IMMIGRATION NEW ZEALAND Immigration ONLINE

Partner or Child Visa Application - A1263593 - Joao Pedro Luz

Goncalves
Date last modified date and time: 07 January 2019 11:49PM (NZT)
Version: November 2018 V2.0

Identity and Contact

The questions on this screen only relate to the Principal Applicant.
Please provide some basic information about yourself.

What is your name as shown on your passport?

Family/last name Luz Goncalves

Given/first name(s) Joao Pedro

Middle name(s) Not answered

Title Mr

Other names you are known by or have ever been known by (if applicable)

Other family/last name Not answered

Other given/first name(s) Not answered

Other middle name(s) Not answered

Name type Not answered

What is your gender? Male

What is your date of birth? 27/05/2005

Where were you born?

Country/territory Brazil

State/province/region Sao Paulo

Town/city Sao Paulo

Provide details of your passport

Passport number FL179681

Country/territory of passport Brazil

Expiry date 15/10/2019

If applicable, provide details of your national identity number

National identity number Not answered

If applicable, provide details of other citizenships you hold

If applicable, provide details of other citizenships you hold Not answered

What is your partnership status? Single

Have you previously applied for a visa for New Zealand? Yes

Client number 13898328

Please provide details of your residential and postal addresses. We will communicate with you via your online account and your nominated email
address, please provide us with an email address you check regularly.

Provide your current residential address

 Country/territory New Zealand

Address 37 Riverside Road, Frankton, Queenstown 9300

Provide your telephone and email contact

Telephone (landline) Not answered

Mobile number 64-02102391649

Email revclaudiogoncalves@gmail.com

Confirmation email revclaudiogoncalves@gmail.com

Is your postal address the same as your current residential address? Yes

Provide your most recent overseas address

Country/territory Brazil

Address line 1 200 Engenheiro Jose Salles Avenue

Address line 2 Unit 5 - Apartament 65

Address line 3 Capela do Socorro

Town/city Sao Paulo

State/province/region Sao Paulo

ZIP/post code 04776-100

Will you be in the same country as your residential address when you Yes
submit this application?

Group application

Will this visa application be submitted together with other visa Yes
applications as part of a group?

No payment will be required until all member applications have been completed and the group containing those member applications is submitted.
See our website for more details.

Group name Goncalves Family 2019

Declaration

Immigration New Zealand (INZ) will use the information you have provided on this page to check if you or anyone else included in this application
may apply for a visa online. By selecting ‘I agree', you give permission for the information you have provided to be used for this purpose. If you do
not agree, you may delete this information by clicking ‘Cancel’. Note that if you do not delete this information, it will be retained in your online
account until deleted according to our retention policy. See the Immigration New Zealand website to download the application form and make a
paper-based application.

If you want to submit your application with other people (such as your family), you will need to complete applications on their behalf. You will be
able to submit the applications together, after they are all completed.

I agree Yes

Visa Details
This application can only be used if you are the partner or dependent child of a supporting person. That supporting person must hold, or have
applied for, a residence class, work or student visa or must be a New Zealand citizen. See our website for information on who is eligible to support
an application for a partner or dependent child.

Are you applying as a partner or dependent child of another person? Not answered

Supporting Person Details

The supporting person is the person whose citizenship or visa status allows you to apply for this visa.

family/last name Not answered

given/first name(s) Not answered

 middle name(s) Not answered

title Not answered

gender Not answered

date of birth Not answered

country/territory of birth Not answered

state/province/region of birth Not answered

town/city of birth Not answered

passport number Not answered

country/territory of passport Not answered

passport expiry date Not answered

Principal Applicant’s Health Details

All visa applicants must have an acceptable standard of health. Depending on the answers provided, you may be required to provide medical
certificates.

Do you have tuberculosis? Not answered

Do you have any medical condition that requires, or may require, one of the following during your stay in New Zealand?

Renal dialysis Not answered

Hospital care Not answered

Residential care Not answered

Are you pregnant? Not answered

Where have you visited or lived for more than 3 months within the last 5 years?

Country/territory Not answered

Have you previously provided a chest X-ray certificate? Not answered

Have you previously provided a General Medical Certificate (INZ 1007) Not answered
or Limited Medical Certificate (INZ 1201)?

When you applied for your last visa, did Immigration New Zealand ask Not answered
you to provide any of the following medical information with this visa
application?

Principal Applicant’s Character Details

All visa applicants must meet our character requirements. You may be required to provide a police certificate from your country of citizenship and
any country you have lived in for five years or more since the age of 17 if you plan to be in New Zealand for 24 months or longer.
Find out how to obtain a police certificate here.

Have you ever been convicted at any time of any offence, including any Not answered
driving offence?

Have you ever been removed from, deported from, expelled from, Not answered
excluded from or refused entry to, any country, including New Zealand?

In any country, including New Zealand, are you currently under Not answered
investigation, wanted for questioning, or facing charges for any offence?

Have you ever been refused a visa by any country, including New Not answered
Zealand?

Have you lived in any country for more than 5 years since the age of 17 Not answered
(not including your country of citizenship)?

Have you provided a police certificate from Brazil with a previous Not answered
application?
Other Contacts
Provide details of your contacts in New Zealand.

Do you have any contacts in New Zealand? Not answered

Apply on Behalf / Assist

Provide information about any person assisting with this application by providing immigration advice, explaining, translating or recording
information on the form for the applicant(s).

Are you completing this form on behalf of someone else? Not answered

Upload Documents
Based on the information you have provided you must upload the following documents to support your visa application. The size of each document
must not exceed 10 MB. If you have multiple documents to upload as evidence for the same requirement, combine these together into one pdf
before uploading. A document that is translated must be a certified or official translation.
See our help pages for uploading documents and taking acceptable passport photos.

Are there any other documents you wish to provide in support of your Not answered
application?
Declaration
Before you submit your application you must agree to the declaration below. Read it carefully and make sure you understand it before selecting "I
agree".
If you have included your children in this application and they are aged under 18 then this declaration will apply to them as well. If your partner or
children aged 18 years of age or older are included in this application, they must sign a separate declaration form which you must upload with this
application.

I have provided true and correct answers to the questions in this form.
I will inform Immigration New Zealand of any relevant fact or change of circumstances (including a change in my employment or partnership
status) that may (i) affect the decision on my application for a visa, or (ii) affect the decision to grant entry permission based on the visa for which
I am applying.
I understand that if I have received immigration advice from an immigration adviser and if that immigration adviser is not licensed under the
Immigration Advisers Licensing Act 2007 when they should be, Immigration New Zealand will not further process my application.
I authorise Immigration New Zealand to make any necessary enquires about information on this form and/or accompanying documentation and to
share this information with other government agencies (including overseas agencies) to the extent necessary to make decisions about my
immigration status.
I authorise any agency whether in New Zealand or overseas, including but not limited to border or immigration agencies, education providers,
financial institutions, foreign embassies, government authorities, healthcare providers, police or other law enforcement agencies, that holds
information (including personal information) related to information on this application form and/or accompanying documentation to disclose that
information to Immigration New Zealand so that they can (i) make a decision on this application, or (ii) answer enquiries about my immigration
status once my application has been decided.
I authorise any agency that holds information (including personal information) related to those matters to disclose that information to Immigration
New Zealand.
I agree that if I am not entitled to free health care in New Zealand, I will pay for any health care or medical assistance I may require in New
Zealand.
I authorise Immigration New Zealand to provide information about my health and my immigration status to any health service agency.
I authorise any health service agency to provide information about my health to Immigration New Zealand.
I understand that Immigration New Zealand may provide information about my entitlement to work to potential employers via the online VisaView
system.
If I undertake a course of study while in New Zealand, I authorise Immigration New Zealand to provide information about my immigration status to
my education provider, including via the online VisaView system.
I agree to leave New Zealand before my visa expires. If I remain in New Zealand after my visa has expired, I may be deported by Immigration
New Zealand.
I have confirmed all the information I have provided is still true and correct, and that I have uploaded all the necessary documents.
I have provided all the documents required by this application.
I agree with the declaration.

I agree Not answered