Form 4 - CSLB

Application for a Licence to Undertake Cadastral Surveys

For an overseas qualified cadastral surveyor (other than Australia) For the period 1 July 2021 – 30 June 2022 applying for their initial Licence

In terms of Part 3 of the Cadastral Survey Act 2002 and Subpart 1 of the Standards for Licensing Cadastral Surveyors 2021

Full Name

Email

Address

Phone

Please Enclose:

1. A copy of your tertiary education qualification in surveying or copies of other documents as evidence that you have met the Board’s Standards for Licensing.

2. A letter from your licensing or registration authority that you have not been the subject of disciplinary action for professional misconduct or you are the subject of any current disciplinary complaint or investigation

3. A full curriculum vitae of your cadastral surveying career. (Note: the Board may also require other information to consider the application).

4. Licence fee of $220.00 ($191.30 plus 28.70 GST).

(Note: The Board will reduce this fee to $115.00 incl GST if it issues the licence after 1 January, for the balance of the year to 30 June).

An invoice will be sent following receipt of application.
Please include your name and invoice number.

Please answer the following questions for the Board’s reporting and statistical purposes

Date of Birth

Gender

Male

Female

Ethnic Group

European

Maori

Pacific

Asian

American

African

Other

I confirm that I have read the Board’s Standards for Licensing, Cadastral Surveyors 2021, (See Standards for Licensing) and meet all the competencies described in Schedule 1. In terms of section 23 of the Cadastral Survey Act 2002, I hereby certify that within the last 5 years I have not been convicted of any offence under sections 217 to 281 of the Crimes Act 1961.

CSLB Form 4
Address: PO Box 1208 Wellington 6140