*** 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. *** CIT009 Te tono kia whakakapihia te tiwhikete kirirarauo Aotearoa Application for replacement of New Zealandcitizenship certificate Use this application to request a replacement of your New Zealand citizenship certificate. Hei mua i te tononga Before you apply Things you need to know: • You can only have 1 copy of your citizenship certificate at a time. • The fee for this application is $112.40. • Your application will be processed in 15 working days. Allow extra time for postage. • There is no urgent application service. • Applications must be completed by the applicant, unless they are aged 15 or under. For applicants aged 15 or under, their parent or legal guardian must complete the application. You must provide: • your original New Zealand citizenship certificate, if it is damaged or has an error • the statutory declaration (section 4 of this form), if your previous citizenship certificate was lost, stolen or damaged • 2 identical photos of yourself, certified by a witness • the completed form • your payment details. Photo requirements You must provide 2 identical passport style photos. The photos need to be signed by the witness named in Section 3 of this application. The photos must be: • of yourself • less than 6 months old • in colour • clear, sharp and in focus. The photos must show: • your head and shoulders • your face looking directly at the camera • your eyes open and clearly visible — not covered by hair or sunglasses • a neutral expression — not smiling or frowning — with your mouth closed • a plain and neutral background. Prescription glasses are permitted as long as your eyes are still visible. Do not staple, glue or paperclip photos to the application form as this may cause damage. Contact details Website: govt.nz/contact-citizenship-office Email: Issuance.2@dia.govt.nz Only use email for queries about the form. To return the form, follow the postage instructions at the end of this form. Do not email the completed form to us. Checklist Make sure you have everything you need. If you do not provide all the documents that you need, your application may be delayed. All original documents will be returned to you. Everyone must supply the following with their application: • the original New Zealand citizenship certificate, if it was damaged or has an error • 2 identical photos of the applicant verified by the witness • the filled out payment section on page 11 of the form. You may also need to send us: • the statutory declaration in Section 4, if the previous certificate was lost, stolen or damaged. Section 1: Applicant details 1. Name at time your New Zealand citizenship was granted or registered First and middle names at time of grant or registration ^ Surname or family name at time of grant or registration ^ 2. Your place and date of birth Village, town, or city of birth ^ Country of birth ^ Date of birth (dd/mm/yyyy) ^ 3. Your gender Gender (male, female or non-binary) ^ 4. Date you were granted New Zealand citizenship (if applicable) Fill in this question if you were granted New Zealand citizenship. You do not need to fill it out if you have New Zealand citizenship by descent. Date of grant (dd/mm/yyyy) ^ Section 2: Applicant declaration The Department of Internal Affairs (DIA) processes applications using information matching programmes to share data with other agencies. These authorised information matching programmes share citizenship data we hold with: • the Electoral Commission • Inland Revenue • Waka Kotahi, New Zealand Transport Agency • the Ministry of Education • the Ministry of Social Development • Immigration New Zealand. Details are available on the DIA website at www.dia.govt.nz Collection and use of information given to support your application We need you to give certain information to support your application. The decision to give us your information is your choice. If you do not give us all the information we need, we may decline your application. We need your information: • to process your application • to check if the application meets the requirements of the Citizenship Act 1977. We collect and hold information from this form at the Department of Internal Affairs, PO Box 10680, Wellington. Under the Privacy Act 2020 you can access, check and correct the personal information you choose to give us. 5. Applicant declaration • I understand that the information, to the best of my knowledge is true, complete and correct. • I understand that if I give false information, any citizenship certificate issued on the basis of that information may be cancelled and the matter referred to the New Zealand Police. • I confirm that I have read and understood all the statements in this applicant declaration. • I allow an authorised matching programme, under Section 112 of the Births, Deaths, Marriages, and Relationships Registration Act 2021 to use my information to determine my eligibility for this application. • I allow DIA to contact me or other agencies, if needed, to process this application. Your name ^ Your signature ^ Date signed (dd/mm/yyyy) ^ If the applicant is aged 15 or under, the consent giver must sign this declaration on the applicant’s behalf. Section 3: Witness section Witness instructions Fill in and sign this questions 6 to 11 of this form. The applicant needs to provide 2 identical photos. On the back of one of the photos, you must: • sign your own name • write the full name of the applicant, and • write the date. You must: • be aged 16 years or over • not be a relative or partner of the applicant • not live at the same address as the applicant. You must have known the applicant: • for more than 1 year, or • since birth if the applicant is under 12 months old. 6. Your name First name and middle names ^ Surname or family name ^ 7. Your date of birth Date of birth (dd/mm/yyyy) ^ 8. Name of the applicant whose photo you are witnessing Full name of applicant ^ 9. How many years have you known the applicant? Number of years ^ 10. Your address Street number and name ^ Suburb ^ Town or city ^ Country ^ Postcode ^ Contact number ^ Email address ^ 11. Witness declaration I declare that: • I am 16 years of age or over. • I have known the applicant for more than 1 year or since birth. • The information I have given is complete and correct to the best of my knowledge. • The person in this photo is the person applying. • I have written the full name and of the applicant, signed my name and written the date on the back of one photograph. • I understand that if I have provided false information, I can, by law be fined or imprisoned. Signature of witness ^ Date signed (dd/mm/yyyy) ^ Section 4: Statutory declaration Complete this section if your previous New Zealand citizenship certificate was lost, stolen or damaged. If you are aged 15 or under, your parent or guardian must complete and sign this declaration on your behalf. You will need to sign this section in front of a person authorised to take a statutory declaration. An authorised person must be: • a Justice of the Peace (JP) • a solicitor or notary public (you may have to pay for their services) • a Registrar or Deputy Registrar of the District Court or the High Court, or • authorised staff in some government agencies. 12. I, Enter your full name. ^ 13. of Enter address where you live. This cannot be a Post Office Box. Street number and name ^ Suburb ^ Town or city ^ Country ^ 14. a Enter your occupation. For example, bricklayer, teacher, unemployed. ^ 16. Further information Explain how your certificate was lost, stolen, destroyed, or damaged in your own words. Include details such as the address the incident happened. For example: ‘My certificate was stolen when my house was burgled on 09/12/2023. My address is 338 High Street, Lower Hutt, New Zealand’. What you write must be true. You can be prosecuted if you make a false declaration. ^ 15. solemnly and sincerely declare that my citizenship certificate was (write whether the certificate was lost, stolen, destroyed, or damaged) ^ If your certificate aws damaged, return it to with this application form. 17. And I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations Act 1957 Fill out and sign this section before a person authorised to take a statutory declaration. Your signature ^ Date signed (dd/mm/yyyy) ^ Declared at (town or city and country) ^ Before (name of authorised person) ^ Qualification of authorised person ^ Signature of authorised person ^ Section 5: Fees and delivery 18. Fees The application fee for a replacement New Zealand citizenship certificate is $112.40. Delivery fee Select a delivery method: I want the certificate(s) couriered to a New Zealand address which costs $5. (Yes or no) ^ I want the certificate(s) couriered to an overseas address which costs $15–$30. (Yes or no) ^ Australia, Asia, Pacific courier costs $15. USA courier costs $20. Europe courier costs $25. Rest of world courier costs $30. Rest of world includes Azerbaijan, Armenia, Bulgaria, Bosnia and Herzegovina, Cyprus, Croatia, Greece, Georgia, Macedonia, Malta, Moldova Contact us if you are unsure whether we can deliver to your country. Contact information is at the beginning of this form. 19. Delivery address We may need your email address to get in contact if your postal address changes. Delivery address ^ Delivery name ^ Street number and name ^ Suburb ^ Town or city ^ Country ^ Postcode ^ 20. Payment Do not post cash or card. Do not email credit card details. Charge my credit or debit card (Visa, MasterCard, American Express, Prezzy Card): Card number ^ Card expiry date ^ Name on card ^ Cardholder signature ^ Next steps Print and sign the form. Post the form, payment information, and documents to us. When you post the application, it is best to use a ‘track and trace’ courier bag to keep track of your original documents. We will return your documents by courier. Postal address Citizenship Office Identity Services Department of Internal Affairs PO Box 10680 Wellington 6140 Courier address Citizenship Office Level 2, 7 Waterloo Quay Pipitea Wellington 6011 New Zealand Last updated 1 May 2024