*** Transcriber's Note: Please set your voice synthesiser to read most punctuation. When you encounter the caret sign (^) at the end of a line, please enter the applicable information, if necessary. ***

The Department of Internal Affairs Te Tari Taiwhenua

You will need to print and sign this form.

Application for information under the Privacy Act 2020

This application form is for use by people wanting to find out about their own citizenship status, or the citizenship status of their child. If the child is 16 years of age or older, they must request the information themselves.

Applications take up to 20 working days to process.

You can send this form to us by scanning it and emailing it to Citizenship@dia.govt.nz, or posting to Citizenship Privacy Requests, PO Box 10680, Wellington 6143, New Zealand. 

Details of record to be searched
Family or last names ^
Given or first names ^
Any other names ever used, for example, maiden name, married name, names legally changed ^
Town or city of birth ^
Country of birth ^
Birthdate (DD/MM/YYYY) ^

Details of requestor
Family or last names ^
Given or first names ^
Street address ^
Suburb ^
City ^
Country ^
Postcode ^
Email address ^
Phone number ^
Relationship to individual ^
Signed ^
Dated (DD/MM/YYYY) ^

Information wanted ^