Financial Undertaking
for a Student
New Zealand
Immigration Service
T e Ratonga Manene
Application No.
For NZIS Use Only
To be completed by the guarantor (this is the person giving the financial undertaking).
This Financial Undertaking applies for a 12 month stay in New Zealand only. Where an applicant is applying for a
further student permit for a period exceeding the initial 12 month period, a new Financial Undertaking must be
completed or other acceptable evidence of sufficient funds must be provided.
Student’s Details
1
Student’s full name:
Please underline the family or surname.
2
Details of spouse and children accompanying the student:
Name
3
Relationship to student
Their address in their home country is:
Guarantor’s Details
4
My full name is:
This is the person accepting the financial undertaking.
5
My residential address and telephone number is:
Telephone
Declaration for Financial Undertaking
I agree and undertake to accept financial responsibility for the person(s) named on this form whilst they are in New
Zealand, including course fees, maintenance and any costs of repatriation. I undertake to make available in New Zealand
funds at the rate of $NZ7000 per year for every person named on this form.
Signature of guarantor
day
month
year
Bank Confirmation
To be completed by bank.
(Name of bank)
Confirms the person providing this financial undertaking has an account with us and has sufficient funds
to be able to make available $NZ7000 in New Zealand for every person named on this form.
Signature of bank officer
day
month
year
Signature of bank officer
day
month
year
Official stamp of bank
Matters required by Privacy Act
The information about you on this form is collected to determine your eligibility to sponsor a student.
The main recipient of the information is the New Zealand Immigration Service of the Department of Labour but it may also be shared
with other Government agencies, which are entitled to this information under applicable legislation.
The address of the New Zealand Immigration Service is PO Box 3705, Wellington, New Zealand. This is not where your application
should be sent.
The collection of the information is authorised by the Immigration Act 1987 and the Immigration Regulations made under that Act. The
supply of the information is voluntary, but if you do not supply it then your application is likely to be declined.
You will, if you come to New Zealand, have a right to access the information about you held by the New Zealand Immigration Service
and to ask for any of it to be corrected if you think that is necessary.
Your application should be sent to your nearest New Zealand Immigration Branch or New Zealand Embassy or
High Commission.
July 2000
This form has been approved under s132(1) Immigration Act 1987
NZIS 1014