Page 1 For more information visit www.justice.govt.nz/courts/maori-land-court MLC 06/15 - 01
For more information visit www.justice.govt.nz/courts/maori-land-court
GENERAL FORM OF APPLICATION
Te Ture Whenua Māori Act 1993
Section(s)....................................................
(State number of section(s) under which application is made)
Form 01
Rule 4.2 (2)
WHAT IS THIS FORM FOR?
Applications that do not have a prescribed form in the rules must be completed using this form. This form is
designed to be generic and allow for different types of application under Te Ture Whenua Māori Act 1993.
HOW TO FILE AND COMPLETE THIS APPLICATION FORM
(i) This form must be accompanied with the
appropriate application fee (if any) and may be
filed at any office of the Court (with the exception
of an application seeking leave to appeal out of
time which must be lodged in the Office of the
Chief Registrar);
(ii) As this is a general application form, please
ensure that all information required on the form is
completed;
(iii) If the order sought is against one or more other
parties you must supply the names and contact
details of those parties;
(iv) Where tick boxes
are provided please
ensure you tick all those boxes that apply to your
application, unless you are required to select one
box, then only select the box that applies;
(v) If there is insufficient room on the form to provide
all the required information you should continue
your application on a separate sheet of paper; and
(vi) Additional information – in addition to completing
this form, if the application requires you to
provide further information you must include all
documents, information or evidence you wish the
Court to consider.
Office use:
Application: ACCEPTED / REFUSED
Dated: ..............................................................
Signed: .............................................................
Name: ..............................................................
Designation: ....................................................
RESET FORM
Page 2 For more information visit www.justice.govt.nz/courts/maori-land-court MLC 06/15 - 01
The Māori Land Court of New Zealand
(Please select the name of the Māori Land Court District in which some or all of the lands or the subject matter of the application is located)
Please select one District Taitokerau Waikato Maniapoto Waiariki
Tairāwhiti kitimu Aotea Te Waipounamu
SUBJECT OF APPLICATION  BLOCK / DECEASED / OTHER MATTER:
(Please state name and block number of land, Māori incorporation, person or other matter in respect of which the application is made)
....................................................................................................................................................................................................................................................................................................................................
....................................................................................................................................................................................................................................................................................................................................
APPLICATION:
I / We ..........................................................................................................................................................................................................................................................................
(state full name)
apply for an order
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REASONS FOR APPLICATION:
(State grounds or reasons and any facts relied upon so as to fully inform the Court as the true nature of the application)
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(Set out nature of order sought so as to clearly inform the Court what is required and if the application is not under
Te Ture Whenua Māori Act give details as to the Act and section that apply)
Page 3 For more information visit www.justice.govt.nz/courts/maori-land-court MLC 06/15 - 01
AFFECTED PARTIES:
Are there any parties who will be affected by this application? (affected parties include any owners,
beneficiaries or occupiers of the land who have an interest that may be affected by this application)
YES
(Complete the list of affected parties by providing their name and contact details)
NO
Preferred place of hearing:
Signature of Applicant(s):
Dated: / /
Dated: / /
CONTACT DETAILS
C
ontact Address: ...............................................................................................................................................................................................................................................................................................
.............................................................................................................................................................................................................................................................................................................................................
(Address to which documents or correspondence in connection with the application can be posted or delivered)
Phone Number(s):
Home: Work:
Mobile: Fax:
Email Address:
NOTE: Where fax or email addresses are given these may be used as a means of notice and service.
Fee: $
(Depending on the type of application a fee of $20.00, $60.00 or $200.00 may apply. If you are unsure of the fee that applies please contact your local
Māori Land Court office for further assistance)
MĀORI LAND COURT CONTACT DETAILS
Applications should be lodged with the Registrar in the Māori Land Court District in which some or all of the lands or the subject matter
of the application is located.
TAITOKERAU
L3, Manaia House
41 Rathbone St
WHANGĀREI
DX Box AX10086
WHANGĀREI
PH: (09) 983 9940
Fax: (09) 983 9941
mlctaitokerau@justice.govt.nz
TAITOKERAU
Auckland Information Office
Avanti Finance Building
65B Main Highway
Ellerslie, AUCKLAND
DX Box EX10912
AUCKLAND
PH: (09) 279 5850
Fax: (09) 279 5852
mlctamakimakaurau@justice.govt.nz
WAIKATO MANIAPOTO
L2, BNZ Centre
354-358 Victoria St
HAMILTON
DX Box GX10101
HAMILTON
PH: (07) 957 7880
Fax: (07) 957 7881
mlcwaikato@justice.govt.nz
WAIARIKI
Hauora House
1143 Haupapa St
ROTORUA
DX Box JX10529
ROTORUA
PH: (07) 921 7402
Fax: (07) 921 7412
mlcwaiariki@justice.govt.nz
TAIRĀWHITI
Ngā Wai e Rua Building
Cnr Lowe Str & Reads Quay
GISBORNE
DX Box PX10106
GISBORNE
PH: (06) 869 0370
Fax: (06) 869 0371
mlctairawhiti@justice.govt.nz
TĀKITIMU
L2, Heretaunga House
Corner Lyndon & Warren Strs
HASTINGS
DX Box MX10024
HASTINGS
PH: (06) 974 7630
Fax: (06) 974 7631
mlctakitimu@justice.govt.nz
AOTEA
Ingestre Chambers
74 Ingestre Street
WHANGANUI
DX Box PX10207
WHANGANUI
PH: (06) 349 0770
Fax: (06) 349 0771
mlcaotea@justice.govt.nz
TE WAIPOUNAMU
30 Sheffield Crescent
Burnside
CHRISTCHURCH
DX Box WX11124
CHRISTCHURCH
PH: (03) 962 4900
Fax: (03) 962 4901
mlctewaipounamu@justice.govt.nz
Whangārei
Page 4 For more information visit www.justice.govt.nz/courts/maori-land-court MLC 06/15 - 01
LIST OF AFFECTED PARTIES
The names and contact details of persons, groups or authorities who you think have an interest that might be
affected by this application
Name ...................................................................................................................................................................................................................................................................................................................
Postal Address ............................................................................................................................................................................................................................................................................................
Email Address ..............................................................................................................................................................................................................................................................................................
Phone No. .........................................................................................................................................................................................................................................................................................................
Name ...................................................................................................................................................................................................................................................................................................................
Postal Address ............................................................................................................................................................................................................................................................................................
Email Address ..............................................................................................................................................................................................................................................................................................
Phone No. .........................................................................................................................................................................................................................................................................................................
Name ...................................................................................................................................................................................................................................................................................................................
Postal Address ............................................................................................................................................................................................................................................................................................
Email Address ..............................................................................................................................................................................................................................................................................................
Phone No. ........................................................................................................................................................................................................................................................................................................
Name ...................................................................................................................................................................................................................................................................................................................
Postal Address ............................................................................................................................................................................................................................................................................................
Email Address ..............................................................................................................................................................................................................................................................................................
Phone No. ........................................................................................................................................................................................................................................................................................................
Name ...................................................................................................................................................................................................................................................................................................................
Postal Address ............................................................................................................................................................................................................................................................................................
Email Address ..............................................................................................................................................................................................................................................................................................
Phone No. ........................................................................................................................................................................................................................................................................................................
Name ...................................................................................................................................................................................................................................................................................................................
Postal Address ............................................................................................................................................................................................................................................................................................
Email Address ..............................................................................................................................................................................................................................................................................................
Phone No. ........................................................................................................................................................................................................................................................................................................
Page 5 For more information visit www.justice.govt.nz/courts/maori-land-court MLC 06/15 - 01
SCHEDULE 2
WHAKAPAPA DETAILS
1.
Full names of owner:
............................................................................................................................................................................................................................................................
.......................................................................................................................................................................................................................................................................................................................
2.
Full names of owner's children:
a. b.
c. d.
e. f.
g. h.
3.
Full names of owner's parents (please state relationship): .................................................................................................................................................................
......................................................................................................................................................................................................................................................................................................................
......................................................................................................................................................................................................................................................................................................................
.......................................................................................................................................................................................................................................................................................................................
4.
Full names of owner's brothers and sisters:
(if any and specify whether full brother or sister,
whether half brother or sister, whether any were adopted in or out of family, whether legally or as a whāngai)
a.
b.
c.
d.
e.
f.
g.
Note: Only complete this schedule if whakapapa is required for your application.
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