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

May 2017 INZ 1189

Tourist/Business
Visitor Visa Application
for use by people outside New Zealand intending a short stay

Apply for your visa online – it’s faster & easier

The fastest and easiest way to apply for a visitor visa is online. Once you have your documents prepared, it should take less
than 15 minutes to complete the online application form. If you are travelling as part of a group or with your family you should
use the paper form instead.
To apply online, go to www.immigration.govt.nz/visit

Who can use this form?

To use this form, you must be:
If you do not meet these requirements, please use the form
• outside New Zealand
Visitor Visa Application (INZ 1017).
• travelling to New Zealand for either tourism or business
• intending to spend less than six months in New Zealand You can use this form to apply for a visa for a single applicant
• financially supported by your own funds if you are or for a family. A family may include a principal applicant,
travelling as a tourist, or by your employer if you are partner, and dependent children under 20.
travelling for business.
When filling in this form, write clearly in English using CAPITAL LETTERS.

Section A Principal applicant’s personal details

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 4.5cm 4.5cm

Family/last name

Given/first name
3.5cm 3.5cm

A2 Other names you are known by or have ever been known by (if any)

A3 Gender Male Female

A4 Date of birth D D M M Y Y Y Y
A5 Preferred title Mr Mrs Ms Miss Dr other (specify)

A6 Town/city of birth Country of birth

A7 Passport details
Number Expiry date D D M M Y Y Y Y Country

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

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

Section B Contact details

All principal applicants must complete this section.
We prefer to contact you using email. Please provide your email address if you have one.

B1 Your residential address in the country you reside in.

Address

Province/region

Telephone (mobile) Telephone (other)

Email

B2 Name and address for communication about this application.

Same as address at B1 , or as below

Family Given

Company name (if applicable) and address

Telephone (mobile) Telephone (other)

Email

B3 Do you authorise the person stated at B2 to act on your behalf? Yes No

B4 Have you received immigration advice on this application?

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

B5 Names 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)

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 B6 List your current and previous two employers, including periods of self-employment. Start with the
current position.
Date from Date to Name of employer Location Occupation/Job title
(DD/MM/YY) (DD/MM/YY) (city and country)
/ / Present

/ / / /

/ / / /

Section C Visa type

All principal applicants must complete this section.

C1 Date you will arrive in New Zealand D D M M Y Y Y Y Date you will depart New Zealand D D M M Y Y Y Y

C2 What 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

Section D Partner’s personal details

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.
If applicable, attach two passport-size photographs of your partner
here. The photographs must be less than six months old. Write your
partner’s full name on the back of both photographs.

D1 Partner’s name as shown in passport

Family/last name 4.5cm 4.5cm

Given/first name
3.5cm 3.5cm

D2 Other names your partner is known by or has ever been

known by (if any)

D3 Partner’s gender Male Female

D4 Partner’s date of birth D D M M Y Y Y Y

D5 Partner’s preferred title Mr Mrs Ms Miss Dr other (specify)

D6 Town/city of birth Country of birth

D7 Partner’s passport details

Number Expiry date D D M M Y Y Y Y Country

D8 Is your partner included in this application? Yes No

D9 Does 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 – May 2017– 3

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

Dependent children’s personal details

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 form.

Dependent child one

Attach two recent passport-size photographs of the child here. The
photographs must be less than six months old. Write the child’s full
name on the back of both photographs.
4.5cm 4.5cm
E1 Child’s name as shown in passport
Family/last name

3.5cm 3.5cm

Given/first name

E2 Child’s gender Male Female E3 Child’s date of birth D D M M Y Y Y Y

E4 Child’s passport details

Number Expiry date D D M M Y Y Y Y

Country

E5 Town/city of child’s birth

Country of child’s birth

Dependent child two

Attach two recent passport-size photographs of the child here. The
photographs must be less than six months old. Write the child’s full
name on the back of both photographs.

E6 Child’s name as shown in passport 4.5cm 4.5cm

Family/last name

3.5cm 3.5cm
Given/first name

E7 Child’s gender Male Female E8 Child’s date of birth D D M M Y Y Y Y

E9 Child’s passport details

Number Expiry date D D M M Y Y Y Y

Country

E10 Town/city of child’s birth

Country of child’s birth

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 Section F Health

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.

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.

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?
G3 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?
G4 Have you, or has anyone included in this application, ever been refused a visa/permit to visit, work, study or
reside in any country?
Yes No

Tourist/Business Visitor Visa Application – May 2017– 5

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

G5 Have you, or has anyone included in this application, ever been a member of, or adhered to, any terrorist
organisation?
Yes No
G6 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.

Section H 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 understand that if false or misleading information is submitted, my application may be declined without further warning.
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.
If my partner is included in this application, we declare we are living together in a genuine and stable partnership.
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.
If I undertake a course of study while in New Zealand, I authorise Immigration New Zealand to provide information about my
immigration status to my education provider, including via the online VisaView system.
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 D D M M Y Y Y Y

Signature of partner Date D D M M Y Y Y Y

Signature of dependent child Date D D M M Y Y Y Y

Signature of dependent child Date D D M M Y Y Y Y

Signature of parent or guardian if principal applicant is under 18 years of age

Date
D D M M Y Y Y Y

This form has been approved under section 381 of the Immigration Act 2009
6 – Tourist/Business Visitor Visa Application – May 2017
 Section I 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. If you have assisted the applicant solely
by acting as a translator or by recording information on the form, you do not have to complete this section.
Complete Section J: Declaration by person assisting the applicant instead.

I1 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 I2

I am exempt from licensing under the New Zealand Immigration Advisers Licensing Act 2007. Go to I3

If you are unlicensed when you should be licensed under the Immigration Advisers Licensing Act 2007, Immigration New Zealand will return your client’s application. It is an
offence to provide immigration advice without holding a licence, unless you are exempt.

I2 Licensed advisers. Licence type full provisional limited List conditions specified in the register.

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

I3 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 J: Declaration by person assisting the applicant.

Tourist/Business Visitor Visa Application – May 2017– 7

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

Section J Declaration by person assisting the applicant

This section must be completed and signed 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 client’s
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 info@iaa.govt.nz or write to them at PO Box 6222, Wellesley Street, Auckland 1141, New Zealand.

Name and address of person assisting applicant

Same as address given at B2
, or as below.
Family/last name Given/first name(s)

Company name (if applicable) and address

Telephone (daytime) Telephone (evening)

Fax Email

I understand that after the applicant has signed this form it is an offence for me to change or add further information, or
change or add any documents attached to the form, without making a statement identifying what information or material
has been changed, added or attached and by whom. If I make these changes or additions, I must state on the form what
they were, who made them and the reason they were made.
I understand 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 I: Immigration adviser’s details are correct.

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

8 – Tourist/Business Visitor Visa Application – May 2017

 Paying your application fee
Where to send your application Section K
and immigration levy
Go to www.immigration.govt.nz/contactus to check To find out how much the fee and immigration levy is and
which Immigration branch will process your application. where to send your application, use our office and fees
finder at www.immigration.govt.nz/fees.
About the information you provide Note: some offshore offices do not accept credit cards. The
office and fees finder contains information about alternative
Immigration New Zealand collects the information methods of payment.
about you on this form to decide whether you are
eligible for a visa. We may also use the information to
contact you for research purposes or to advise you on Your application fee and immigration levy
immigration matters.
Amount you are paying:
Collecting the information is authorised by the
Immigration Act 2009 and the Immigration Regulations Amount
made under that Act. You do not have to provide the
information, but if you do not we are likely to decline Currency
your application. (e.g. NZD, USD, RMB)
The information we collect may also be used to
Application number
determine whether you are allowed to board a flight
(office use only)
to New Zealand. We will not share your personal
information with airline check-in agents; however, we
will send a boarding message to the airline check-in Preferred methods of payment
agent based on the information you have provided in
this form. We recommend that you use one of the following methods
of payment for better security and faster processing:
Immigration New Zealand may also share the
information you have provided with other government Bank cheque/bank draft
agencies that are entitled to it by law, or with other Credit card (choose one)
agencies (as you have agreed in the declaration).
Mastercard Visa
You are able to ask for the information we hold about
SWITCH card issue number
you and have any of it corrected if you think it is SWITCH card (UK only)
necessary. The address of Immigration New Zealand Name of cardholder
is PO Box 1473, Wellington 6140, New Zealand. This is
not where your application should be sent.

Card number

Application checklist
CVC/CVV number
OFFICE
CHECK
USE Information and documents you must supply LIST Note: Your CVC/CVV number is the three-digit number found on the signature
ONLY
strip on the back of your credit card.
I have completed and signed the application form.
I have provided my application fee and immigration levy. Expiry date

I have attached my passport or travel document*. Signature of cardholder

I have attached two recent passport-size photographs.
I have attached my itinerary.
I have attached evidence of funds for support. Date
I have attached a letter from my employer regarding my
purpose in New Zealand (if travelling for business)
Other methods of payment
*While you can provide a certified copy of your passport
with your application, we highly recommend you provide Personal cheque. Note that we will hold your application for
your original passport. This will enable us to process your 10 working days to allow the cheque to be cleared.
application faster and it may be needed to complete your
application. Please note during the processing of an application Cash. Our New Zealand offices do not accept cash. Most of our offices
outside New Zealand do not accept cash.
an immigration officer may request any document, including
your original passport. EFTPOS. Note this option is only available for applications lodged in
person in one of our New Zealand offices.

We do not accept money orders.

Tourist/Business Visitor Visa Application – May 2017– 9

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

Returning your documents

Tick one of the following options

I wish to collect my documents when ready.

Return all documents to me by secure post at the address given at B2 .

You may be required to pay for postage. Please see www.immigration.govt.nz/
contactus and select your branch to check if a postage fee applies.

10 – Tourist/Business Visitor Visa Application – May 2017

Tourist/Business Visitor Visa Application – May 2017– 11
 When filling in this form, please write clearly using CAPITAL LETTERS.

12 – Tourist/Business Visitor Visa Application – May 2017