evidence that our accommodation costs are already paid. I have attached a completed Sponsorship Form for Temporary Entry (INZ 1025) guaranteeing accommodation, maintenance, and financial support.
When filling in this form, please print clearly using CAPITAL LETTERS.
I2
Please tick one of the options below to show how you will travel out of New Zealand. I have attached copies (not originals) of valid tickets to a country which I have the right to enter. I have attached evidence of sufficient funds in New Zealand to purchase a ticket to a country which I have the right of entry. I have attached a completed Sponsorship Form for Temporary Entry (INZ 1025) guaranteeing my repatriation from New Zealand. Note that any non-refundable travel arrangements are made at your own risk.
I3
I have attached a Sponsorship Form for Temporary Entry (INZ 1025) guaranteeing my sponsor will cover the cost of accommodation, maintenance, repatriation and health care. I have attached evidence of my family relationship to my sponsor. Go to Section N: Declaration by applicant.
Section J
Partners of New Zealand citizens, and partners of residence class, work or student visa holders
Complete this section if your partner is a New Zealand citizen, residence class visa holder, student visa holder, or work visa holder, and you are applying for a visa on the basis of that partnership. Otherwise, go to Section K: Application for a visa for the purpose of a culturally arranged marriage.
For more information about the questions in this section, see Completing Section J: Partners of New Zealand citizens, and partners of residence class, work, or student visa holders in the Visitor Visa Guide.
J1
Are you and your partner living in a genuine and stable partnership? Yes No. If you have answered No, please explain why.
J2
How long have you and your partner been together in this partnership?
J3 Will your partner be in New Zealand for the same period of time that you are here? Yes No. If you have answered No, please explain why.
Yes
No
J5 If your partner is a New Zealand citizen or residence class visa holder, do you intend to apply for residence under Immigration New Zealands Partnership Instructions? Yes Go to
J6
No Go to
J7
Not applicable Go to
J7
J6 Will your partner be eligible to support your application for residence? Yes No. If you have answered No, please explain why.
Section K
Complete this section if you are applying for a visa for the purpose of a culturally arranged marriage. Otherwise, go to Section L: Dependent children of Essential Skills work visa holders. K1 Are you coming to New Zealand to enter a marriage in accordance with an identified cultural tradition? Yes No
K2 Has another person (not you or the person you are marrying) arranged the marriage? This includes the initial selection of you and the person you are marrying. Yes No
K3 Do you intend to marry within three months of your arrival in New Zealand? Yes No
K4 Do you intend to apply for residence under Immigration New Zealands Partnership Instructions? Yes No. If you have answered No, please explain why.
K5 Will your intended spouse be eligible to support your application for residence? Yes No. If you have answered No, please explain why.
K6 Do you agree to leave New Zealand if the marriage does not take place within three months of your arrival in New Zealand? Yes No
When filling in this form, please print clearly using CAPITAL LETTERS.
Section L
Complete these questions if you are the dependent child of an Essential Skills work visa holder(s). If you do not have to complete this section, go to Section M: Guardians of students. L1 Provide the following information for your parent(s).
Name of parent(s) as shown in passport Date of birth of parent(s) INZ client number for parent(s) (if known)
L2
Does your parent(s), who is the holder of an Essential Skills work visa meet the minimum income threshold? Note: If
both parents hold an Essential Skills work visa both salaries or wages can be counted towards the minimum income threshold. The minimum income threshold can be found in Completing Section L: Dependent children of Essential Skills work visa holders in the Visitor Visa Guide
Yes L3
No
Have you provided evidence of the salary or wages earned by your parent(s)? Acceptable evidence includes original or
certified copies of a job offer with salary or wages equal to or higher than the minimum income threshold.
Yes
No
Section M
Guardians of students
Complete this section if you are applying for a visitor visa to live with and care for an overseas student who requires a guardian to accompany them in New Zealand. Otherwise, go to Section N: Declaration by applicant. M1 I have attached evidence that I am the legal guardian of the student that I am accompanying.
Section N
Declaration by applicant
All of the people included in this application must complete this section. I have provided true and correct answers to the questions in this form. I will inform Immigration New Zealand of any relevant fact or change of circumstances that may (i) affect the decision on my application for a visa, or (ii) affect the decision to grant entry permission based on the visa for which I am applying. 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 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 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. If I am granted a visa with the condition that I accompany a student, I agree to live with that student. I understand that both the student and I may be liable for deportation if I do not meet this condition. If I am granted a limited visa , I agree that I will leave New Zealand on or before the expiry date of that visa . If I do not leave New Zealand, I may be immediately deported from New Zealand without the right of appeal. Signature of principal applicant Signature of partner Signature of dependent child Signature of dependent child Signature of dependent child Signature of dependent child
Note that a parent or guardian may sign on behalf of a child under 18 years.
When filling in this form, please print clearly using CAPITAL LETTERS.
Section O
This section must be completed by the applicants immigration adviser. If the applicant does not have an immigration adviser, this section does not have to be completed. O1 Tick the one option that applies to you. I am a licensed immigration adviser under the New Zealand Immigration Advisers Licensing Act 2007. Go to I am exempt from licensing under the New Zealand Immigration Advisers Licensing Act 2007. Go to
O3 O2
If you are unlicensed when you should be licensed under the Immigration Advisers Licensing Act 2007, Immigration New Zealand will return your clients application. It is an offence to provide immigration advice without holding a licence, unless you are exempt.
O2 Licensed advisers. Provide your licence details. Licence type full provisional limited. List conditions specified in the register.
Licence number 2 0
O3 Exempt from licensing. Tick one box below to show why you are exempt from licensing. I provided immigration advice in an informal or family context only, and I did not provide the advice systematically or for a fee. I am a New Zealand member of Parliament or member of their staff and I provided immigration advice as part of my employment agreement. I am a foreign diplomat or consular staff. I am an employee of the New Zealand public service and I provided immigration advice within the scope of my employment agreement. I am a lawyer and I hold a current practising certificate as a barrister or as a barrister and solicitor of the High Court of New Zealand. I am employed by, or I am working as a volunteer for, a New Zealand community law centre where at least one lawyer is on the employing body of the community law centre or is employed by or working as a volunteer for the community law centre in a supervisory capacity. I am employed by, or I am working as a volunteer for, a New Zealand citizens advice bureau.
Go to Section P: Declaration by person assisting the applicant.
This form has been approved under section 381 of the Immigration Act 2009
Section P
This section must be completed and signed by the applicants 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 unlicensed when you should be licensed under the Immigration Advisers Licensing Act 2007, Immigration New Zealand will return your clients application. It is an offence to provide immigration advice without holding a licence. For more information, go to the Immigration Advisers Authority website www.iaa.govt.nz, or email [email protected] or write to them at PO Box 6222, Wellesley Street, Auckland 1141, New Zealand.
B3
, or
as below.
Telephone (evening)
I understand that after the applicant has signed this form it is an offence to change or add further information, change any documents attached to the form, or attach any further documents to the form. 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. 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 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 O: Immigration advisers details are correct. Signature of person assisting Date
D D M M Y Y Y Y
When filling in this form, please print clearly using CAPITAL LETTERS.
Application checklist
OFFICE USE ONLY
Check list
Check list
I have provided evidence about my character. I have completed the application form. Each person included in the application has signed the form. I have provided the application fee. I have attached passports or travel documents (the original documents) for each person included in the application. I have attached two recent passport-size photographs of each person included in the application. I do not have to provide this evidence.
Guardians of students only
I have provided evidence that I am the legal guardian of the student that I am accompanying.
Partners of New Zealand citizens/residence class, work or student visa holders only
Financial support Principal applicant applying under the parent and grandparent multiple entry visitor visa instructions only.
I have attached a completed Sponsorship Form for Temporary Entry (INZ 1025).
Financial support All other principal applicants. Please tick one of the options below to show what evidence you are providing of financial support in New Zealand
I have provided evidence that my parent(s) meets the minimum income threshold as listed in Section L.
Immigration advisers details
I have attached copies (not originals) of evidence that I have NZ$1000 per month for each person included in this application. I have attached copies of evidence that I have NZ$400 per month for each person included in this application for maintenance, and a completed Sponsorship Form for Temporary Entry (INZ 1025) guaranteeing accommodation. I have attached a completed Sponsorship Form for Temporary Entry (INZ 1025).
Please tick one of the options below to show how you will travel out of New Zealand.
I have received immigration advice on this application. I have not received immigration advice on this application.
I have attached copies of valid ticket(s) to a country which I have the right to enter. I have attached evidence of sufficient funds in New Zealand to purchase a ticket to a country to which I have the right of entry. I have attached a completed Sponsorship Form for Temporary Entry (INZ 1025).
Health
I have provided evidence about my health. I do not have to provide this evidence.
If you do not complete this section your application will not be affected.
Section Q
Please see our Fees Guide (INZ 1028) or our website www.immigration.govt.nz/fees for more information about current fees and payment methods.
Visa
SWITCH card Issue number
Card number
Expiry date
Signature of cardholder
Date
Personal cheque. Note that we will hold your application for 10 working days to allow the cheque to be cleared. Cash. Our New Zealand branches do not accept cash. Most of our
branches outside New Zealand do not accept cash.
*Your CVC/CVV number is required if you are paying by electronic credit card and your application is being lodged at Immigration New Zealands Bangkok branch, London branch, or the MFAT post in The Hague. If your application will be lodged in one of these branches, please provide your CVC/CVV number here.
Note: your CVC/CVV number is the three-digit number found on the signature strip on the back of your credit card.
When filling in this form, please print clearly using CAPITAL LETTERS.