Apply to renew a duty manager's certificate

1. Applicant details

Do you want us to save your progress?

Your answers will be saved in your device's web browser as you fill them in. Not recommended for public or shared devices.

YesNo

Are you filling out this form on behalf of the duty manager (applicant)? *

YesNo - I am the duty manager

Applicant

Given names *

Family name (surname) *

If you use a single name, please enter it here.

Have you been known by any other names? *

This could include maiden names and birth names

YesNo

Date of birth *

Day

Month

Year

Country of birth *

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Upload photo identification *

This can be a valid passport, a New Zealand driver licence, or a Kiwi Access Card (18+ card)

Gender *

MaleFemaleGender diverse/gender non-binary

Occupation *

Applicant’s address *

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Applicant’s email address *

Applicant’s phone number *

Does the applicant have a criminal conviction? *

Please state all criminal convictions other than convictions for offences against the provision of the Land Transport Act 1998 (not contained in Part 6) and offences to which the Criminal Records (Clean Slate) Act 2004 applies.

YesNo