Immigration Assessment Form

A. Principal Applicant - Personal Information
*Full Name: (Mr/Mrs/Ms):
*Address:
*Date of Birth:
*Marital Status :	Single Married
*Nationality:
*Tel. (residence):
Mobile:
Tel. (business):
Fax:
*Email Address:
Countries lived in during the past 10 years:

B. Spouse - Personal Information (if applicable)
Full Name: (Mr/Mrs/Ms):
Address:
Date of Birth:
Nationality:
Tel. (residence):
Mobile:
Tel. (business):
Fax:
Email Address:
Countries lived in during the past 10 years:

C. Children (Write on separate sheet of paper if necessary)
Child's Name:	Child's Birthdate :	Child's Country of Birth:

D. Two Closest Relatives in New Zealand (if any) prepared to sponsor you
Relative 1
Name:
Address:
Telephone:
Relationship:
Visa status in New Zealand:

Relative 2
Name:
Address:
Telephone:
Relationship:
Visa status in New Zealand:

E. Miscellaneous
Do you or any member of your family* you intend to include in your application suffer from any medical problems	Yes No
* Family means your spouse and your children that will migrate with you.
If YES: Give details & approx date
Have you or any member of your family you intend to include in your application ever been convicted of a criminal offence?	Yes No
If YES: Give details & approx date
Have you ever applied to migrate to New Zealand before?	Yes No
If YES: Give details & approx date
Have you ever visited New Zealand?	Yes No
If YES: Give details & approx date

F. Principal Applicant - Education Details
Level of Educational / Training completed:
Date of Graduation (Month/Year):
Name of University/College:
Major Area of Study/Training:
Are you currently studying /under training?	Yes No
If yes, please indicate (Bachelor's / Master's / Ph.D.):
Expected Graduation Date(Month/Year):
Any other education details you wish to include:

G. Spouse - Education Details (if applicable)
Level of Educational / Training completed:
Date of Graduation (Month/Year):
Name of University/College:
Major Area of Study/Training:
Are you currently studying /under training?	Yes No
If yes, please indicate (Bachelor's / Master's / Ph.D.):
Expected Graduation Date(Month/Year):
Any other education details you wish to include:

H. Principal Applicant - Language Ability
English Proficiency
Speak:	Fluently With Difficulty Not at all
Write:	Fluently With Difficulty Not at all
Read:	Fluently With Difficulty Not at all
Other Language/s Proficiency:

I. Spouse - Language Ability
English Proficiency
Speak:	Fluently With Difficulty Not at all
Write:	Fluently With Difficulty Not at all
Read:	Fluently With Difficulty Not at all
Other Language/s Proficiency:

J. Principal Applicant - Employment details (if not self-employed)
Current Occupation:
Name & Address & Tel. No. of Current Employer:
Job title and detailed job description:
Length of Experience:
Previous Occupation:
Length of Experience:
Intended Occupation in New Zealand:

K. Spouse - Employment details (if not self-employed)
Current Occupation:
Name & Address & Tel. No. of Current Employer:
Job title and detailed job description:
Length of Experience:
Previous Occupation:
Length of Experience:
Intended Occupation in New Zealand:

L. For Business Owner applicants only
Details of intended business or investment in New Zealand.
How much capital do you intend to have available for your planned business?
NZ$
What are your spouse and your combined net business and personal assets? Please provide your combined net worth each year for the last 4 years in NZ Dollars?
Year:	Net Worth:
Year:	Net Worth:
Year:	Net Worth:
Year:	Net Worth:
Do you have experience in managing, operating or owning a business?	Yes No
If yes, provide the following details:
Type of business - Manufacturing, Trading, Investment, Services, etc.
Annual Turnover of your business in each year for the last 4 years in NZ Dollars:
Year:	Turnover:
Year:	Turnover:
Year:	Turnover:
Year:	Turnover:
Total net Business Assets only in each year for the last 4 years in NZ Dollars:
Year:	Business Assets:
Year:	Business Assets:
Year:	Business Assets:
Year:	Business Assets:

If you and/or your spouse do not own the whole business interest then what percentage of the business interest do you and/or your spouse own?	%
Your current Total Net Business & Personal Assets of you and your spouse in NZ Dollars:	NZ$

M. For Investor applicants only
Details of intended business or investment in New Zealand (if any).
Do you have experience in managing your own business or managing a portfolio of your own investment?	Yes No
If yes provide the following details:
Details of your current investment portfolio or business activity in strict confidence:
Have you ever managed a portfolio value greater than NZ$ 1.5 million?	Yes No
If not, would the portfolio value that you have ever managed be greater than NZ$750,000?	Yes No
How much is your current investment portfolio value in NZ	$

N. For Senior Executive applicants only
Details of intended business or investment in NZ.
Are you a Senior Executive of your business organisation where your current job position is in the top 3 levels (not to be confused with the top 3 positions) of the management structure of the organisation?	Yes No
Are you responsible for or do you play a major role in the strategic policy development of your organisation?	Yes No
If yes, how many years have you played this role or held this position?
Describe in what way you play the role:
Is your personal and business assets at least NZ$500,000 or at least NZ$250,000?
At least NZ$
Is your organisation's annual turnover in 2 out of the last 4 years at least greater than NZ$ 50million or greater than NZ$10 million?
Greater than NZ$ million

O. Additional Information
Please provide any other information you think maybe of assistance to your application:
Please read the following and indicate your agreement before submitting this form.
I confirm I have prepared the answers to these questions and to the best of my knowledge and I believe them to be truthful and correct. I will not hold Mark Manhire Lawyer liable for any adverse consequences arising out of their actions when relying on the information given by me in this Assessment Form.
YES I CONFIRM NO
Payment of the NZ$225.00 assessment fee can be made by bank draft or telegraphic transfer. If paying by bank draft please make the draft payable to "Mark Manhire Practice Account" and send it to: Mark Manhire Practice Account PO Box 147 366 Ponsonby Auckland New Zealand Details of Telegraphic Transfer are as follows: Mark Manhire Practice Account. Bank: BNZ Bank Branch: Takapuna, Auckland 491-493 Lake Rd, Takapuna, Auckland 0622 Account Number: 02-0272-0044947-02 Swift Code: BKNZNZ22

* Disclaimer: While every care has been taken with the material contained within this website the site is provided by Mark Manhire as a service to the public. As legal advice must be tailored to the specific circumstances of each case, nothing provided herein should be used as legal advice.This Website is not an offer to represent you and the act of sending electronic mail to our office will not create a lawyer-client relationship nor will it impose any obligation on Mark Manhire. Any unsolicited electronic communication between us may not be privileged, secure or private.

A. Principal Applicant - Personal Information

B. Spouse - Personal Information (if applicable)

C. Children (Write on separate sheet of paper if necessary)

D. Two Closest Relatives in New Zealand (if any) prepared to sponsor you

E. Miscellaneous

F. Principal Applicant - Education Details

G. Spouse - Education Details (if applicable)

H. Principal Applicant - Language Ability

I. Spouse - Language Ability

J. Principal Applicant - Employment details (if not self-employed)

K. Spouse - Employment details (if not self-employed)

L. For Business Owner applicants only

M. For Investor applicants only

N. For Senior Executive applicants only

O. Additional Information