Entrepreneur Assessment Form

This category is only for the owners of existing NZ businesses that have been operating successfully in NZ for at least 2 years.

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 Entrepreneur category. 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 printout 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.

There is no charge for our assessment of this information.

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

NOTE - PLEASE TAB TO EACH FIELD
[pressing enter will ask you for confirmation of form submission].

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]:

Your Business

Name of your business:
Description of your business in New Zealand (please explain briefly the products or services provided):
Is the company registered in NEW ZEALAND? Yes No
If yes, please give company registration number
Ownership structure - Shareholding
Has the business provided you with a living wage and produced a profit for the last two years? Yes No
Please list the names of Shareholders and their respective shares held:
Please advise any additional information that you consider will assist us with our initial assessment.

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.