Identity referee declaration DL26

Use this form to verify that the photo attached is a photo of the person named in the applicant details section of this form. This form must
be completed in full.

Identity referee details

Check to make sure you can be an identity referee: Applicant photo

I hold a current New Zealand passport or New Zealand driver licence, AND Please attach the photo of
the applicant.
I am 16 years of age or older, AND ATTACH
I have known the applicant for a year or more, AND You (the referee) need to PHOTO
have written the applicant’s
the applicant is not related to me or part of my extended family, AND full name and signed and HERE
the applicant is not my spouse or partner, AND dated the back of the photo.

the applicant and I do not live at the same address.

Your New Zealand passport or New Zealand driver licence number How many years have you known the applicant?
years

Surname/family name First and middle names

Date of birth
/ /

Physical address
Street number and name Home phone number

Suburb
Daytime phone number
Town/city

Applicant details
Surname/family name First and middle names

Date of birth
/ /

Declaration
I declare that:
• the information I have given is complete and correct to the best of my knowledge
• the person in this photo is the person named in the Applicant details section
• I have written the full name of the applicant on the back of the photo
• I have signed and dated the back of the photo.

Identity referee signature Date

/ /
04/15