For more information visit www.justice.govt.nz/tribunals
Disputes Tribunal
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Page 1 For more information visit www.justice.govt.nz/tribunals DT 07/11 - 8
What is this form for? Use this form if you wish to have enforced a term of an agreed settlement that has not been complied with.
Completing and 1. Fill in all sections below.
this form submitting 2. Print in CAPITAL LETTERS.
3. Check, before submitting this form, that it is complete and that you have signed and dated it.
4. Submit this form by post or in person to the District Court where your original Disputes Tribunal claim
was heard.
Part 1: Applicant (individual or organisation)
Individual’s family name(s):
Individual’s first name(s):
Organisation’s name (if a corporation and unincorporated body of persons, for example, an individual’s employer):
Attention (organisation’s contact):
Physical address (A physical address is required)
Street or road (number and name):
Rural delivery number:
Suburb:
City, town or district:
Postcode:
Postal address (if different from physical address)
Street or road (number and name):
Rural delivery number:
Suburb:
City, town, or district:
Postcode:
Contact details
Daytime telephone number: ( ) Mobile telephone number:
Email address:
CIV:
(Office use only)
Form 8: Request to Enforce Part of an Agreed
Settlement
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Part 2: First respondent (individual or organisation)
Individual’s family name(s):
Individual’s first name(s):
Organisation’s name (if a corporation or unincorporated body of persons, for example, an individual’s employer):
Attention (organisation’s contact):
Physical address (A physical address is required)
Street or road (number and name):
Rural delivery number:
Suburb:
City, town or district:
Postcode:
Postal address (if different from physical address)
Street or road (number and name):
Rural delivery number:
Suburb:
City, town, or district:
Postcode:
Contact details
Daytime telephone number: ( ) Mobile telephone number:
Email address:
Part 3: Second respondent (if any, individual or organisation)
Individual’s family name(s):
Individual’s first name(s):
Organisation’s name (if a corporation or unincorporated body of persons, for example, an individual’s employer):
Attention (organisation’s contact):
Physical address (A physical address is required)
Street or road (number and name):
Rural delivery number:
Suburb:
City, town or district:
Postcode:
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Part 3: Second respondent (if any, individual or organisation)
continued
Postal address (if different from physical)
Street or road (number and name):
Rural delivery number:
Suburb:
City, town, or district:
Postcode:
Contact details
Daytime telephone number: ( ) Mobile telephone number:
Email address:
Part 4: Decision
Date of Tribunal decision / / (day / month / year)
Place of hearing (that is, name of the District Court where the Disputes Tribunal hearing was held):
CIV number (as stated on the Tribunal’s decision)
Part 5: Request
Please state the term you want enforced; the reasons why you consider the term has not been complied with, and any other
relevant information.
(If you need more space please attach a separate sheet)
Signature Date / / (day / month / year)
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