Completing the form Request for Criminal Conviction History - Third Party
Guide for priority service users
July 2014
To get a copy of a person’s criminal conviction history, both you and the person will need to fill
in the form Request for criminal conviction history – third party. You can get this form from
justice.govt.nz/services/criminal-records
This guide explains the information needed in each step of the form.
Avoid processing delays
We can only process your application if the form is filled in correctly. If details are missing or
incorrect, we may need to contact you or return the form to you. This will cause delays.
How to fill in this form
1. Please read all the instructions in the form.
2. Fill in the form electronically or by hand.
3. Check the form carefully before you send it to us so you can avoid processing delays.
Filling in the form by hand

Print the form.

Write clearly. We are unable to process your request if we can’t read the handwriting on the
form.

Use a black or blue ballpoint pen.
Filling in the form electronically

Type in your answers.

Print the form and sign it using a black or blue ballpoint pen. (Electronic signatures cannot
be accepted.)
1
Complete all the relevant sections
In the form, you are referred to as the ’third party’.
You need to fill in Step 1. The person whose criminal conviction history you want to check needs
to fill in the rest of the form.
Step 1 is the grey section on page 1.
Step 1 Third party to complete this section
Full name of third party
Write in the name of your business or organisation
Full name of the person or
organisation the third party is
acting for (if applicable)
If you are acting for someone else (such as a company that
has hired your recruitment agency to hire staff), please
write the name of the company you are acting for.
Third party reference number (if
applicable)
You can provide your own a reference number for request
tracking purposes if you want.
Third party return address details
This is the person we will send the criminal conviction
report to, and the address we will use.
Signature
Check you have signed the form at the bottom of page 1
next to the red X.
If you have not signed the form, we will send it back to you.
2
The person who is authorising the release of their criminal conviction history to you needs to
complete the following steps (the blue sections). You need to check they have filled in the
information correctly.
Step 2
Your details
Your Personal Details
Check the information is correct
Please make sure the surname, first name, middle names
and date of birth the person writes in here match the
identification they provide in Step 3.
Place of birth
Check that the person has written the town or city, not
the hospital they were born in.
For people born overseas, we need the town or city and
the country.
Previous names
We need the person to provide any other names they are
known as or have used.
This information helps us to match the identity to any
criminal conviction history.
Your postal address
Please make sure this is filled in, as we use addresses to
match the criminal conviction history to an identity.
Current residential address
The person needs to fill this in only if they live at a
different address to their postal address.
Please list any other New Zealand
addresses you have lived at in the
last 10 years
We only need New Zealand addresses.
This information helps us to match the criminal
conviction history to an identity.
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Step 3 Your identification
Check the person has attached a
photocopy of any one of these
identification documents

New Zealand Driver Licence – can be current or expired
within the last 2 years, but cannot be cancelled, defaced
or a temporary licence.

New Zealand Passport – can be current or expired
within the last 2 years, but cannot be cancelled or
defaced. Must show the person’s signature.

Overseas Passports – must be current and cannot be
expired, cancelled or defaced. Must show the person’s
signature.

New Zealand Firearms Licence – must be current and
cannot be expired or defaced.
Check the photocopy is legible
We will not be able to process your form if we cannot read
the details on the identification.
Make sure the signature
matches
Check the person’s signature on the form matches the
signature on their identification. If the signature does not
match we will not be able to process the request.
If the person is using a passport as their identification, make
sure the copy given to you includes the person’s signature.
In some passports, the signature page is separate from the
photo page.
What if the person does not
have any of these forms of
identification?
If they don’t have any of the identification listed in Step 3,
check they have filled in Step 5.
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Step 4 Your authority to release information to a third party
Tick the report required
Check the person has ticked the box for the type of
convictions report you need.
I want a copy of the report
provided to the third party
If the person wants a copy of the report we will send to you,
they need to tick the ‘Yes’ box.
Your signature
Check the person has signed the form at the bottom of
page 3 next to the red X.
If you send the form to us and the person has not signed it,
we will send it back to you.
Date
Check that the person has written the date under their
signature.
We cannot process a form that is more than six months old.
If the dates on the form are changed from the original, we
will send it back to you.
Step 5 Proof of identity
If the person does not have one of the identification documents listed in Step 3, they will need
to find someone who can confirm their identity.
Who can be the identifier?
The identifier must:

have known the person for more than 12 months

be aged 18 years or over

have a daytime phone number and be available during
normal business hours (9:00am to 5:00pm)

not be a relative (a relative is a person connected by
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blood or marriage)

not live at the same address.
Identifier’s declaration
Make sure this section names the person whose identity is
being confirmed, not the identifier.
Signature of the identifier
Check the identifier has signed at the bottom of page 4 next
to the red X.
What if the person can’t get
someone to complete Step 5?
If the person can’t get someone to confirm their identity,
they will need to complete a statutory declaration. You can
get this form from justice.govt.nz/services/criminal-records
Frequently asked questions
For priority service customers
How long does it take to get the
criminal conviction history?
Your request will be processed in 5–8 working days,
depending on how complex it is.
What happens if the request is
not returned after 8 working
days?
If we have not contacted you after 8 working days, please
email your Criminal Records Priority Service Account
Manager for an update using your dedicated Ministry of
Justice email address.
How do you measure service
level times?
If your request is received in your Ministry of Justice email
inbox by 9:00am on a working day, it will be processed
within 5–8 working days from that date.
If we receive your request after 9:00am, it will be processed
within 5–8 working days from the next working day.
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For standard service customers
How long does it take to get the
criminal conviction history?
We will try to process your request within 20 working days
from the date we receive it. This does not include the time it
takes for the application to arrive to us or the time it takes
to return our response to you in the post.
Please do not phone us about your application until at
least 20 working days have passed.
What happens if the request is
not returned after 20 working
days?
If we have not contacted you after 20 working days, please
phone us on +64 4 918 8800 and ask to speak to a Criminal
Records Officer.
Please do not phone us about your application until at
least 20 working days have passed.
Can I email my request to the
Ministry?
No, you can’t email your request to us.
Please post your request to:
Criminal Records Unit
Ministry of Justice
SX10161
Wellington 6011
New Zealand
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