Principle Liquidation

LIMITED PARTNERSHIP APPLICATION FORM

APPLICANT SECTION

Office Area applied for:

Personal details

Given names:

Family name:

Preferred name:

Address:

Telephone Daytime:

Mobile:

Email:

Entity name for the Agreement:

Current Qualifications and Memberships

Qualification Title/Memberships	Institution/training provider	Year completed	Action

Previous Experience (most recent first)

Employer or Establishment		Date From	Date To

Position Held	Reason for Leaving	Office use Check/Initial/Date	Action

Proof of Identity and Right to Work in New Zealand

Are you a New Zealand citizen?

Yes No

If not, do you have resident status?

Yes No

A current work permit?

Yes No

Police Vetting - Criminal Record Check

Are you a New Zealand citizen?

Yes No

Do you have any Criminal prosecutions pending?

Yes No

You must supply a current a Criminal Record Check with this application:

Click here to apply

References Section

Do you agree to have your referees contacted in relation to this application?

Yes No

(checks will be conducted in an ethical manner and all information derived will remain confidential.)

Please provide details of three people who can speak on your behalf...

Name	Contact No.	Comment	Position held/working relationship

Office use Check/Initial/Date			Action

Referees

Confidential - reference check for office use only

Referee Name	Comments	Initial	Date	Action

Notes:

Declaration

I declare that, to the best of my knowledge, the information given in this application is true and correct. I understand that inaccurate, misleading or untrue statements or any knowingly withheld information may result in termination of any subsequent Limited Partnership Agreement entered into. I understand that this application does not constitute an offer to become a Limited Partner. I understand that my signature below authorises Principle Insolvency Limited to undertake personal and/or company credit checks with any or all relevant credit agencies.

Date:

Time:

IP Address:

Location: