New Zealand Investor Assessment You may use this form if you wish to know if you are eligible to apply for a New Zealand Investor Visa. Your information is regarded as confidential and protected by the New Zealand Privacy Act and will not be passed on to others and will not be kept on record unless you specifically ask us to do so. Your assessment will be processed as soon as possible. The result of your assessment will be sent to the email address that you provide below. If your spouse/partner will be included in the visa application if eligible, please fill out that section of the Assessment Form as well. Note: this is not a Visa Application form! Conditions for the use of this form: All information asked for on this form is crucial to assess your chances - incomplete forms will lead to disappointment and will therefor not be processed or answered. Any assessment is based on the information that your provide. HiTS Immigration Services or any of its staff members will not be held responsible or liable for the results of incomplete or incorrectly provided information nor for the results of any action, undertaken by any person based on the results of this assessment. Contact Information   Valid email address: Note: If this field is left blank, we will be unable to return your assessment result to you.   Telephone: (optional)   Personal Information   Family Name: First Name(s):   Your Nationality:   Your Date of Birth: - 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 - January February March April May June July August September October November December    day        month             year   Sex: Male Female   Current marital status: Single Married or DeFacto/Common Law Separated Divorced Widowed If you have been divorced or widowed but in a relationship now, please opt 'Married or Defacto/Common Law'.   Duration marriage or defacto relationship: Longer than 12 months Less than 12 months Not applicable   Partner's Name: first and last name please. (if applicable) Partner's Nationality: Partner's Date of Birth: - 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 - January February March April May June July August September October November December    day        month             year   Please indicate the number of children that you have: younger than 17: (0-17 years) 17-24: (17-24 years)   Relative Residing in New Zealand   Do you (or your accompanying spouse) have a close relative residing in New Zealand, who is a NZ citizen or holds permanent resident status in New Zealand?  If so, please provide us with the relationship of the closest relative and the location in which your relative resides.   Relationship: No Relative in New Zealand Mother or Father Grandmother or Grandfather Brother or Sister Lawful Guardian Spouse or Fiancé(e) Daughter or Son   Location: No Relative in New Zealand Northland Auckland Taranaki Wellington Hawkes Bay Nelson Marlborough Canterbury Westland Otago Southland Other   Funds available for transfer to New Zealand   Amount: NZ$3.5 Million+ NZ$10 Million+ NZ$20 Million+   For Business visa category, please specify the amount:   English Language Ability   Please indicate your proficiency in the English language, as follows: High:  Very good command of the language in a range of social and work situations and no difficulty communicating in a professional capacity. Moderate:  Can communicate reasonably well about personal and familiar things. Basic:  Command of just a few basic words.   Proficiency: Speak Read Write Listen English: High Moderate Basic Not at All High Moderate Basic Not at All High Moderate Basic Not at All High Moderate Basic Not at All     Business experience   Please provide us with complete details of your business experience history.   Present/most recent business started in: - January February March April May June July August September October November December ended in: - January February March April May June July August September October November December     month             year City, Country: Description:   IMPORTANT: Please provide a detailed description of your business.   Previous business (if applicable) started in: - January February March April May June July August September October November December ended in: - January February March April May June July August September October November December     month            year City, Country: Description: IMPORTANT: Please provide a detailed description of your business.   Remarks or additional business experience: Describe any additional business experience here.   Curriculum Vitae & Comments   CV Paste Area: You may "cut and paste" a detailed curriculum vitae in this area.   Remarks: Please mention any prior applications for permanent residence, any known medical issues, criminal issues such as convictions, etc.   Optional but appreciated:  How did you hear about HiTS Immigration Services? Make a selection... Google Message board/Forum MSN Yahoo From a Friend Other Site or Search Engine (specify below)   Submit Form   Your assessment result will be sent to you by email as soon as possible If you do not provide a valid email address then we will be unable to respond to your assessment request. By submitting this form you declare to agree with the conditions for the use of this form.