Fillable Employer Supplementary Form (Accident Compensation Corporation New Zealand)

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Employer Supplementary Form (Accident Compensation Corporation New Zealand)

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OFFICE USE ONLY Client no.: Date received: / / Application no.:
December 2018
Employer Supplementary
Form
INZ 1113
for employers who have offered a position
to a person from overseas who is applying for a work visa
immigration.govt.nz
Information for employers
This form must be completed and signed by a person who
has authority to make representations and enter into
agreements on the employer’s behalf. Please answer all
questions. If any question does not apply please answer
“N/A” for “not applicable”. Complete this form if you are
an employer who has offered a position to a person from
overseas who is applying for a work visa or varying the
conditions of a work visa.
This form must be used for:
• Essential Skills work visa applicants; and
• Work to Residence: Long Term Skill Shortage List (LTSSL)
work visa applicants; and
• Post-study work visa (employer assisted) applicants; and
• Silver Fern Practical Experience work visa applicants; and
• Specific Purpose work visa applicants, where a job offer
is required; and
• Variation of Condition work visa applicants
This form is not required for any other work visa category.
This form must be submitted by the person you have offered
a position to with the Work Visa Application (INZ1015) form
or the Application for a Variation of Conditions or Variation
ofTravel Conditions (INZ1020)form.
Note: If you are an Accredited Employer, you do not have to
complete this form to support a work visa holder applying
to vary the conditions of their Work to Residence – Talent
workvisa.
Providing this information will help us to process the
application, however we may need to contact you for
moreinformation.
Submit photocopies only. Do not submit original documents
as they will not be returned to you. If we need to see an
original document we will ask you to produce it at a latertime.
Work entitlement
It is an offence under the Immigration Act 2009 to employ
a person who is not entitled to work in NewZealand. One
way for employers to avoid committing this offence is to
check a person’s entitlement to work through Immigration
NewZealand’s online VisaView system. For more information
or to register please visit www.immigration.govt.nz/visaview.
Disclosure of information through VisaView is authorised
bylegislation.
Supporting Essential Skills work visa applications
In most cases employers with ANZSCO skill level 4 or 5
vacancies must engage with Work and Income before
supporting an Essential Skills work visa application. Work and
Income will refer candidates who are suitable and available
for the role (if there are any) and provide a Skills Match
Report if you choose to support a work visa application.
You can find more details on our website at
www.immigration.govt.nz/employ-migrants.
When filling in this form, please write clearly in English
using CAPITAL LETTERS.
About the information you provide
Immigration New Zealand collects the information about you
on this form to determine your request to recruit overseas
workers. We may also use the information to contact you for
research purposes or to advise you on immigration matters.
The address of Immigration New Zealand is POBox1473,
Wellington 6140, New Zealand. Do not send your application
tothis address.
Collecting the information is authorised by the Immigration Act
2009 and the Immigration Regulations made under that Act.
Youdo not have to provide the information, but if you do not
weare likely to decline your application.
Immigration New Zealand may also share the information
you have provided with other government agencies that are
entitled to it by law, or with other agencies (as you have agreed
in the declaration).
You have the right to access the information we hold about
youand have any of it corrected if you think it is necessary.
For more information
If you have questions about completing this form:
• see our website www.immigration.govt.nz
• telephone our call centre on 0508 558 855
(within New Zealand).
2 – Employer Supplementary Form – December 2018
When filling in this form, please write clearly using CAPITAL LETTERS.
Section A
Employer details
Attach a copy of the full employment agreement and complete the following.
A1
State the name of the person to whom you have offered a position in your business
Family/last name Given/first name(s)
A2
Full name of person completing this form.
Position or title of person completing this form.
Business name (if applicable) and physical and postal addresses.
Telephone (daytime) Telephone (evening)
Fax
Email
Website
Mobile
A3
New Zealand Business Number
For help search: www.nzbn.govt.nz
A4
How long has this business been in operation?
A5
How many people does the business currently employ?
A6
How many current employees are New Zealand citizens or residence class visa holders?
A7
Has the business made anybody redundant, or been through a consultation with respect to potential
redundancies, in the past six months?
Yes Provide details, including how many people were affected and their roles.
No
A8
State the names of any associated companies or businesses (such as parent or subsidiary companies, and
companies associated with substantial owners or directors of this business).
This form has been approved under section 381 of the Immigration Act 2009.
Employer Supplementary Form – December 2018 – 3
When filling in this form, please write clearly using CAPITAL LETTERS.
A9
Have you provided any of the following:
Skills Match Report from Work and Income. Attach a copy of the Skills Match Report to this form.
Go to ‘Section C: Overseas recruitment based on non-availability of New Zealand residents’
Approval in Principle from Immigration New Zealand to recruit workers for this position.
State your 8-digit AIP reference number
Go to ‘Section D: Declaration by employer’
Section B
Position details
If you have provided a Skills Match Report or have an Approval in Principle to recruit workers for this position,
you do not need to complete this section.
Provide details of the position you have offered to the potential employee named in this application.
B1
Job title
B2
ANZSCO occupation title, occupation code, and skill level (ANZSCO is the Australian and NewZealand
Standard Classification of Occupations. Most New Zealand occupations are listed in the ANZSCO, with
a six-digit occupation code and a skill level ranging from 1 (highly-skilled) to 5 (unskilled). For more
information see www.immigration.govt.nz/anzsco.
ANZSCO occupation title
  
ANZSCO occupation code
B3
The address of the place of employment (if different from that stated in question
A2
).
B4
The type of work, duties and responsibilities.
B5
Details of pay and conditions of employment (for example, holidays).
B6
Hours of work.
B7
The duration of the job.
B8
Qualifications required.
B9
Type of experience required.
Length of experience required.
B10
Other skills or competencies required.
4 – Employer Supplementary Form – December 2018
When filling in this form, please write clearly using CAPITAL LETTERS.
B11
Does the worker require occupational registration in New Zealand?
Yes The applicant will need to produce evidence that this has been obtained at the time of submitting the work visa application.
No
Section C
Overseas recruitment based on non-availability of New Zealand residents
This section must be completed if the person you have offered employment to is applying under the Essential
Skills work category unless:
• the occupation is on an Immigration New Zealand skill shortage list (either the Long Term, Immediate,
or Construction and Infrastructure skill shortage list) and the person meets the qualification and/or work
experience requirements of the list, or
• the person wishes to continue working in the role they currently hold, and they have been invited to apply
or have applied under the Skilled Migrant Category based on this employment.
You must answer the questions below and attach evidence to show that you have made genuine attempts to recruit
New Zealand citizens or residence class visa holders for the position. We can make a faster visa decision if you provide
satisfactory evidence of doing so now.
If your vacancy is skill level 4 or 5 of the ANZSCO, in most cases you must engage with Work and Income before
supporting an Essential Skills work visa. Work and Income will refer candidates who are suitable and available for the
role (if there are any) and give you a Skills Match Report if you choose to support a work visa. For details of exemptions
from this requirement see the Essential Skills work visa requirements section of the Work Visa Guide (INZ1016).
C1
Have you made genuine attempts to recruit New Zealanders for the role offered?
Yes Attach evidence, such as dated copies of advertising or records of your engagement with a recruitment company.
The evidence must show where advertising occurred, as well as the frequency and duration.
No
C2
Have you made efforts as an employer to train New Zealanders to fill the positions available?
Yes Attach documents outlining the types of training provided and the outcome of that training.
No Provide a written statement outlining why you have not made efforts to train New Zealanders.
C3
Explain why the New Zealanders considered for this role were not suitable. Provide details such as how many
New Zealanders were considered, why they couldn’t perform the duties described in the job description and
why they were not able to be trained.
Employer Supplementary Form – December 2018 – 5
When filling in this form, please write clearly using CAPITAL LETTERS.
Section D
Declaration by employer
This section must be read and signed by a person who has authority to make representations and enter into
agreements on the employer’s behalf.
I understand the notes and questions in this form and I declare that the information given about my business
istrueand correct.
I understand that further information relating to business records, sets of accounts, financial statements and
other records deemed necessary may be requested.
I understand that if I make any false statements, or provide any false or misleading information, or have
changed or altered this form in any way, that I may be committing an offence under sections 342 and 348 of
the Immigration Act 2009 and may be liable to prosecution.
I agree to inform Immigration New Zealand about any relevant changes to the circumstances of my business
that occur after I lodge this form that may impact on current or prospective applicant’s employment.
I agree to pay any Essential Skills work visa holder in my employment the remuneration required by their
visaconditions.
I authorise Immigration New Zealand to:
• seek information concerning my compliance with New Zealand’s immigration and employment laws from
anyrecords held by the Ministry of Business, Innovation and Employment
• make any enquiries it deems necessary in respect of the documents or information provided in respect of
thisform
• share information provided about me or my business with other government agencies (including overseas
agencies) to the extent necessary to make decisions.
Signature
Date
D M Y YD M Y Y
Name
  
Job title or position
6 – Employer Supplementary Form – December 2018
When filling in this form, please write clearly using CAPITAL LETTERS.
Employer Supplementary Form – December 2018 – 7
When filling in this form, please write clearly using CAPITAL LETTERS.
8 – Employer Supplementary Form – December 2018
When filling in this form, please write clearly using CAPITAL LETTERS.
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