OFFICE USE ONLY
Client no.:Date received: / /Application no.:
immigration .
A1
A2
A4 A6 A7 Passport details
Number
Expiry date Country
A8 Partnership status Married Partner Engaged Never married Separated/Divorced Widowed A9 Do you have a national identity number, or other unique identifier that was issued to you by any government? Yes National identity number/unique identifier
No
When filling in this form, please write clearly using CAPITAL LETTERS.
All principal applicants must complete this section.康辉旅行社云南6天5晚双人游卡
B1Your residential address in the country you reside in.
Address
Province/region
Telephone (mobile) Telephone (other)
Email
B2Name and address for communication about this application.
Same as address at B1 or
as below
Family Given
Company name (if applicable) and address
B3Do you authorise the person stated at B2to act on your behalf? Yes No
B4Have you received immigration advice on this application?
You can find a definition of immigration advice at vt.nz/advice. Please note immigration advice does not include assisting the applicant by acting as a translator or by recording information on this form.
Yes Please make sure that your immigration adviser completes Section I: Immigration adviser’s details
No
B5Names and addresses of any friends, relatives, or contacts you have in New Zealand (if applicable) Name
Address
Relationship Friend Family member Other (please specify)
Name
Address
Relationship Friend Family member Other (please specify)
B6List your current and previous two employers, including periods of self-employment. Start with the current
position.
2 – Tourist/Business Visitor Visa Application - November 2014
All principal applicants must complete this section.
C1
D
C2What is the purpose of your visit to New Zealand? Tourism Business* Visiting family/friends * If you are travelling for business, please enclose a letter from your employer and/or the relevant company in New Zealand to confirm the purpose of your visit
All principal applicants who have ticked ‘Married’, ‘Partner’ or ‘Engaged’ at A8 must complete this section with their partner’s 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.
D1
D2
D4 Partner’s date of birth
D5
D6Town/city of birth Country of birth
D7Partner’s passport details
Number Expiry date Country
D8Is your partner included in this application? Yes No
D9Does your partner have a national identity number, or other unique identifier that was issued by any government?
Yes Partner’s national identity number/unique identifier
No
Tourist/Business Visitor Visa Application - November 2014 3
4 – Tourist/Business Visitor Visa Application - November 2014
When filling in this form, please write clearly using CAPITAL LETTERS.
You must complete this section with the details of each dependent child included in this application. If you wish to include more than two children in your visa application, please print an extra copy of this page and attach it to the
E1
E2
E4 Country
E5 Town/city of child’s birth
Country of child’s birth
E6
E7 E9 E10 Town/city of child’s birth
Country of child’s birth
Tourist/Business Visitor Visa Application - November 2014 5
All principal applicants must complete this section.
F1 Do you or any person included in this application have tuberculosis (TB)? Yes No
F2 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?
• Renal dialysis Yes No • Hospital care
Yes No
• Residential care Yes No
Residential care is defined as in-patient care for people with psychiatric, sensory or intellectual disabilities or live-in facilities for the aged.
F3 Are you or any person included in this application pregnant? Yes No F4 If you have answered Yes to any of the questions in F1
to
F3
, please provide details.
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.
G1 Have you, or anyone included in this application, been convicted at any time of any offence, including any driving
offence? Please note that this includes any conviction(s) outside of New Zealand subsequently cleared or wiped by ‘clean slate’ legislation. Yes No G2 Are you, or is anyone included in this application, currently:
• under investigation Yes No • wanted for questioning Yes No • facing charges
Yes No
for any offence in any country?
Have you, or has anyone included in this application, ever been:
• excluded Yes No • refused entry Yes No
• removed or deported Yes No
from any country, including New Zealand?
Have you, or has anyone included in this application, ever been refused a visa/permit to visit, work, study or
农家乐休闲农庄reside in any country?
Yes No G3G4
6 – Tourist/Business Visitor Visa Application - November 2014
When filling in this form, please write clearly using CAPITAL LETTERS.
青海民族大学研究生院
四川黄龙天气预报15天
Have you, or has anyone included in this application, ever been a member of, or adhered to, any terrorist
organisation?
Yes
No
Have you, or has anyone included in this application, had (or currently have) an association with, membership
of, or involvement with, any government, regime, group or agency that has advocated or committed
war crimes, crimes against humanity and/or other gross human rights abuses? Yes No
If you have answered yes to any of the questions above give full details. This includes full details of any charges, convictions and the sentence or penalty imposed. Continue on a separate piece of paper if necessary.
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 understand that I am not entitled to free health care in New Zealand, and 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 sh
ould 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 and/or accompanying documentation, 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 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.Signature of principal applicant Date
Signature of partner Date
Signature of dependent child Date
Signature of dependent child
Date
Signature of parent or guardian if principal applicant is under 18 years of age
Date
This form has been approved under section 381 of the Immigration Act 2009
