Property order and/or Welfare Guardianship application questionnaire
You are answering these questions, because you want a property order and/or a welfare guardianship from the family court for a person, of whom you think is not able (or fully able) to make decisions.
General Information
Is your application for (select all that apply)
*
Property manager
Welfare guardian
Personal Order
Have you ever applied for this before?
*
Yes
No
Do you or the person you are applying for need an interpreter?
*
Yes
No
Your Personal Information
Full name
*
First Name
Last Name
Personal contact number
*
Format: (000) 000-0000.
Date of birth
*
-
Day
-
Month
Year
Date
Email
*
Home address
*
Street Address
Street Address Line 2
Town/City
Region
Postcode
Ethnicity
*
NZ European
Maaori
Pasifika
Asian
Middle Eastern / Latin American / African
Other
Occupation
*
Name of your employer
*
Work contact number
*
Format: (000) 000-0000.
Work address
*
Street Address
Street Address Line 2
City
Region
Postcode
What is your relationship to the person you are applying for?
*
e.g. they are my parent, I am their social worker.
Questionnaire
Have you ever been bankrupt?
*
Yes
No
Are you under a compulsory treatment order under the Mental Health (Compulsory Assessment & Treatment) Act?
*
Yes
No
Do you have any criminal convictions?
*
Yes
No
Please list your criminal convictions.
Are you subject to a property order/welfare guardianship order?
*
Yes
No
Are there any conflicts between your interests and the interests of the person you are applying for? (e.g. you jointly own a home).
*
Yes
No
What conflicts could there be?
Information about the person you are applying for
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
Town/City
Region
Postcode
Do they live permanently in New Zealand?
*
Yes
No
Date of birth
*
-
Day
-
Month
Year
Date
Occupation
*
Ethnicity
*
NZ European
Maaori
Pasifika
Asian
Middle Eastern / Latin American / African
Other
Are they married or in a civil union or de facto relationship?
*
Yes
No
Partner's name
First Name
Last Name
Do they have any children? (please name)
*
Please name any other whaanau/family actively involved in their care?
*
Do you think the person is partly, or wholly unable to manage their own affairs?
*
Partly
Wholly
Why are they unable to manage their own affairs?
*
Is the person you are applying for under a compulsory treatment order under the Mental Health (Compulsory Assessment & Treatment) Act?
*
Yes
No
What is the name of their GP and any other Doctors you know who are involved in their care?
*
Property
Please list the assets (and their value) that they own.
*
Is the property situated in New Zealand?
Yes
No
Information about others affected by the property manager/welfare guardian application
Please list other people or organisations affected by this application?
Include any immediate family i.e. partner / children.
Have all the other people affected agreed for you to be appointed property manager/welfare guardian?
Yes
No
Please list those who have agreed for you to be appointed as property manager/welfare guardian?
Who should the application not be served on? And why?
*
Are there other people/ organisations(including whaanau/family members) who should be served with the application?
Is the person the application is about able to attend court? Why/Why not?
*
Submit
Should be Empty: