Business Investor Assessment Form

To proceed with a request for a formal, personalised assessment, please complete the this form. Our assessment will be based on the latest information available from our authorities and will identify whether or not you qualify for residence in New Zealand. The information requested in this questionnaire is necessary for us to evaluate your eligibility under the Investor category.

Please note this is a free service and we can only provide an accurate assesment if all the required information is provided in detail. If you do not provide all the information requested, your assessment will be dealyed or could be delayed.

Please answer all the questions fully. It may take you some time to obtain the information and complete the questionnaire and you may prefer to print or save a copy of this file and work off-line. If you already have all the required information in a different format, you may prefer to attach that document instead of completing this form. When completed please forward to us by email, fax or mail.

Note: Your information is confidential to us and will not be provided to any other organisation without your written permission.

NOTE - PLEASE TAB TO NEXT FIELD
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Principal Applicant Details

Title	- Please select - Mr Mrs Ms Miss Dr Sir
(the following details to be shown as per passport)
Family Name:
Given Names:
Date of Birth:	Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month 01 02 03 04 05 06 07 08 09 10 11 12 Year Age[years]:
Email address: [please type carefully]
Postal address for mail delivery:
Street address for courier delivery:
Telephone:
Fax:

Spouse/DeFacto of Principal Applicant Details

(defacto partnership to be at least 18 months)

Title	- Please select - Mr Mrs Ms Miss Dr Sir
(the following details to be shown as per passport)
Family Name:
Given Names:
Date of Birth:	Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month 01 02 03 04 05 06 07 08 09 10 11 12 Year Age [years]:

Investment Funds

Points are available for assets or funds that you can transfer to New Zealand. The minimum investment is NZD 2,000,000. Please show current valuations for all major assets and funds, converted to US dollars (USD). Describe assets and then show total value below.

Total Asset Value $US (or $NZD)

Principal Applicant Business Experience

Organisation Name	Type of Business	Start Year	End Year

Spouse Business Experience or Work Details

Organisation Name	Type of Business	Start Year	End Year

Children

Please advise if you have any children and if so, what are their ages? List children's full names and ages

English Skills

The minimum acceptable level is 'an English speaking background' or an IELTS test confirming a minimum band score of 5 in each of the four components.
Can you provide evidence?	Yes	No
English skills for spouse/partner/dependents ages 16 years and over.
Can they provide evidence?	Yes	No

Principal applicants must be able to meet the minimum acceptable level of 'an English speaking background' or provide an IELTS test confirming a minimum band score 5 in each of the four components. Non-principal applicants in the Business immigration categories category may pre-purchase English language training. The cost of the English language tuition will depend on the level obtained in the IELTS test.

Verification

In order for us to verify that you are a real person, please re-type the numbers and letters into this field.