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

November 2022 INZ 1202

Parent Category
Expression of Interest Form

Ballot Pool
You are submitting an Expression of Interest (EOI) into the Parent Category Ballot Pool (Pool).
EOIs are selected randomly from this Pool.
EOIs that have not been selected from the Pool will expire two years after they are submitted.
More information about EOI expiry and selection dates can be found at www.immigration.govt.nz.

Use the guide to help you complete this form

For help completing this form, refer to the Parent Category Guide (INZ 1207).
When you submit this Expression of Interest to Immigration New Zealand (INZ), we will consider offering you an
Invitation to Apply for residence in New Zealand only if you meet the following requirements:
• character • family relationship
• health • financial/sponsorship
• English language
The criteria for each of these requirements are explained in this form as per the Residence Instructions (Parent Category).
You must complete all the questions in the form, unless the form specifically directs you straight to another
question or section. If a question does not apply to you, mark it ’N/A’ or ‘not applicable’. If you fail to answer any
questions or to mark them clearly as ‘N/A’ or ‘not applicable’, we may send the incomplete form back to you and
it will not be submitted into the Expression of Interest Pool until all necessary information is provided.
Expressions of Interest must be accompanied by the correct Expression of Interest fee and sent to:
Immigration New Zealand, PO Box 76895, Manukau City, Auckland 2241, New Zealand
Do not send supporting documentation when submitting your Expression of Interest. Only include any additional
sheets required to explain your answers to questions in the form.
Detailed explanations to assist you to fill out this form can be found in the Parent Category Guide (INZ 1207) or on our
website at www.immigration.govt.nz.
If you are found to have provided false information or to have omitted any relevant information in your Expression
of Interest, any subsequent application may be declined and you will lose the right to appeal any decision to decline
your application.
Note: For the purpose of this form, a person who intends to apply for residence under the Parent Category, is referred
to as ‘the submitter’. A person who has been invited to apply for residence is referred to as ‘the applicant’.
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 Expression of Interest. For more information and to view the register of licensed advisers, go to the
Immigration Advisers Authority website www.iaa.govt.nz or email [email protected].
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.

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

Section A Identity
In this section we need to confirm that you are who you say you are.

For more information, see ‘Your identity and personal details’ in the Parent Category Guide.

A1 Name as shown in passport

Family/last name Given/first name(s)

A2 Provide all other names you are known by or have ever been known by

A3 Preferred title Mr Mrs Ms Miss Dr Other (specify)

A4 Gender Male Female

A5 Date of birth

A6 Town/city of birth

Country of birth

A7 Birth certificate number

Name of the issuing authority

A8 Main country of citizenship

A9 List other citizenships you hold.

A10 Details of all passports held.

Passport 1
Number Country

Expiry date Issue date Place of issue

Family/last name as shown in passport Given/first name(s) as shown in passport

Passport 2
Number Country

Expiry date Issue date Place of issue

Family/last name as shown in passport Given/first name(s) as shown in passport

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 Passport 3
Number Country

Expiry date Issue date Place of issue

Family/last name as shown in passport Given/first name(s) as shown in passport

A11 Where applicable, provide the following details.

Taxation number
Taxation number

Country

Social Security number

Social Security number

Country

National ID number or other unique identifier that was issued to you by any government.
National ID number

Country

Chinese Commercial Code

A12 Provide your residential address and contact details (do not use your adviser’s address). This is considered your
permanent place of residence for tax purposes.
Address

Telephone (daytime) Telephone (evening)

Fax Email

A13 Provide your mailing address if this is different to your residential address (do not use your adviser’s address).
If you are in New Zealand and list a New Zealand address, this will be your New Zealand address for the purpose of the New Zealand
Immigration Act.

Number and street name/PO Box

Suburb

City, PIN/ZIP code

Country

A14 If your residential address is in New Zealand, also provide your last residential address in your main country
of citizenship.
Number and street name/PO Box

Suburb

City, PIN/ZIP code

Country

Parent Category Expression of Interest Form – November 2022 – 3

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A15 Name and address for communication about this Expression of Interest (EOI).

Same as address at A12 or A13 or A14 or Other

Name of contact person

Organisation name (if applicable) and address

New Zealand Business Number (if applicable) For help search: www.nzbn.govt.nz

Telephone (daytime) Telephone (evening)

Fax Email

A16 Do you authorise the person stated at A15 to act on your behalf? Yes No

A17 What is your preferred means of communication in relation to this EOI? Email Letter
If you prefer to be contacted by email, what email address do you want communications sent to?
Email address given at A12 or Email address given at A15 or Email address given below.

A18 Do you authorise all other licensed immigration advisers or persons exempt from licensing who work for the
organisation named at A15 to act on your behalf (if applicable)?
Yes Note: the person identified at A15 will receive all communication from Immigration New Zealand.

No Only the person indicated at A15 may act on my behalf.

A19 Have you received immigration advice on this EOI?

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

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

No

A20 If you have previously submitted an EOI provide the EOI number here

A21 What is your current partnership status? (Select only one)

Single Separated Partner/De facto Divorced
Married/in civil union Engaged Widowed
Note: If you have a partner it is important to declare at A23 whether they are to be included in this Expression of Interest or not.

A22 Do you meet the minimum requirements for recognition of partnerships? Yes No

Refer to the Parent Category Guide (INZ 1207) under Partner in the section ‘Summary of Terms’.

A23 Will your partner be included in your Expression of Interest? Yes No

Please note that if you have a partner who is eligible to be included in your Expression of Interest, but you do
not include them, they will not be eligible for residence based on your partnership later on, even if you become
a New Zealand resident.
Partners are considered eligible for inclusion in an EOI even if it appears that your sponsor (or sponsors) may not meet
the income requirement to sponsor multiple Parent category applicants.

4 – Parent Category Expression of Interest Form – November 2022

 Section B Partner’s identity
In this section we need to gather and confirm your partner’s personal details. You must provide this information
even if your partner is not intending to apply for residence with you.

For more information, see ‘Partner’s identity and personal details’ in the Parent Category Guide.

B1 Partner’s name as shown in passport

Family/last name Given/first name(s)

B2 Provide all other names your partner is known by or has ever been known by

B3 Partner’s preferred title Mr Mrs Ms Miss Dr other (specify)

B4 Partner’s gender Male Female B5 Date of birth

B6 Partner’s country of birth

Partner’s place of birth (ie town, city, or province)

B7 Provide your partner’s birth certificate number and the name of the issuing authority.

Birth certificate number

Name of the issuing authority

B8 State your partner’s main country of citizenship

B9 List any other citizenships your partner holds

B10 Details of all passports held by your partner.

Passport 1
Number Country

Expiry date Issue date Place of issue

Family/last name as shown in passport Given/first name(s) as shown in passport

Passport 2
Number Country

Expiry date Issue date Place of issue

Family/last name as shown in passport Given/first name(s) as shown in passport

Passport 3
Number Country

Expiry date Issue date Place of issue

Family/last name as shown in passport Given/first name(s) as shown in passport

Parent Category Expression of Interest Form – November 2022 – 5

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B11 Where applicable, provide the following details.

Taxation number
Taxation number Country

Social Security number

Social Security number Country

National ID number or other unique identifier that was issued to you by any government.
National ID number Country

Chinese Commercial Code

B12 If your partner has previously submitted an EOI provide the EOI number here

Section C Character requirements

In this section we need to confirm that you and any partner are of good character. This is a prerequisite
of the Parent Category.
Questions C1 to C9 relate to sections 15 and 16 of the Immigration Act 2009 (persons prohibited from being
granted a resident visa). People described in sections 15 and 16 of the Immigration Act 2009 cannot ordinarily
be granted residence in New Zealand.
Questions C10 to C20 relate to other character requirements. People described in questions C10 to C20 require
a character waiver to be granted residence.

If you do not have a partner who you are including in this Expression of Interest, answer each question for
yourself only.
For more information, see ‘Character requirements’ in the Parent Category Guide.

C1 Have you or your partner ever been sentenced to imprisonment for a term of five years or more (including
any suspended sentences or any expunged criminal records)?
Yes No

C2 Have you or your partner been sentenced to imprisonment for a term of 12 months or more within the last
10 years (including any suspended sentences or any expunged criminal records)?
Yes No

C3 Are you or your partner subject to a period of prohibition under the Immigration Act 2009? Yes No

C4 Have you or your partner ever been deported from any country, excluding New Zealand? Yes No

C5 Have you or your partner been involved in any terrorist activities or supported similar violent activities?
Yes No

C6 Have you or your partner been a member of, or belonged to, any terrorist group? Yes No

C7 Have you or your partner been involved in any drug trading or trafficking? Yes No

C8 Have you or your partner been a member of, or belonged to, any group with criminal objectives? Yes No

C9 Have you or your partner been a member of, or belonged to, any group that has engaged in or supported
criminal activities?
Yes No

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 If you answered Yes to any of questions C1 to C9 , you must provide a full explanation about the
surrounding circumstances. If, having considered your explanation, INZ assesses that you are a person
to whom sections 15 and 16 of the Immigration Act applies, you will not be invited to apply for residence.

C10 Are you or your partner currently under investigation, or wanted, by any law enforcement agency in any country?
Yes No

C11 Have you or your partner ever been convicted or found guilty of any offence(s) against the law in any country
(including convictions that resulted in a suspended sentence or any expunged criminal records)?
Yes No

C12 Have you or your partner been convicted of an offence (including a traffic offence), committed within the last
five years, involving dangerous driving, driving having consumed excessive alcohol (including drunk driving and
driving with a blood or breath alcohol content in excess of a specified limit) or driving having consumed drugs
(including convictions that resulted in a suspended sentence or any expunged criminal records)?
Yes No

C13 Have you or your partner ever been charged with any offence against the law in any country? Yes No

C14 Have you or your partner ever been refused entry to any country, excluding New Zealand? Yes No

C15 Have you or your partner ever been refused a visa/permit for any country, excluding New Zealand?
Yes No

C16 Have you or your partner been involved in any people trafficking? Yes No

C17 Have you or your partner been a member of, or belonged to, any group of people that had/has objectives
or principles based on hostility against people or groups of people on the basis of colour, race, ethnic or
national origins?
Yes No

C18 Have you or your partner been a member of, or belonged to, any group of people that had/has objectives or
principles based on an assumption that persons of a particular race or colour are inherently inferior or superior
to other races or colours?
Yes No

C19 Have you or your partner, in the course of applying for a New Zealand visa, made any statement or provided any
information, evidence, or submission that was false, misleading or forged, or withheld material information?
Yes No

C20 Have you or your partner, in supporting any application by another person for a New Zealand visa, made any
statement or provided any information, evidence, or submission that was false, misleading, or forged?
Yes No
If you answered Yes to any of questions C10 to C20 , you must provide a full explanation about the
surrounding circumstances. If your Expression of Interest is selected from the Pool you, or your partner,
may be asked to provide a police certificate or other relevant information to enable INZ to fully consider
those circumstances.

Attach additional sheets if necessary.

Parent Category Expression of Interest Form – November 2022 – 7

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Section D Health requirements

In this section we need to confirm that you and any partner meet a minimum standard of health, which is a
prerequisite of the Parent Category. Providing accurate information about your health status is very important.
Questions D1 to D4 list medical conditions for which a medical waiver cannot be granted. People with these
conditions cannot ordinarily be granted residence in New Zealand.

If you do not have a partner who you are including in this Expression of Interest, answer each question for
yourself only.

Read the leaflet Health Requirements (INZ 1121) for more information.

D1 Do you or your partner require, or are either of you likely to require, dialysis treatment in the immediate future?
Yes No

D2 Do you or your partner have tuberculosis (TB)? Yes No

D3 Do you or your partner have severe haemophilia? Yes No

D4 Do you or your partner have a physical incapacity that requires full-time care? Yes No
If you answered Yes to any of questions D1 to D4 , you must provide an explanation of your medical
condition. If, having considered your explanation, we assess that your medical condition is one for which
a medical waiver cannot be granted, you will not be invited to apply for residence.

D5 Have you or your partner been exposed to, or diagnosed with, any infectious or communicable diseases?
Yes No

D6 Are you or your partner receiving, or have either of you received, any treatment for any psychiatric condition or
developmental disorder?
Yes No

D7 Do you or your partner have any condition that is likely to require ongoing treatment or medication?
Yes No
If you answered Yes to any of questions D5 to D7 , you must provide an explanation of your or your partner’s
medical condition. If your Expression of Interest is selected from the Pool, you may be asked to provide a
medical certificate to confirm this information to enable INZ to fully consider those circumstances.

Attach additional sheets if necessary.

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 Section E English language ability
In this section we ask you to confirm that you meet the minimum standard of English language, which is
a prerequisite of the Parent Category. Provide the following details about your English language ability.
For more information, see ‘English language ability’ in the Parent Category Guide.

E1 How do you meet the requirement for a minimum standard of English? (Select only one.)
Acceptable English Language test results. See the table on the next page.
Completed a qualification, that was conducted entirely in English, to the minimum standard as defined in
the guide.
Completed qualifications that meet the minimum standard, as defined in the guide.
Otherwise meets the minimum standard, as defined in the guide.
I intend to purchase English for Speakers of Other Languages (ESOL) tuition to meet the English requirement.
None of the above.
Note: Your partner must pre-purchase English for Speakers of Other Languages (ESOL) tuition if they do not meet the minimum standard
of English. Your partner will need to attend English language classes once you arrive in New Zealand.

Acceptable English language test results

The following English language test results are acceptable:
Test Minimum score required

International English Language Testing System 4.0 or more in at least two of the four skills (Listening, Reading, Writing and Speaking)
(IELTS) – General or Academic Module Or
An overall score of 5.0 or more

Test of English as a Foreign Language Internet- At least two of the following skill scores:
based Test (TOEFL iBT) Listening: 2 or more
Reading: 2 or more
Writing: 11 or more
Speaking: 11 or more
Or
An overall score of 35 or more

Pearson Test of English Academic (PTE 29 or more in at least two of the four skills (Listening, Reading, Writing and Speaking)
Academic) Or
An overall score of 36 or more

Cambridge English B2 First (FCE) 142 or more in at least two of the four skills (Listening, Reading, Writing and Speaking)
or Or
B2 First for Schools (FCE for Schools) An overall score of 154 or more

Occupational English Test (OET) Grade D or higher in at least two of the four skills (Listening, Reading, Writing and Speaking)
Or
Grade C or higher in all four skills (Listening, Reading, Writing and Speaking)

E2 How does your partner meet the requirement for a minimum standard of English (select only one)?
Acceptable English language test results, as set out in the table above.
Completed a qualification, that was conducted entirely in English, to the minimum standard as defined in the
guide. Go to Section F: Family details.
Completed qualifications that meet the minimum standard, as defined in the guide. Go to Section F: Family details.
Otherwise meets the minimum standard, as defined in the guide.
I intend to purchase English for Speakers of Other Languages (ESOL) tuition to meet the English requirement.
None of the above.
Note: Your partner must pre-purchase English for Speakers of Other Languages (ESOL) tuition if they do not meet the minimum standard
of English. Your partner will need to attend English language classes once you arrive in New Zealand.

Parent Category Expression of Interest Form – November 2022 – 9

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

Section F Family details

In this section, please give details of ALL your family, whether they are migrating with you or not. It is not
necessary to list deceased family members. If you or your partner have any dependent child(ren) you will not
be eligible for residence under the Parent Category.
For more information, see ‘Family details’ in the Parent Category Guide.

F1 Do you or your partner (if any) have any dependent children? Yes No

F2 Please give your parents’ details. Include both biological and adoptive parents, if applicable. If your parents are
deceased, give details of legal guardians (if any), and/or grandparents.

Full name Gender Date of birth Partnership status Country of residence

(M/F) (DD/MM/YYYY) (eg single, married, partner
etc)
/ /
/ /
/ /
/ /

F3 Please give the details of your brothers and sisters. Include half-, step-, and adopted brothers and sisters.

Full name Gender Date of birth Partnership status Country of residence

(M/F) (DD/MM/YYYY) (eg single, married, partner
etc)
/ /
/ /
/ /
/ /
/ /
/ /
/ /

F4 Please give details of any children you have. Include any biological, adopted, and step-children from previous or
current marriages/relationships.

Full name Gender Date of birth Partnership status Country of residence

(M/F) (DD/MM/YYYY) (eg single, married, partner
etc)
/ /
/ /
/ /
/ /
/ /
/ /
/ /

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Answer questions F5 to F7 if you are including a partner.

In the following questions, please give details of ALL your partner’s family. It is not necessary to list deceased
family members.

F5 Please give your partner’s parents’ details. Include both biological and adoptive parents, if applicable. If both
parents are deceased, give details of legal guardians (if any), and/or grandparents.

Full name Gender Date of birth Partnership status Country of residence

(M/F) (DD/MM/YYYY) (eg single, married, partner
etc)
/ /
/ /
/ /
/ /

F6 Please give the details of your partner’s brothers and sisters. Include half-, step-, and adopted brothers and sisters.

Full name Gender Date of birth Partnership status Country of residence

(M/F) (DD/MM/YYYY) (eg single, married, partner
etc)
/ /
/ /
/ /
/ /
/ /
/ /

F7 Does your partner have any children? This includes biological children, adopted children, and step-children from
previous marriages/relationships.
Yes. Provide details below.
No. Go to Section G: Sponsor details.

Full name Gender Date of birth Partnership status Country of Does the person
(M/F) (DD/MM/YYYY) (eg single, married, residence intend to migrate
partner etc) with you? (Y/N)
/ /
/ /
/ /
/ /
/ /
/ /
/ /

Parent Category Expression of Interest Form – November 2022 – 11

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Section G Sponsor details

For more information, see ‘Sponsor details’ in the Parent Category Guide.

G1 How will you meet the sponsor income requirement?

Income of one sponsor (adult child). Please answer G2 – G19 ; or

Joint income of two sponsors (adult child and second sponsor). Please answer G2 – G37

Do not provide evidence with your Expression of Interest.

G2 Sponsor name as shown in their passport

Family/last name Given/first name(s)

G3 Other names they are known by or have ever been known by

G4 Gender Male Female G5 Date of birth

G6 Country of birth

G7 Country (or countries) of citizenship

G8 Your sponsor’s current address and telephone number.

Address

Telephone (daytime) Telephone (evening)

Fax Email

Sponsor eligibility

If your expression of interest is selected before your sponsor is eligible, you may not be invited to apply
for residence.
For more information on sponsor eligibility, see ‘Requirements to gain residence’ in the Parent Category Guide.

G9 Is your sponsor currently in New Zealand? Yes No

G10 Is your sponsor a New Zealand residence class visa holder or a New Zealand citizen?

Yes If applicable, what date were they first granted residence in New Zealand?
No
Sponsors must be a New Zealand citizen or the holder of a current residence class visa and have been a New Zealand citizen and/or the holder
of a New Zealand residence class visa for the past three years.

G11 If your sponsor holds a residence class visa, is it subject to conditions under Section 49 of the Immigration Act?
Yes No Not applicable

G12 If your sponsor holds a New Zealand residence class visa, is your sponsor liable for deportation?
Yes No Not applicable

12 – Parent Category Expression of Interest Form – November 2022

G13 Is this sponsor currently sponsoring another person under the Parent Category?
Yes No
Provide the names of the person/s currently being sponsored.

G14 Is New Zealand your sponsor’s primary place of established residence? Yes No

G15 Has your sponsor previously breached any sponsorship obligations or do they have any outstanding debts as a
result of another sponsorship arrangement?
Yes No

G16 Has your sponsor entered insolvency procedures or been adjudicated bankrupt? Yes No

G17 Is your sponsor serving a custodial sentence or are they awaiting sentencing after being convicted of a crime
which carries a custodial sentence?
Yes No

G18 Has your sponsor ever been convicted of an offence under Immigration law? Yes No

G19 Is your sponsor sponsoring you for the purpose of receiving a financial reward or fee? Yes No

Second sponsor

Your second sponsor will need to agree to act as a sponsor and undertake sponsorship obligations.

G20 Who is your second sponsor?

My adult child’s partner
You will need to provide evidence that your adult child and their partner are in a genuine and stable partnership if you make an application
for residence.

My other adult child

My partner’s adult child

G21 Second sponsor’s name as shown in their passport

Family/last name Given/first name(s)

G22 Other names they are known by or have ever been known by

G23 Gender Male Female G24 Date of birth

G25 Country of birth

G26 Country (or countries) of citizenship

Parent Category Expression of Interest Form – November 2022 – 13

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Second sponsor’s eligibility

If your expression of interest is selected before your second sponsor is eligible, you may not be invited to apply.

G27 Is your second sponsor currently in New Zealand? Yes No

G28 Is your second sponsor a New Zealand residence class visa holder or a New Zealand citizen?

Yes If applicable, what date were they first granted residence in New Zealand?
No
Sponsors must be a New Zealand citizen or the holder of a current residence class visa and have been a New Zealand citizen and/or the holder
of a New Zealand residence class visa for the past three years.

G29 If your second sponsor holds a residence class visa, is it subject to conditions under Section 49 of the
Immigration Act?
Yes No Not applicable

G30 If your second sponsor holds a New Zealand residence class visa, are they liable for deportation?
Yes No Not applicable

G31 Is this sponsor currently sponsoring another person under the Parent Category?
Yes No
Provide the names of the person/s currently being sponsored.

G32 Is New Zealand this sponsor’s primary place of established residence? Yes No

G33 Has this sponsor previously breached any sponsorship obligations or do they have any outstanding debts as a
result of another sponsorship arrangement?
Yes No

G34 Has this sponsor entered insolvency procedures or been adjudicated bankrupt? Yes No

G35 Is this sponsor serving a custodial sentence or are they awaiting sentencing after being convicted of a crime
which carries a custodial sentence?
Yes No

G36 Has this sponsor ever been convicted of an offence under Immigration law? Yes No

G37 Is this sponsor sponsoring you for the purpose of receiving a financial reward or fee? Yes No

Section H Sponsor’s income

For more information, see ‘Sponsor’s income’ in the Parent Category Guide.

If you are invited to apply (ITA), your sponsor and your second sponsor (if applicable) will need to meet the minimum
income requirement for any two 12-month periods out of the past three years before your ITA date. For the current
income thresholds please visit our website at www.immigration.govt.nz.
The minimum income requirement must be met by taxable income that is recorded on your sponsor’s (or sponsors’)
Inland Revenue tax statements (Summary of Income). For self-employed sponsors, the taxable income recorded on
their Inland Revenue Final Tax Summary for the most recent financial year may be used.

14 – Parent Category Expression of Interest Form – November 2022

H1 Do you understand that your sponsor/s will need to meet the minimum income requirement for any two
12-month periods out of the past three years before your ITA date?
Yes No

H2 Do you understand that evidence to support the income of your sponsor/s must be their Inland Revenue tax
statements?
Yes No

Section I Declaration for the Expression of Interest

This section must be signed by the principal submitter on behalf of all the people included in this Expression
of Interest. Make sure you understand the declarations below before you sign and agree to them.

For more information on the declarations sections, see ‘Declarations’ in the Parent Category Guide.

Important
I understand that if I make any false statements, or provide any false or misleading information, or have changed
or altered this form in any material way, my Expression of Interest may not be accepted, any resident visa application
may be declined and I may lose any right of appeal. I may become liable for deportation. I may also be committing an
offence and liable to prosecution.

I understand the notes and questions in this form and I declare the information given about myself, my partner and
any children is true and complete.
I declare that I have listed all my family members, including any adopted by law or by custom, and understand that
the non-declaration of any family members may result in that family member not being recognised as part of my
family in future applications, my application being declined, or that I will become liable for deportation.
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 I intend to apply for.
I declare that there are no matters or warrants outstanding, or investigations of any kind, which could have any
current or future effect on the assessment of my good character, or the good character of any other persons included
in this Expression of Interest.
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, INZ will return my Expression
of Interest.
I authorise INZ to make any enquiries it deems necessary regarding the information provided on this form and to
share this information with other Government agencies (including overseas agencies) to the extent necessary to
make decisions about my immigration status. I also consent to any organisation providing relevant information to
INZ about me.
I authorise INZ to provide information about my state of health and my immigration status to any health service
agency. I authorise any health service agency to provide information about my state of health to INZ.
I accept that any advice given to me by INZ before expressing interest and submitting this form was intended to
assist me, and acting on that does not mean that any later application for residence will be granted.
I understand that in order to work in certain occupations in New Zealand, registration is required by law. I accept
that the grant of residence does not guarantee that registration will be granted.
I have not included any documents with this Expression of Interest.

Signature of principal submitter Date

Parent Category Expression of Interest Form – November 2022 – 15

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Section J Immigration adviser’s details

This section must be completed by the submitter’s immigration adviser. If the submitter does not have an
immigration adviser, this section does not have to be completed.

J1 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 L2 .
I am exempt from licensing under the New Zealand Immigration Advisers Licensing Act 2007. Go to L3 .
If you are unlicensed when you should be licensed under the Immigration Advisers Licensing Act 2007,
INZ will return your client’s expression of interest. It is an offence to provide immigration advice without
holding a licence, unless you are exempt.

J2 Licensed advisers. Provide your licence details.

Licence type: full provisional limited. List conditions specified in the register.

Licence number Go to Section K: Declaration by person assisting.

J3 Exempt from licensing. Tick the boxes 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 K: Declaration by person assisting.

Section K Declaration by person assisting

This section must be completed and signed by the submitter’s immigration adviser, or by any person who
has assisted the submitter by providing immigration advice, explaining, translating, or filling in the form.
If the submitter does not have an immigration adviser, and no one helped the submitter 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, INZ will return your client’s Expression of
Interest. 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.
Name and address of person assisting submitter.

Family/last name

Given/first name(s)

16 – Parent Category Expression of Interest Form – November 2022

Company name (if applicable) and address

New Zealand Business Number (if applicable) For help search: www.nzbn.govt.nz

Telephone (day) Telephone (night)

Fax Email

I understand that after the submitter has signed this form it is an offence for me to change or add further
information, change any documents attached to the form, or attach any further documents to the form. 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 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.
I certify that the submitter 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 submitter as an interpreter/translator.

I have assisted the submitter with recording information on the form.

I have assisted the submitter in another way. Specify

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

Signature of person assisting principal submitter

Date

Section L Submitting your Expression of Interest

Send your Expression of Interest to:

Postal address Courier address

Immigration New Zealand Immigration New Zealand
PO Box 76895 DX Box: EP71514
Manukau City 20 Fairfax Avenue
Auckland 2241 Penrose
New Zealand Auckland 1061
New Zealand
Please do not send any additional documents with this Expression of Interest.
You may attach additional pages required to answer questions in the form.

Parent Category Expression of Interest Form – November 2022 – 17

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

18 – Parent Category Expression of Interest Form – November 2022

 Section M Paying your expression of
About the information you provide
interest fee
The information about you and your family in this To find out how much to pay, payment methods, where to
form is being collected to determine whether we send your application, and how long a decision may take,
will invite you to apply for residence in New Zealand see www.immigration.govt.nz/fees.
and may also be used to contact you for research or
marketing purposes or to advise you on immigration
matters. This information may also be used to Your application fee and immigration levy
determine your entitlement to board a flight to
come to or return to New Zealand. Your personal Amount you are paying:
information will not be shared with airline check
in agents, however a boarding message will be Amount
returned to the airline check in agent based on
Currency
information you have supplied on this form.
(e.g. NZD, USD, RMB)
The main recipient of the information is Immigration
New Zealand (INZ), a service of the Ministry of Application number
Business, Innovation and Employment, but it may (office use only)
also be shared with other Government agencies that
are entitled to this information under applicable Credit/debit card details
legislation. In particular, the Ministry of Social
Development (Work and Income) may be given
Mastercard Visa
information about your personal resources.
Name of cardholder
The collection of the information is authorised by
the Immigration Act 2009 and the Immigration
Regulations made under that Act. The supply of
the information is voluntary, but if you do not Card number
supply the mandatory information required by the
Expression of Interest form, then your Expression
of Interest cannot be accepted. CVC/CVV number
You will, if you are in New Zealand, have the right Note: Your CVC/CVV number is the three-digit number found on the
to see the information about you held by INZ, and signature strip on the back of your credit/debit card.
to ask for any of it to be corrected if you think that
is necessary. INZ addresses can be found on our Expiry date D D M M Y Y Y Y

website at www.immigration.govt.nz.
Signature of cardholder
For more information
If you have questions about completing the form:
• see our website
www.immigration.govt.nz/contactus Date D D M M Y Y Y Y

• telephone our call centre on 0508 558 855

(within New Zealand).

Parent Category Expression of Interest Form – November 2022 – 19

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

20 – Parent Category Expression of Interest Form – November 2022