All applicants must complete this section. Note: if your application is declined for character reasons,
Immigration New Zealand may place a notation in your passport indicating that you applied for a visa
for New Zealand.
D1
Have you been convicted at any time of any offence, including any driving offence?
Please note that this includes
any conviction(s) outside of New Zealand subsequently cleared or wiped by ‘clean slate’ legislation.
Yes
No
D2
Are you currently:
• under investigation
Yes
No
• wanted for questioning
Yes
No
• facing charges
Yes
No
for any offence in any country?
D3
Have you ever been:
• excluded
Yes
No
• refused entry
Yes
No
• removed or deported
Yes
No
from any country, including New Zealand?
D4
Have you ever been refused a visa/permit to visit, work, study or reside in any country?
Yes
No
D5
Have you ever been a member of, or adhered to, any terrorist organisation?
Yes
No
D6
Have you had (or do you currently have) an association with, membership of, or involvement with, any
government, regime, group or agency that has advocated or committed war crimes, crimes against humanity
and/or other gross human rights abuses?
Yes
No
If you have answered yes to any of the questions above give full details. This includes full details of any charges,
convictions and the sentence or penalty imposed. Continue on a separate piece of paper if necessary.