OFFICE USE ONLY Client no.: Date received: / / Application no.

INZ 1021

Group Visa
Application
for visitors to New Zealand

To be completed by tour organiser or adviser, and lodged with individual Visitor Visa Application (INZ 1017) for each group member.
Full name Indicate Gender Date of birth Citizenship or nationality Passport number or
principal Male/Female (DD/MM/YY) certificate of identity
applicant(s)
1. / /
2. / /
3. / /
4. / /
5. / /
6. / /
7. / /
8. / /
9. / /
10. / /
11. / /
12. / /

List any additional applicants on the form Additional Group Visa Application (INZ 1022) and attach to this application.
Declaration by tour organiser or adviser
This declaration includes any and all names
attached on Additional Group Visa Application
(INZ 1022) forms as required.
I confirm that all the people listed on this
document intend to travel to New Zealand for
the same purpose, on the same day, and for
the same length of time.
Signature of organiser or adviser Affix visa
Name of organiser or adviser
label here

Date

Number of pages

Total number of people included in this

application
Number of principal applicants Number of dependants

For further information on immigration November 2010

visit www.immigration.govt.nz
 When filling in this form, please print clearly using CAPITAL LETTERS.

Immigration Advisers Licensing Act 2007

Under the Immigration Advisers Licensing Act 2007 it is an offence to provide immigration advice without being licensed or
exempt. If your immigration adviser is not licensed when they should be, Immigration New Zealand will return your application.
For more information and to view the register of licensed advisers, go to the Immigration Advisers Authority website
www.iaa.govt.nz or email info@iaa.govt.nz.

2 – Group Visa Application This form has been approved under section 381 of the Immigration Act 2009.