Inz 1175 Form – Fill Out and Use This PDF

April 2016	INZ 1175

Application from a Resident or Former Resident Visa Holder

for a permanent resident visa, second or subsequent resident visa, or a variation of travel conditions

Use the guide to help you complete the application form

Please read the Guide for Resident or Former Resident Visa Holders (INZ 1176) before you complete this application form. The guide gives detailed information about the evidence and documents you need to send. Do not use this form if you are a New Zealand citizen. Complete the form New Zealand Citizen Endorsement Application (INZ 1174).

Holders of residence permits and returning resident’s visas granted under the Immigration Act 1987

If you hold a residence permit or returning resident’s visa, you are deemed to hold a resident visa or permanent resident visa under the Immigration Act 2009. For information see the Guide for Resident or Former Resident Visa Holders (INZ 1176).

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

You must provide passports or certiicates of identity for everyone included in this application.

Tick the statement that applies to you. For help determining which statement applies to you, see the checklist ‘What do I need to apply for?’ on page 10.

I hold a resident visa, or I have held one in the last three months, and I am applying for a permanent resident visa. (Note: you must have held a resident visa for at least 24 months to be eligible for a permanent resident visa.)

You must complete sections A, B, C, D, and sections G to K.

I hold a resident visa and I am applying for a variation of travel conditions. You must complete sections A, B, C, E, and sections G-K.

I held a resident visa but it expired because I was outside New Zealand without valid travel conditions, therefore I am applying for a second or subsequent resident visa. You must complete sections A, B, C, F, and sections G-K.

A2	Preferred title	Mr	Mrs	Ms	Miss	Dr Other (specify)

immigration.govt.nz

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

A11 Are you a New Zealand citizen?

Yes You cannot be granted a resident or permanent resident visa. Please complete a New Zealand Citizen Endorsement Application

(INZ 1174).

Section B Contact details

All principal applicants must complete this section.

B1 Name and address for communication about this application Name of contact person

Organisation name (if applicable) and address

B2 If you have given someone else’s name above do you authorise that person to act on your behalf?

Yes No Not applicable

B3 Do you authorise all other licensed immigration advisers or persons exempt from licensing who work for the

organisation named at B1 to act on your behalf (if applicable)?

Yes Note: the person identiied at	B1 will receive all communication from Immigration New Zealand.
No Only the person indicated at B1	may act on my behalf.

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B4 Have you received immigration advice on this application?

You can ind a deinition of immigration advice at www.immigration.govt.nz/advice.

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

No

Section C Partner’s and children’s personal details

Only people included in the original resident visa application may be listed here.

Application from a Resident or Former Resident Visa Holder – April 2016 – 3

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

Expiry date

D

D

M

M

Y

Y

Y

Y

Country

Relationship to applicant

Continue on a separate sheet of paper if necessary.

C5 List your immediate family (ie your partner, children, parents and siblings) not included in this application.

	Full name	Date of birth		Country currently residing	Nationality	Relationship to applicant
		(DD/MM/YY)		in
	1.	/	/
	2.	/	/
	3.	/	/
	4.	/	/
	5.	/	/
	6.	/	/
	7	/	/
	8	/	/
	9	/	/
	10	/	/
	11	/	/
	12	/	/
	13	/	/

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Section D Applicants for a permanent resident visa

You must have held a resident visa for at least 24 months before you can be granted a permanent resident visa. If you have held a resident visa for a shorter period, you will not be granted a permanent resident visa and may be granted a 12-month variation of travel conditions instead.

D1 To be eligible for a permanent resident visa, you must have met one of the ive ‘commitment to New Zealand criteria’ set out below. Please tick to indicate which you meet:

The principal applicant has been in New Zealand for 184 days or more in each of the 12-month portions of the 24 months immediately preceding this application.

The principal applicant has obtained tax residence status in New Zealand, and been in New Zealand for at least 41 days or more in each of the 12-month portions of the 24 months immediately preceding this application.

The principal applicant has maintained an investment of NZ$1,000,000 in New Zealand for 24 months.

The principal applicant has established a business in New Zealand at least 12 months ago.

The principal applicant has established a base in New Zealand.

You must provide evidence relevant to the criteria that you meet as detailed in the Guide for Resident or Former Resident Visa Holders (INZ 1176). You are not required to provide evidence of time spent in New Zealand as INZ holds these records.

D2 If your visa is subject to conditions, have you met these conditions?

Note: if you held a returning resident’s visa or residence permit subject to requirements under section 18A of the Immigration Act 1987, these are considered to be conditions under section 49 of the Immigration Act 2009.

D3 If you do not meet the requirements for a permanent resident visa as set out in the Guide for Resident and Former Resident Visa Holders (INZ 1176), do you give permission for INZ to assess your eligibility for the grant of a variation of travel conditions or a second or subsequent resident visa instead?

Go to Section G: Character declaration.

Section E Variation of travel conditions

E1 Indicate the duration and criteria of travel conditions you are applying for.

One-year variation of travel conditions as the principal applicant has been in New Zealand for 184 days or more in one of the 12-month portions of the 24 months immediately preceding this application.

One-year variation of travel conditions as the principal applicant has obtained tax residence status in New Zealand, and been in New Zealand for at least 41 days or more in one of the 12-month portions of the 24 months immediately preceding this application.

Two-year variation of travel conditions as the principal applicant is the partner of a New Zealand citizen.

Two-year variation of travel conditions as the principal applicant is seconded overseas as part of their New Zealand employment.

Two-year variation of travel conditions as the principal applicant is an Australian citizen or resident.

Two-year variation of travel conditions as the principal applicant has met the investment conditions of their resident visa.

14-day variation of travel conditions as the applicant is in New Zealand and none of the criteria above have been met.

The Guide for Resident and Former Resident Visa Holders (INZ 1176) contains the full criteria to be eligible for a variation of travel conditions. You must provide evidence as outlined in the guide that you meet the criteria, however you are not required to provide evidence of time spent in New Zealand as INZ retains these records.

Application from a Resident or Former Resident Visa Holder – April 2016 – 5

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

E2 During the assessment of your application, INZ may determine that you are eligible for a permanent resident visa, or that you are not eligible for a variation of travel conditions but you are eligible for a second or subsequent resident visa. Do you give permission for INZ to grant you one of these alternatives, rather than a variation of travel conditions?

Yes Go to Section G: Character declaration

No Go to Section H: Declaration by applicant

Section F Second or subsequent resident visa

You must apply for a second or subsequent resident visa to return to New Zealand as a resident if:

you left New Zealand after the travel conditions on your resident visa expired, or

you were outside New Zealand on the date the travel conditions on your resident visa expired.

Your eligibility for a second or subsequent resident visa is based on whether you would have been able to obtain a permanent resident visa or variation of travel conditions on the date your resident visa expired.

Section G Character declaration

The following questions apply to every person included in this application 17 years of age and over.

You must complete the character declaration below in full, stating whether you have any convictions or other character issues of concern. For more information, see the Can my application be declined? section in the Guide for Resident and Former Resident Visa Holders (INZ 1176).

6 – Application from a Resident or Former Resident Visa Holder – April 2016

This form has been approved under section 381 of the Immigration Act 2009.

Continue on a separate sheet if necessary.

Section H Declaration by applicant

I have provided true and correct answers to the questions in this form. I know of no reason why I should not be issued a permanent resident visa, resident visa, or a variation of travel conditions.

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 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 make any enquiries it deems necessary in respect of the information provided on this form and/or accompanying documentation, and to share this information with other government agencies (including overseas agencies) to the extent necessary to make decisions about my immigration status.

I authorise any agency whether in New Zealand or overseas, including but not limited to border or immigration agencies, education providers, inancial institutions, foreign embassies, government authorities, healthcare providers, police or other law enforcement agencies, that holds information (including personal information) related to information on this form and/or accompanying documentation to disclose that information to Immigration New Zealand.

I hereby authorise Inland Revenue to release to INZ any information to enable INZ, when necessary, to verify my tax residence status in New Zealand and, where applicable, the relationship between that status and tax residence status in any other country.

Signature of principal applicant		Date
Signature of partner		Date

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

Date

Signature of accompanying dependent child 1 over 18 years of age (if applicable)

Date

Signature of accompanying dependent child 2 over 18 years of age (if applicable)

Date

Signature of accompanying dependent child 3 over 18 years of age (if applicable)

Date

Application from a Resident or Former Resident Visa Holder – April 2016 – 7

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

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.

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. Provide your licence details.

Licence type

full	provisional	limited. List conditions speciied in the register.

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 certiicate 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 applicant.

8 – Application from a Resident or Former Resident Visa Holder – April 2016

Section J Declaration by person assisting 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 filling in 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.

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 ine 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 illing in the form

I have assisted the applicant in another way. Specify

I have provided immigration advice (as deined in the Immigration Advisers Licensing Act 2007) and my details in Section I: Immigration adviser’s details are correct.

For more information

If you have questions about completing the form:

see our website www.immigration.govt.nz

telephone our call centre on 0508 558 855 (within New Zealand)

Application from a Resident or Former Resident Visa Holder – April 2016 – 9

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

What do I need to apply for? (optional checklist)

This section will help identify if you need to apply for a permanent resident visa (Section D), a variation of travel conditions (Section E) or a second or subsequent resident visa (Section F). Please note that this section is not mandatory- you may use it to help determine the best option for you.

All applicants must complete:

Section A: Principal applicant’s personal details

Section B: Contact details

Section G: Character declaration

Section H: Declaration by applicant

If applicable, you may also need to complete:

Section C: Partner and children’s personal details

Section I: Immigration adviser’s details

Section J: Declaration by person assisting applicant.

If you were the principal applicant in the original residence application, you can use this information to help you complete this form correctly.

If you were not the principal applicant, you will usually only qualify for the same status as the principal applicant. For more information, refer to ‘Principal and non-principal applicants’ in the Guide for Resident or Former Resident Visa Holders (INZ 1176).

Do you currently hold a resident visa?

Yes Complete part A below to determine what visa or travel conditions to apply for

No Complete part B below to determine what visa to apply for

Note: If you are not sure whether you currently hold a resident visa, refer to the section ‘Do I currently hold a resident visa?’ in the Guide for Resident or Former Resident Visa Holders (INZ 1176)

Part A: Resident visa holders

1.Was your current resident visa granted more than two years ago?

Yes

No Complete Section E: Variation of travel conditions

2.Have you met any conditions imposed under section 49(1) of the Immigration Act 2009?

Yes

No

Note: For more information, refer to the section ‘What are section 49(1) conditions?’ in the Guide for Resident or Former Resident Visa Holders (INZ 1176)

3.Have you met one of the ive following criteria to show a commitment to New Zealand?

a.Time spent in New Zealand

b.Tax residence status

c.Investment in New Zealand

d.Business established in New Zealand

e.Base established in New Zealand

Yes

No

Note: For details about meeting these requirements, see the section ‘Requirements for a permanent resident visa’ in the Guide for Resident or Former Resident Visa Holders (INZ 1176).

10 – Application from a Resident or Former Resident Visa Holder – April 2016

Application from a Resident or Former Resident Visa Holder – April 2016 – 11

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

About the information you provide

Immigration New Zealand collects the information about you on this form to decide whether you are eligible for a permanent resident visa, a variation of travel conditions or a second or subsequent resident visa. We may also use the information to contact you for research purposes or to advise you on immigration matters.

The address of Immigration New Zealand is PO Box 3705, Wellington, New Zealand. This is not where your application should be sent.

Collecting the information is authorised by the Immigration Act 2009 and the Immigration Regulations made under that Act. You do not have to provide the information, but if you do not we are likely to decline your application.

The information we collect may also be used to determine whether you are allowed to board a light 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 agent based on the information you have provided in this form.

Immigration New Zealand may also share the information you have provided with other government agencies that are entitled to it by law, or with other agencies (as you have agreed in the declaration). In respect only of applicants who state that they hold a current Australian Permanent Residence Visa or a current Australian Resident Return Visa, this information may also be shared with the issuing authority, in order to conirm that statement.

If you are in New Zealand, you will be able to ask to see the information we hold about you and have any of it corrected if you think it is necessary.

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. VisaView is authorised by legislation.

If you believe that an employer has been given the wrong entitlement information via VisaView you may contact the Immigration Contact Centre (0508 558 855) to request correction of that information.

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 info@iaa.govt.nz.

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.

12 – Application from a Resident or Former Resident Visa Holder – April 2016