Civil Address Request Form

To help enforce civil and tribunal orders by the court

Please Note: The information supplied from the Motor Vehicle Register (MVR) held by the Ministry of Justice
will also be searched for address information when you submit this form.

YOUR APPLICATION CANNOT BE PROCESSED UNLESS YOU ATTACH A COPY OF YOUR CIVIL OR TRIBUNAL ORDER

YOUR INFORMATION
Full name:

Address:

Contact number Mobile number

Email address

DEBTOR’S DETAILS (please include as much information as you can so we can identify the person)

Full name:

Date of birth: Order Number:

Last known
address:

Home phone
Mobile number:
number:
Employer

Any other
information that
could help

eg any aliases

Other previous
addresses

I AGREE :

that I am requesting information about another person for the sole purpose of commencing and/or assisting
with enforcement of my civil court or tribunal order. I agree to this information being released to the court
only. I accept that this information will be held by the court and I will not have access to it.

ATTACH A COPY OF THE CIVIL OR TRIBUNAL ORDER AND RETURN FORM TO

Collections CPU, DX SX10042, Wellington

call 0800 233 222 – if you have any questions about civil enforcement