Ernst & Young Ltd Tel: +64 4 499 4888

100 Willis St, Wellington 6011 Fax: +64 4 495 7400

P O Box 490, Wellington 6140 ey.com/nz

Client Authorisation, Consent and Acknowledgement Form

For Immigration Services and Advice
- Principal Applicant -

Authorisation to Act as Immigration Adviser

I hereby authorise Kristy Verster, (licensed immigration adviser no 201200459), Tomas Lawler (licensed immigration adviser
no 201002468), Trent Young (licensed immigration adviser no 201300517), Isabel Maria Chorao (licensed immigration
adviser no 201100384), Hui Anny McLeod (Anny) (licensed immigration adviser no 201200608), and Amanda Gaskin
(provisional licensed immigration adviser no 201900290) of Ernst & Young Limited New Zealand, to act as my immigration
advisers.

I understand that Amanda Gaskin is supervised by Trent Young, licensed immigration adviser no 201300517, of Ernst &
Young Limited New Zealand.

Consent to Disclosure of Personal Information

I hereby consent to have my employer disclose to Ernst & Young Limited New Zealand (including other member firms of the
Global Ernst & Young Network, collectively “EY”) and their agents, any personal or employment information as is deemed
necessary for the purpose of allowing Ernst & Young Limited New Zealand and its licensed immigration advisers to provide
immigration services to me and my family.

I also consent to have Ernst & Young Limited New Zealand and its agents share my personal information between the
member firms of Ernst & Young and their agents as well as my employer as deemed necessary for the purpose of allowing
Ernst & Young Limited New Zealand to provide immigration services to me.

* Please note that additional privacy consents may be required for compliance with the laws and regulations of other
jurisdictions.

Dual Representation
I acknowledge that Ernst & Young Limited New Zealand and its member firms and agents may represent me, my family
members, as well as my employer in the execution of immigration services for me and my family.

Fees
I further acknowledge that any fees relating to the immigration services performed for me by Ernst & Young Limited New
Zealand and their licensed immigration advisers will be paid directly by my employer.

Document Receipt
I confirm that I have received a copy of the New Zealand Licensed Immigration Advisers Professional Responsibilities leaflet
and have been advised how to access a full copy of the Licensed Immigration Advisers Code of Conduct 2014 and the
Immigration Advisers Authority’s complaints procedure.

Ernst & Young Internal Complaints Procedure for Immigration Services

Ernst & Young is committed to providing quality services to our clients. In the event that you are dissatisfied with the
immigration services Ernst & Young or any of our advisers have provided and you would like to make a formal complaint
please do so in writing. Please forward your concerns to the Oceania Immigration Leader, 200 George Street, Sydney, NSW
2000, Australia.

Your complaint should include the grounds that form the basis of your complaint. It is our policy to acknowledge, investigate
and respond to all complaints made. We endeavour to deal with any complaint promptly, efficiently and equitably.
You may also raise a complaint with the Immigration Advisers Authority via their website at www.iaa.govt.nz.

Confirmation of Identity
I confirm that I have read, understand and agree to the above matters. My identity and personal details are as follows:
Applicant’s Full Name
Christopher Stanley George
Email address
chris@imagodesign.co.nz
Telephone Number
0272325676
25/02/2021
Signature dd/mm/yy