PAS300 02/14

Application for a
Uruwhenua Aotearoa

New Zealand Passport
USE THIS FORM if you are 16 years or over and:

Adult Renewal

your name has not changed since your last passport was issued, AND your passport has not been lost or stolen. Use the Adult form if you are 16 years or over and: you are applying for a New Zealand Passport for the first time; or your name has changed since your last passport was issued; or your passport has been lost or stolen.

Our New Zealand Passport
Our passport is valued and respected around the world for its integrity. We ask you to provide a range of information so that we can maintain its integrity by confirming your identity and entitlement to a New Zealand Passport. The New Zealand Passport is valid for a maximum period of 5 years. The validity period starts from the date of issue and runs until the date of expiry. This icon is used when you need to take extra care. The instructions with this icon will help you to understand whether you need to complete a particular section, or remind you not to miss out important details.

What you need to complete this application Two (2) identical recent colour photos of yourself Someone to act as an identity referee who is over 16 years of age and has a valid New Zealand Passport The correct application fee

How to contact us
New Zealand: Freephone 0800 22 50 50 Phone +64 4 463 9360 Fax +64 4 382 3410 Australia: Freephone 1300 559 535 Phone +61 2 9225 2300 Fax +61 2 9223 0223 United Kingdom: Phone +44 20 7968 2730 Fax +44 20 7968 2739 Website: www.passports.govt.nz

Please call our helpline if you need any assistance to complete this form

How to complete this application form
Use this guide section to help you to fill in the form. The numbers in this guide will take you through each step in the form.

READ ALL INSTRUCTIONS CAREFULLY
Check you have answered all the questions on this form that relate to you. We can only process your application if you complete the form accurately. If you miss out any details we may need to contact you and there may be a delay in processing your application. This application form will be scanned and processed using computer software. We ask you to follow the instructions below to improve the accuracy and efficiency of our scanning and data capture. Use a BLACK or BLUE ballpoint pen and complete in your own handwriting, unless using the editable pdf. If entering text into the PDF on your computer, you must still print off the application form and sign by hand where applicable. Write in CAPITAL letters inside each box like this

ABC 123

, NOT like this a q

C 78 6

Put a line through mistakes like this ABC . DO NOT use correction fluid or correction paper.

1

Your personal details
Names Write your name exactly as it appears in your passport. If you only have one name, write it in the space provided for surname or family name. Name Endorsements The Department is no longer able to include “also known as” name endorsements into a passport. If your current passport contains an also known as name, this will not be included in your new passport If you already have your married name endorsed into your current passport and want your new passport issued in this name, then write this name in question 1. Height and eye colour Height and eye colour is important information. We can’t process your application without it. • Write in your height using centimetres. • Choose an eye colour that is closest to your own, such as brown, blue, green, grey, hazel or black. Passport number Write your passport number exactly as it appears in your passport. We do not need you to send us your passport. Please do not send it in with your application.

2

Your contact and delivery details
Your home address This is the place where you are currently living. Do not give a box or bag number, or a ‘care of’ (c/-) address. Your contact details We need your contact details in case we have questions about your application. Write in phone numbers and an email address so we can contact you.
Example of how to write your phone number:

+

064
COUNTRY CODE

04
AREA CODE

4748100
PHONE NUMBER

Your delivery address • If you want your passport delivered to a home address in New Zealand, someone must be at home to sign for it. If there is no one at home to sign for it, you will need to organise a redelivery • If you want your passport delivered to a business, write the name and the address of the business • If you want your passport delivered by international courier you must provide a street address, not a Post Box number.
3

Your emergency contact
Give us the name and contact details of a person who can be contacted in emergency situations. If you have an accident, become sick or are involved in an incident while you are travelling overseas, someone can be contacted on your behalf. We recommend that you choose a person who is not likely to be travelling with you.

WARNING Once your passport application has been received, your old passport will be cancelled immediately and cannot be used for travel. Anyone attempting to travel on a cancelled passport will be refused travel. Emergency Travel Document If you are applying for a replacement of your Emergency Travel Document you must use the Adult form. Please do not complete this form. The Department of Internal Affairs reserves the right to request the return of any travel document from the holder at any time.
GUIDE NOTES 1

4

Identity referee
Who can be your identity referee? Your identity referee must: • have a valid New Zealand Passport

• have known you for 1 year or more • be 16 years of age or older • not be related to you or part of your extended family group • not be your spouse or partner • not live at the same address as you. You need to provide your identity referee’s passport number, name, date of birth and contact phone numbers.
5

Photographic image requirements Photo age • photos must be less than 6 months old. Photo size • standard size 35mm x 45mm. Head size • head, including hair, should fit within the oval shown in the template below • maximum size of head, including hair, must be 80% of photo • head must be centred, with a clear gap around the sides and top of the head, including hair. Paper quality • use high quality, high resolution photo paper • you can also use colour film or low gloss coated thermal papers as long as the printer is high resolution • DO NOT use matt paper, heavy-backed thermal paper or an ink-jet printer. Photo quality • photo must be a true image, not altered in any way • photo must be in focus, with no red-eye and no reflected light on the face. Background • the background must be plain and light, but not white • there must be strong contrast between image and background, with no shadows. Pose • face the camera straight on, with your head straight, eyes open and mouth closed • maintain a neutral expression, not smiling or frowning • ensure you have no hair across your face or eyes as eyes must be clearly visible. Glasses • eyes must be clearly showing through glasses, with no reflection • remove glasses with heavy-rimmed frames • do not wear sunglasses, or glasses with tinted lenses that obscure your eyes. Head covering or headband • no head covering or headband should be worn in the photo, unless you must wear either for religious or medical reasons. In this case you must tick the box in the Applicant Declaration at section 5 . If you did not wear a head covering or headband in your last passport please complete a Statutory Declaration form and send it to us with your application.

Your Applicant Declaration
Head covering If you wear a head covering for religious or medical reasons, please tick this option. If you did not wear a head covering in your last passport, please complete a Statutory Declaration form telling us why you now wear one, and send it to us with your application. You must sign this declaration if: • you have filled in your application form yourself • you can sign your own name but someone else has filled in the application form for you. If you cannot sign your own name, please leave the section unsigned and tick this option. If you were able to sign your name in your last passport, the person who filled in the application form for you must complete a Statutory Declaration form stating the reason why you are now unable to sign this application. Please send the Statutory Declaration to us with your application. Write on the back of one photo Write your full name and the date on the back of one photo. Photos – getting passport quality photos Provide two identical colour photos that are less than 6 months old and send them with this application. Do not staple or paperclip the photos to the application as this will damage them and we may not be able to use them in your passport. New technology has been introduced to scan your photos and ensure that they meet international travel standards. We strongly recommend that you obtain your photos from a business that provides a passport photo service, as the business will help ensure that your photos meet our requirements. Photographs that do not meet our requirements will NOT be accepted and this will delay the issue of your new passport. To help you avoid some of the most common problems with photo quality, we have summarised the main requirements below and provided some sample photos. If you need more detailed information about photos, visit our website www.passports.govt.nz or phone us at the contact numbers listed on the front cover of these Guide Notes.
45mm (height)

Actual photo size
3mm Gap

Actual head size
(including hair)

EYES BETWEEN

35mm (80%)

35mm (width)

28mm (80%)

GUIDE NOTES 2

Photographic image requirements - examples
Please note that these example photos are not actual size.

6

Application fees and payment
Choosing a level of service When we have all the information we need and the correct payment, we will process your application within the following service times. Standard service: up to 10 working days Urgent service: up to 3 working days Callout service: outside business hours by appointment only Remember to add on delivery time to and from the Passport Office for Standard and Urgent service. Urgent service There is an extra fee for using the Urgent service. Callout service There is an extra fee for using the Callout service. This service is available by appointment outside business hours, 7 days a week, for emergency situations. Contact us for more information. Cost of your application and courier fees To find out the cost of application fees and courier fees, refer to the Fee Sheet included with this application or visit www.passports.govt.nz or phone one of the following numbers: New Zealand: Freephone 0800 22 50 50 within New Zealand +64 4 463 9360 from overseas Australia: Freephone 1300 559 535 within Australia +61 2 9225 2300 from overseas United Kingdom: +44 20 7968 2730 If you are using the Urgent or Callout service because your travel is for bereavement or serious illness, you may not have to pay the extra fee or we may refund the extra fee. Send us a letter (in English) from a doctor, hospital or the police to explain the circumstances. How to pay Your application fee must be paid in the currency of the country where you are sending your application to be processed. If you apply by mail you can pay your fee by credit card, debit card, cheque or money order. DO NOT POST CASH. If you apply in person at a Passport Office counter, you can also pay by cash or EFTPOS. If you pay by cheque or money order • fill in all parts of the cheque or money order and make it payable to the Department of Internal Affairs • if your cheque is dishonoured you will have to pay additional bank or debt collection charges. If you pay by credit card or debit card • provide all requested details in section 6 of the form • note that Diners card is not accepted. Delivery details If your delivery address for your new passport is in the same country where you are lodging your application, it will be sent at no additional cost to you. The delivery service is courier in New Zealand, courier in Australia or First Class Mail in the United Kingdom. If you want your new passport sent to an address outside the country where you are lodging your application, you will need to pay a fee for delivery by international courier. The international courier fee is available on the Fee Sheet included with this application form or visit www.passports.govt.nz or phone one of the numbers above.

Head size and facial expression

Acceptable

Unacceptable

Head too big

Expression not neutral

Glasses, head covering, scarves and hair

Acceptable

Unacceptable

Frames too heavy

Frames obscuring eyes

Acceptable

Unacceptable

Light reflection on lenses

Tinted lenses obscuring eyes

Acceptable

Unacceptable

Scarf covering chin/ edges of face

Face partially covered by head covering

Contrast and lighting

Acceptable

Unacceptable

Shadows on background

Contrast too dark

GUIDE NOTES 3

7

Send your application to us
Send us your application. We recommend you send your application to us by courier so you can track delivery. NEW ZEALAND Post to: New Zealand Passport Office Department of Internal Affairs PO Box 1568 Wellington 6140 New Zealand Courier to: New Zealand Passport Office Department of Internal Affairs Level 3, 109 Featherston Street Wellington 6011 New Zealand

UNITED KINGDOM Post or courier to: New Zealand Passport Office Department of Internal Affairs New Zealand House 80 Haymarket London SW1Y 4TQ United Kingdom

OTHER COUNTRIES
If you live outside New Zealand, Australia, or the United Kingdom, either post or courier your application to the New Zealand Passport Office nearest you. Alternatively, contact your nearest New Zealand High Commission or Embassy to see if you can submit your application via their office for an additional fee. NB Not all offices provide this service. To find the contact details of your nearest New Zealand High Commission or Embassy visit www.mfat.govt.nz

AUSTRALIA Post to: New Zealand Passport Office Department of Internal Affairs GPO Box 365 Sydney NSW 2001 Australia Courier to: New Zealand Passport Office Department of Internal Affairs Level 10, 55 Hunter Street Sydney NSW 2000 Australia

GUIDE NOTES 4

Privacy statement
The information you provide helps us establish your identity and determine if you are eligible for a New Zealand passport. We may obtain information from other sources (including, but not limited to, the Citizenship Office and the RegistrarGeneral of Births, Deaths and Marriages) using an authorised information-matching programme (under Section 78A of the Births, Deaths, Marriages and Relationships Registration Act 1995 or Section 26A of the Citizenship Act 1977). How is your privacy protected? All relevant information about you is collected in line with the Passports Act 1992 and is held securely by the New Zealand Passport Office, Department of Internal Affairs, 120 Victoria Street (PO Box 10-526), Wellington. Under the Privacy Act 1993 you may access and request a correction of any of that personal information. When may information from your passport records be disclosed? Under the Passports Act 1992 and the Privacy Act 1993, this information may be disclosed, subject to agreement in writing between the Secretary of Internal Affairs and the Chief Executive of the organisation requesting the information, to any appropriate agency, body, or person to aid border security, facilitate the processing of passengers, verify the identity of a holder of a travel document, or determine whether a person is a New Zealand citizen. Information may also be disclosed under an authorised information matching programme in accordance with Part 10 of the Privacy Act 1993. For more information, including a list of authorised information matching programmes, visit www.dia.govt.nz The information that may be disclosed includes the information recorded in your passport; your eye colour; your height; the status of your passport; our passport database key number; and any other information relating to your passport that may be required.

Checklist
Have you checked your application form and ensured it has been correctly completed? Have you included the correct payment for your application? Have you signed the applicant declaration in section
5

of your application form?

Have you supplied 2 identical recent colour photos of yourself? Have you written your name and the date on the back of one photo?

Will you need to send any documents

with this application?

No. We do not require your old passport. Please do not send it to us.
Please note that in some circumstances we may need to contact you for further information or original documents if we are unable to verify your details by computer.

Detach the guide notes here

GUIDE NOTES 5

PAS300 02/14

Application for a
Uruwhenua Aotearoa

New Zealand Passport

Adult Renewal

Please use a BLACK or BLUE ballpoint pen and write in CAPITAL letters inside each box so that our computer software can accurately capture your information.

1

Your personal details
Write your name as it appears in your passport
Surname or family name

First and middle names

Write your place of birth
City or town you were born in

Country you were born in

Write your date of birth Tick your gender Write your height Write your eye colour Write your passport number
Male

/

/
Female

e.g.

29 / 09 / 1968

(centimetres) e.g. BROWN, BLUE, GREEN, GREY, HAZEL, BLACK

We do not require your old passport. Please do not send it to us.
WARNING Once your application has been received your old passport will be cancelled immediately and cannot be used for travel. Anyone attempting to travel on a cancelled passport will be refused travel.

2

Your contact and delivery details
Write your home address
Unit and/or house number Street name

Suburb

City or town

Post code

State

Country

AR902

Page 1 of 4

Write your contact details
Home + phone
COUNTRY CODE AREA CODE PHONE NUMBER

Work + phone
COUNTRY CODE AREA CODE PHONE NUMBER

Mobile + phone
COUNTRY CODE CARRIER CODE PHONE NUMBER

e.g. +

064

021

12345678

Please write your email address in CAPITAL letters so that our computer software can accurately capture your information. Email

@ Write the address you want your passport delivered to if different from your home address
If you want your passport delivered by international courier, you must provide a street address, not a Post Box number.
Business name (if required)

Unit and/or house number OR Street name

Post Box number

Post Box holder name

Suburb

City or town

Post code

State

Country

3

Your emergency contact
Write the name and contact details of a person who can be contacted in case of emergency
Surname or family name

First and middle names

Write their address and contact details
Unit and/or house number Street name

Suburb

City or town

Post code

State

Country

Home + phone
COUNTRY CODE AREA CODE PHONE NUMBER

Day-time + phone
COUNTRY CODE AREA CODE PHONE NUMBER

Page 2 of 4

AR902

4

Your identity referee
Your identity referee must not be related to you or part of your extended family group Write your identity referee’s New Zealand Passport number Write your identity referee’s name
Surname or family name

First and middle names

Write your identity referee’s date of birth
Day-time phone +
COUNTRY CODE AREA CODE PHONE NUMBER

/

/

Write your identity referee’s contact phone numbers
After hours + phone
COUNTRY CODE AREA CODE PHONE NUMBER

5

Your Applicant Declaration
Tick any box that applies
I wear a head covering or headband for religious or medical reasons. I am unable to sign my name.
If someone else has filled in this application for you but you are able to sign your own name, you must sign this section. If you are unable to sign your own name, the signature in this section must be left blank. The person who filled in the application form for you must not sign this section.

I declare that the information I have given in this application is, to the best of my knowledge, true, complete and correct. I understand that if I have provided false information my passport can be cancelled and I can, by law, be fined or imprisoned. I confirm that I have read the section relating to Privacy in the Guide Notes for this application. I agree that, for the purposes of this application, other government agencies may release personal information about myself which will assist the Passport Office in determining my entitlement to be issued with, or continue to hold, a New Zealand Passport. I understand that if I use, or have possession of, a forged or false New Zealand travel document, I may be liable on conviction to imprisonment for a term not exceeding 10 years, a fine not exceeding NZ$250,000, or both.

Write your name and the date on the back of one of your photos
Do not: staple, glue or paperclip ATTACH photos to the application PASSPORT as this may cause damage. Write your name and the date on the back of one ATTACH photograph.
WARNING It is an offence against the Passports Act 1992 to knowingly or recklessly make a statement that is false or misleading in a material particular for the purposes of gaining a New Zealand Passport.

PHOTOS HERE

PASSPORT PHOTOS HERE

Sign your Applicant Declaration here
Date signed

/

/

AR902

Page 3 of 4

PAS300 02/14

6

Application fees and payment
Before completing this section, read section 6 of the Guide Notes. To find out the cost of application and courier fees, refer to the Fee Sheet included with this application or visit www.passports.govt.nz or phone your nearest Passport Office.

Tick the level of service you want
Standard - up to 10 working days Urgent - up to 3 working days Callout - by phone appointment only

Write the amount you need to pay
Application fee International courier fee TOTAL AMOUNT
Tick the currency you are paying in

. . .
NZD

You only need to pay the international courier fee if you want your passport delivered to a different country from the office where you are lodging your application.

AUD

GBP

Tick the method of payment you want
Credit card
Please complete the payment card details section

Debit card Cheque Money order Cash or EFTPOS (in person only)

7

Send your application to us
Send us your completed application form by courier or post. Refer to the Guide Notes section 7 to find the New Zealand Passport Office nearest to you.

OFFICE USE ONLY

IN BC MC CUC Cit/Des NCDoc GDoc POrd Let Other IN Photos x2

Supporting Documents NPC NTW O/S NZPPT NZDIP NZOFF RTD COI ETD Foreign C/use

Previous Travel Documents IN EC BTA NTW

Requested Passport Type DIP OFF ADD

Date received:

DEC11

IN Cit BDM

Other Products DEP O/S

Completed by:

Approved by:

CA

HC

NOF

TBI

IC

RBDB HFETDR

Payment witnessed by:

Page 4 of 4

AR902

Payment card details
Tick card type
Card number Name as it appears on card

Visa

MasterCard

AMEX

Debit card
Card expiry date

MM / Y Y

If you are paying by a UK debit card write the start date and issue number below (if applicable)
Debit card start date

MM / YY

Debit card issue number

Cardholder’s signature

CARDHOLDER SIGN HERE

I authorise the Department of Internal Affairs to charge the total amount across to my credit or debit card.

ONLINE
ONLINE - ADULT RENEWAL

FEES SHEET
Lodged Online

(up to 10 working days)

Standard Service Only

NZD $124.50

For further information on how to apply Online go to www.passports.govt.nz
The application fee for paper based applications must be paid in the currency of the country where you are sending your application form to be processed. ADULT - First Time Standard Service Urgent Service
(up to 10 working days) (up to 3 working days) Lodged in New Zealand Lodged in Australia Lodged in the United Kingdom

NZD $140.00 NZD $293.30 NZD $651.00
Lodged in New Zealand

AUD $138.00 AUD $276.00 AUD $528.00
Lodged in Australia

GBP £91.00 GBP £182.00 GBP £347.00
Lodged in the United Kingdom

(by appointment only)

Callout Service

ADULT Replacement Standard Service Urgent Service
(up to 10 working days) (up to 3 working days)

NZD $134.50 NZD $287.80 NZD $645.50
Lodged in New Zealand

AUD $138.00 AUD $276.00 AUD $528.00
Lodged in Australia

GBP £91.00 GBP £182.00 GBP £347.00
Lodged in the United Kingdom

Callout Service

(by appointment only)

CHILD Standard Service Urgent Service

(up to 10 working days) (up to 3 working days)

NZD $81.70 NZD $235.00 NZD $592.70

AUD $71.00 AUD $209.00 AUD $461.00

GBP £47.00 GBP £138.00 GBP £303.00

Callout Service

(by appointment only)

If you reside outside of New Zealand, and are sending your application to New Zealand for processing, we will exclude the GST amount from the above New Zealand application fees. Please note that International Courier Fees apply. A summary of fees exclusive of GST is available at www.passports.govt.nz.

International Courier Fees

C

International Courier Fees

If you want your passport delivered to a country different from the country where you are lodging your application, you will need to pay an international courier fee for delivery. DELIVERY ZONE
New Zealand Lodged in New Zealand Lodged in Australia Lodged in the United Kingdom

Included in application fee

Lodge your application in New Zealand

Lodge your application in New Zealand

Australia

NZD $10.00

Included in application fee

Lodge your application in Australia UK First Class Mail – included in application fee or Courier - GBP £9.00 Lodge your application in New Zealand or Australia

United Kingdom

NZD $25.00

Lodge your application in the United Kingdom

Asia Pacific countrie

NZD $15.00

AUD $24.00

United States

NZD $20.00

AUD $28.00

GBP £22.50

Europe (excluding the UK)

NZD $25.00

Lodge your application in the United Kingdom Lodge your application in New Zealand or the United Kingdom

GBP £13.50

the ‘Rest of World’

NZD $25.00

GBP £29.50

NOTE: • If your delivery address is in Pakistan or the Ukraine – please lodge your application in the • United Kingdom. • If your delivery address is in Iran – please contact the New Zealand Embassy in Tehran for further advice. Please note that international deliveries may be subject to additional fees and charges, imposed for example by the courier company and/or customs of the country where your new passport is being delivered to. These fees and charges must be paid directly by the applicant in the country of delivery and cannot be paid in advance to the Department.

Application Fees

C