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A – CERTIFICATE OF APPROVAL APPLICATION – 30/03/2021
Application for a Certificate of Approval
PRIVATE SECURITY PERSONNEL LICENSING AUTHORITY
Completing this form
• You can fill in this form electronically. If
you do, you must print, sign, and submit it
to the Authority.
• You can also print and fill in this form by
hand. Use a black pen or blue pen, and
print clearly IN CAPITALS.
• Answer every question on the form unless
the instructions tell you otherwise.
Payment information
The fee for filing an application for;
• A certificate of approval is $200
• Temporary certificate of approval is an
additional $20
To confirm how you pay the application fee,
visit our website:
https://www.justice.govt.nz/tribunals/licences-
certificates/pspla/forms-and-fees/
If you need further assistance, then please
contact the Authority on:
Ph: 0800 477 752
Email: pspla@justice.govt.nz
Application fees are non-refundable.
Application process
In normal circumstances, it will take a month to
hear the outcome of your application.
If you have a criminal conviction your application
may take longer to process.
Important information
If you:
• Provide false or misleading information to
the Licensing Authority, you may be liable
for a fine of up to $20,000.
• Work for a licensee or as a Crowd
Controller or Repossession Agent without
holding a Certificate of Approval you could
be fined up to $20,000.
When to use this form
Use this form to apply for a certificate of approval to enable you to work for a licence holder in the private
security industry. You can apply for a certificate in one of nine categories. These categories are listed in
Step 3.
What you need with your application
To complete your application, you need to send:
• A fully completed form
• A passport style photo (Selfies will NOT be accepted)
• The fee for filing this application ($200 or $220 if you are also applying for a temporary certificate)
Private Security Personnel and Private Investigators Act 2010
A – CERTIFICATE OF APPROVAL APPLICATION – 30/03/2021
Step 1. Photograph requirements
Step 2. Type of application
Are you applying for a renewal? (Please tick to confirm)
Yes
No
Step 3. Application details
What class or classes of work are you applying for? (you may tick more than one)
Private investigator
Property guard
Security technician
Monitoring officer
Security consultant
Confidential document destruction agent
Crowd controller
Repossession agent
Personal guard
Any photograph of an individual submitted to the Licensing Authority in non-
electronic form for the purpose of sections 24, 46, or 111 must:
(a) be of good quality; and
(b) have been taken not more than 6 months before the date on which it is
supplied; and
(c) be a full front view of the face, head and shoulders of the person, with the
head filling most of the photograph; and
(d) have a plain, light coloured background (not white or dark) with no
background shadow; and
(e) show the individual without a head covering, hat, head band, bandanna or
scarf except for religious or medical reasons. In all cases, facial features from
the bottom of the chin to the top of the forehead and both edges of the face
must be clearly shown; and
(f) be a colour photograph; and
(g) be a good likeness of the person wide; and
(i) be on good quality paper.
Attach photo
here
35x45mm
A – CERTIFICATE OF APPROVAL APPLICATION – 30/03/2021
If you need to work for a licence holder whilst your application is being processed, you may be eligible
for a Temporary Certificate of approval.
Do you wish to apply for a temporary certificate of approval? (Please tick to confirm)
Yes
No
You cannot apply for a temporary certificate if you are applying for renewal. Your certificate will remain active
while your application is being processed.
Step 4. Give us your details
Full name
First
Surname/Family name
Are you known by, or have you ever been known by another name? (Please tick to confirm)
Yes
No
If yes, please supply the additional names. If no, leave this blank and move on to the next question
Other names
First
Middle
Surname
First
Middle
Surname
Other names
First
Surname/Family name
First
Surname/Family name
Date of Birth
/
/
(day/month/year)
What is your gender? (Please tick to confirm)
Male
Female
Are you currently employed? (Please tick to confirm)
Yes
No
If yes, please supply further details below. If no, please move to the residential address question
What is your occupation?
Occupation
Address
No.
Street
Suburb
City
State (if outside NZ)
Country
Post code
A – CERTIFICATE OF APPROVAL APPLICATION – 30/03/2021
If yes, please provide us your postal address
Address No.
Street Suburb
City State (if outside NZ)
Country Post code
Phone Day Mobile
Email
I consent to being contacted regarding my application at this email address
Yes
No
Step 5. Photo identification details
Photo identification is required to verify your identity when you pick up your Certificate of Approval and
ID badge. Please provide details of your Passport, New Zealand Driver’s Licence, HANZ 18+ card or New
Zealand Firearms Licence below:
Passport number
Nationality as shown on passport
Date issued
/ /
(day/month/year)
Passport expiry date
/ /
(day/month/year)
or
New Zealand Drivers Licence number
Drivers Licence expiry date
/ /
(day/month/year)
Drivers Licence version number
or
Other identification type
HANZ 18+
NZ Firearms licence
Other identification number
Do you have a different postal address? (Please tick to confirm)
Yes
No
A – CERTIFICATE OF APPROVAL APPLICATION – 30/03/2021
Step 6. Disqualification criteria
You may not be eligible to hold a certificate of approval if disqualification criteria apply to you.
Section 62 of the Private Security Personnel and Private Investigators Act 2010 lists certain grounds that may
disqualify you from being granted a certificate of approval. If you meet any of the grounds of disqualification listed
below, you will be able to make a statement about your character, circumstances or background.
The Licensing Authority may still grant your application, but only if the Authority is satisfied that you are suitable to
work in the class or classes of work to which the application relates. Please note that no refund is payable if your
application is unsuccessful.
You can find more information at https://www.justice.govt.nz/tribunals/licences-certificates/pspla/
Please answer each individual question below. (Please tick to confirm)
Have you ever been convicted of a ‘specified offence’ as defined in section 4 of the
Criminal Records (Clean Slate) Act 2004?
Yes
No
In the last 7 years, have you been convicted by a New Zealand court of an offence under
the Arms Act 1983?
Yes
No
In the last 7 years, have you been convicted by a New Zealand court of an offence under
sections 216H to 216J of the Crimes Act 1961?
Yes
No
In the last 7 years, have you ever been convicted by a New Zealand court of an offence
under sections 10, 11, 13, 16, 19, 21, 24, 47F, or 47J of the Fair Trading Act 1986?
Yes
No
In the last 7 years, have you ever been convicted by a New Zealand court of an offence
under section 103(1) of the Credit Contracts and Consumer Finance Act 2003 that
involves a breach of any provision of Part 3A of that Act?
Yes
No
In the last 7 years, have you ever been convicted by a New Zealand court of an offence
under section 8 or 25 of the Harassment Act 1997?
Yes
No
In the last 7 years, have you ever been convicted by a New Zealand court of an offence
under section 6 of the Misuse of Drugs Act 1975 in relation to quantities deemed for
supply of a Class A, B or C controlled drug or drugs?
Yes
No
In the last 7 years, have you ever been convicted by a New Zealand court of an offence
of dishonesty, as defined in section 4 of the Private Security Personnel and Private
Investigators Act 2010 (“offence of dishonesty”)?
Yes
No
In the last 7 years, have you ever been convicted by a New Zealand court of an offence
of violence, as defined in section 4 of the Private Security Personnel and Private
Investigators Act 2010 (“offence of violence”)?
Yes
No
In the last 7 years, have you ever been convicted by a New Zealand court of an offence
under sections 16, 34 or 52 of the Private Investigators and Security Guards Act 1974?
Yes
No
Have you ever been disqualified from driving for an indefinite period and ordered to
attend an assessment centre under section 65 of the Land Transport Act 1998, or an
earlier equivalent provision?
Yes
No
Have you ever been ordered by a New Zealand court to be imprisoned following
conviction for an offence and that conviction or order has not been quashed on appeal?
Yes
No
In the last 7 years, have you ever been convicted by a New Zealand court of an offence
under the Private Security Personnel and Private Investigators Act 2010 or Private
Investigators and Security Guards Act 1974 for working without a licence or certificate or
approval or employing or engaging a person without a certificate of approval?
Yes
No
A – CERTIFICATE OF APPROVAL APPLICATION – 30/03/2021
In the last 7 years, have you had a licence or certificate of approval cancelled under the
Private Security Personnel and Private Investigators Act 2010 or the Private Investigators
and Security Guards Act 1974?
Do you hold a licence or certificate of approval that has been suspended?
Yes
No
Have you ever had an order made in relation to you under section 34(1)(b) of the Criminal
Procedure (Mentally Impaired Persons) Act 2003, section 118 of the Criminal Justice Act
1985, or section 39J of the Criminal Justice Act 1954 (being an order imposed, instead of
passing sentence, that you be treated or cared for in a manner that your mental
impairment requires, either in your own interest, or the safety of the public, or for the
safety of the public, or for the safety or a person or class of person)?
Yes
No
Are you currently subject to a court order that requires you to be detained in a hospital
because of a mental condition?
Yes
No
If you have answered yes to a ground for disqualification you can provide further information to support
your application (for example, evidence of your character, circumstances, or background).
If you need extra space, please attach a separate sheet to this application
Step 7. Training disqualification criteria
Have you met any requirements prescribed in regulations made under section 114
(1)(h)(i) of the Private Security Personnel and Private Investigators Act 2010, (which
relate to the mandatory training required for licences and certificates of approval)?
[If you have answered Yes, please attach a copy of your NZQA record of achievement
to this application]
Yes
No
Have you met any requirements prescribed by the Licensing Authority to meet the
requirements of ss 26 or 47 of the Private Security Personnel and Private Investigators
Act 2010 (which relate to competency, knowledge and skills required for licences and
certificates)?
[If you have answered Yes, please supply competency evidence to support your
application]
Yes
No
Examples of evidence for the restricted classes can be found at https://www.justice.govt.nz/tribunals/licences-
certificates/pspla/training-and-skills/
Yes
No
A – CERTIFICATE OF APPROVAL APPLICATION – 30/03/2021
Step 8. Overseas mental health orders and convictions
Section 46 of the Private Security Personnel and Private Investigators Act 2010 also requires that you specify
if you have had an overseas mental health order or conviction. You may provide further information to support
your application (for example, information about your character, circumstances, or background) if you have
specified a conviction or order as follows: You can find more information at:
https://www.justice.govt.nz/tribunals/licences-certificates/pspla/
Please answer each individual question below. (Please tick to confirm)
Have you ever had an order imposed in relation to you by any court or tribunal outside
of New Zealand, instead of passing sentence, that you be treated or cared for in relation
to your mental impairment?
Yes
No
Have you ever been convicted of an offence outside of New Zealand?
Yes
No
If you need extra space, please attach a separate sheet to this application
Step 9. Certificate and badge collection
Which branch of NZ Post would you prefer to pick up your certificate of approval and ID badge from (should your
application be successful?) – a list of branches can be found at https://www.justice.govt.nz/tribunals/licences-
certificates/pspla/
Location
A – CERTIFICATE OF APPROVAL APPLICATION – 30/03/2021
Step 10. Consent and certification
I consent to the Ministry of Justice undertaking a criminal history check using the information contained in my
application. I certify that the above particulars are true and correct.
Name
Signature
Date
Step 11. Do a quick check
You have answered every question
You have attached your photograph
You have signed and dated this form; and
You have paid the fee
Step 12. Send in this form
You can fill in this form and post it to:
Private Security Personnel Licensing Authority
SX10042
Wellington
New Zealand
Address: Level 1, 86 Customhouse Quay, Wellington 6011
Phone: 0800 477 752 between 9am and 5pm Monday to Friday (not Public Holidays)
Email: pspla@justice.govt.nz
Website: https://www.justice.govt.nz/tribunals/licences-certificates/pspla/
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Completed 28 November 2021

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