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Kāinga
Whai Tāngata
Our Papakāinga
Our History
Our Stories
Whai Rawa
Retirement Villages
Mangatawa Development Ltd
Horticulture
Whai Oranga
Shareholder Details Form
Grants & Scholarships
Papakāinga Application
Annual Reports
Papakāinga Application
Papakāinga Application
Step
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5
20%
CAPTCHA
Applicant Details
Name
(Required)
First
Last
Home Phone
Mobile
Email
(Required)
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
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Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
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Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
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Palestine, State of
Panama
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Pitcairn
Poland
Portugal
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Samoa
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Thailand
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Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
How long have you lived at this address?
Years
Months
Please state why you are leaving this address
Have you applied to be on the Social Housing register through WINZ?
(Required)
Yes
No
If you have do you know what your current social housing rating number is?
Yes
No
Identification
Photo ID
Max. file size: 300 MB.
Please provide photo identification, such as your driver’s licence.
Drivers License Number
NB: Provision of this number is voluntary and will only be sued to verify your identity and for carrying out a credit check.
Car / vehicle registration number
Make & model
Alternative form of ID
Shareholder Information
If you are currently renting, please provide your landlord’s name and contact details.
Shareholder Status
(Required)
I am a shareholder
I am nominated by my whānau trust which is a shareholder
I am a beneficiary of a shareholder
I have a life interest from a shareholder
None
Shareholder Number
(Required)
Name and shareholder number of whānau trust
(Required)
Note: Mangatawa will confirm your nomination with the Trustees of the whanau trust.
Shareholder name / Number
(Required)
Name and shareholder number of whom life interest received
(Required)
Relationship Status
Single
I have a spouse / partner (we wish to rent as a couple)
I / We are on a benefit
Yes
No
Benefit customer number
If any, how many children do you have in your care?
Children
Name
Age
Gender
Add
Remove
The names and ages of our children are: add on another sheet if more rows required
Living Assistance
Do you or family members who will live with you have any permanent mobility issues: (e.g. use wheelchair, crutches, mobility scooter etc? Please describe
Do you or family members who will live with you require assisted living: e.g. a care giver (live-in or part time visiting) Please describe:
Emergency Contact
Name
First
Last
Address
Phone
Email
May I contact this person for a reference?
(Required)
Yes
No
Please describe your current living conditions
Landlord's Name
Phone
Email
May I contact this person for a reference?
(Required)
Yes
No
References
Please provide two referees that I can contact. Referees can be a friend, co-worker, your employer or someone who knows you well: One of your referees should be able to provide a reference about your creditworthiness. If you have already provided your current landlord’s details, only one additional referee is needed. Please let these people know I may be contacting them for a reference.
Referee name 1
Phone
Email
Referee name 2
Phone
Email
Required Housing
State whether you wish to apply for a
1
2
OR 4 bedroom home
State whether you wish to apply for a
Whānau rental home
Kaumātua home
License to Occupy home
Signature
If necessary I agree to follow Kainga Ora process and be available for an assessment interview. I agree to follow the Mangatawa Papamoa Block Inc. rules as told to me during interview and in the Residents Information Booklet.
Consent
(Required)
I authorise the Landlord/Property Manager to:
Collect, retain and use this information for the purpose of assessing my creditworthiness and suitability for the tenancy; and
Disclose information about me, whether collected from me directly or from any other source, to any other credit provider or any credit reporting agency for the purposes of providing or obtaining a credit report (which will involve the credit reporting agency providing information about me to the Landlord/Property Manager)
Disclose information about me, whether collected from me directly or from any other source, to Tenancy Services for the purposes of providing or obtaining a tenancy report (which will involve the Tenancy Services agency providing information about me to the Landlord/Property Manager)
Share information with and collect information from MSD (WINZ) if necessary (this may include requesting a Rent Redirection order to ensure rent payments are made as required
Consent
(Required)
I authorise the Landlord/Property Manager to:
May hold my information on their credit reporting database and use it for providing credit reporting services, and they may disclose my information to their subscribers for the purpose of credit checking or debt collection; and
As part of providing a credit report, may check the Ministry of Justice fines database for any overdue fines I may have.
Under the Privacy Act 1993, you have the right to ask for a copy of all information held about you, and have the right to request the correction of any incorrect information
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