Application for a Certificate of Approval Application for a Certificate of Approval PRIVATE SECURITY PERSONNEL LICENSING AUTHORITY Step 1 of 7 14% When to use this form Use this form to apply for a Certificate of Approval to enable you to work for a licence holder in the private security industry. You can apply for a certificate in one of nine categories. These categories are listed in Step 3. What you need with your application To complete your application, you need to submit: A fully completed form A passport style photo (Selfies will NOT be accepted) NZQA record of achievement (if applicable) Competency evidence (if applicable) Application process In normal circumstances, it will take a month to hear the outcome of your application. If you have a criminal conviction your application may take longer to process. Important information If you: Provide false or misleading information to the Licensing Authority, you may be liable for a fine of up to $20,000. Work for a licensee, as a Crowd Controller or Repossession Agent without holding a Certificate of Approval you could be fined up to $20,000. Step 1. Photograph requirements Please supply an electronic passport-style photograph of yourself All photos submitted to the Licensing Authority for the purpose of sections 24, 46, or 111 must: a) be of good quality; and b) have been taken not more than 6 months before the date on which it is supplied; and c) be a full front view of the face, head and shoulders of the person, with the head filling most of the photograph; and d) have a plain, light coloured background (not white or dark) with no background shadow; and e) show the individual without a head covering, hat, head band, bandanna or scarf except for religious or medical reasons. In all cases, facial features from the bottom of the chin to the top of the forehead and both edges of the face must be clearly shown; and f) be a colour photograph; g) be a good likeness of the person; Please email this photo separate to this application to [email protected] with your FULL NAME IN THE SUBJECT LINE. Step 2. Type of applicationAre you applying for a renewal? (Please tick to confirm)*YESNOIf you have previously held a licence or a certificate of approval under the Private Investigators and Security Guards Act 1974 or the Private Security Personnel and Private Investigators Act 2010, provide your licence number or certificate number Step 3. Application detailsWhat class or classes of work are you applying for? (you may tick more than one)* Private investigator Security technician Security consultant Crowd controller Property guard Personal guard Monitoring officer Confidential document destruction agent Repossession agent If you need to work for a licence holder whilst your application is being processed, you may be eligible for a Temporary Certificate of approval. Do you wish to apply for a temporary certificate of approval? (Please tick to confirm)*YESNOYou cannot apply for a temporary certificate if you are applying for renewal. Your certificate will remain active while your application is being processed. Step 4. Give us your detailsName* First Middle Last Are you known by, or have you ever been known by another name?*YESNOIf Yes, please supply the additional names. If No, please select No above and move on to putting in your date of birthDate of Birth* Date Format: DD slash MM slash YYYY What is your gender?*MaleFemaleAre you currently employed?*YESNOWhat is your occupation?What is your residential address?*Do you have a different postal address?*YESNOIf yes, please supply your postal address*Phone*Mobile*Email* Step 5. Photo identification details Photo identification is required to verify your identity when you pick up your Certificate of Approval and ID badge. Please provide details of your Passport, New Zealand Driver’s Licence, HANZ 18+ card or New Zealand Firearms Licence below: Please select one of the below to proceed*Passport numberNew Zealand Drivers Licence numberHANZ 18+/ Kiwi Access cardNZ Firearms LicencePassport number*Nationality shown on passport*Date of issue* Date Format: DD slash MM slash YYYY Passport expiry date* Date Format: DD slash MM slash YYYY New Zealand Drivers Licence number*Drivers Licence expiry date* Date Format: DD slash MM slash YYYY Drivers Licence version numberHANZ 18+/ Kiwi Access card*Expiry date*NZ Firearms Licence*Expiry date*Other identification number* Step 6. Disqualification criteria You may not be eligible to hold a certificate of approval if disqualification criteria apply to you. Section 62 of the Private Security Personnel and Private Investigators Act 2010 lists certain grounds that may disqualify you from being granted a certificate of approval. If you meet any of the grounds of disqualification listed below, you will be able to make a statement about your character, circumstances or background. The Licensing Authority may still grant your application, but only if the Authority is satisfied that you are suitable to work in the class or classes of work to which the application relates. Please note that no refund is payable if your application is unsuccessful. You can find more information at www.PSPLA.govt.nz Please answer each individual question below. (Please tick to confirm)Have you ever been convicted of a ‘specified offence’ as defined in section 4 of the Criminal Records (Clean Slate) Act 2004?*YESNOIn the last 7 years, have you been convicted by a New Zealand court of an offence under the Arms Act 1983?*YESNOIn the last 7 years, have you been convicted by a New Zealand court of an offence under sections 216H to 216J of the Crimes Act 1961?*YESNOIn the last 7 years, have you ever been convicted by a New Zealand court of an offence under sections 10, 11, 13, 16, 19, 21, 24, 47F, or 47J of the Fair Trading Act 1986?*YESNOIn the last 7 years, have you ever been convicted by a New Zealand court of an offence under section 103(1) of the Credit Contracts and Consumer Finance Act 2003 that involves a breach of any provision of Part 3A of that Act?*YESNOIn the last 7 years, have you ever been convicted by a New Zealand court of an offence under section 8 or 25 of the Harassment Act 1997?*YESNOIn the last 7 years, have you ever been convicted by a New Zealand court of an offence under section 6 of the Misuse of Drugs Act 1975 in relation to quantities deemed for supply of a Class A, B or C controlled drug or drugs?*YESNOIn the last 7 years, have you ever been convicted by a New Zealand court of an offence of dishonesty, as defined in section 4 of the Private Security Personnel and Private Investigators Act 2010 (“offence of dishonesty”)?*YESNOIn the last 7 years, have you ever been convicted by a New Zealand court of an offence of violence, as defined in section 4 of the Private Security Personnel and Private Investigators Act 2010 (“offence of violence”)?*YESNOIn the last 7 years, have you ever been convicted by a New Zealand court of an offence under sections 16, 34 or 52 of the Private Investigators and Security Guards Act 1974?*YESNOHave you ever been disqualified from driving for an indefinite period and ordered to attend an assessment centre under section 65 of the Land Transport Act 1998, or an earlier equivalent provision?*YESNOHave you ever been ordered by a New Zealand court to be imprisoned following conviction for an offence and that conviction or order has not been quashed on appeal?*YESNOIn the last 7 years, have you ever been convicted by a New Zealand court of an offence under the Private Security Personnel and Private Investigators Act 2010 or Private Investigators and Security Guards Act 1974 for working without a licence or certificate or approval or employing or engaging a person without a certificate of approval?*YESNOIn the last 7 years, have you had a licence or certificate of approval cancelled under the Private Security Personnel and Private Investigators Act 2010 or the Private Investigators and Security Guards Act 1974?*YESNODo you hold a licence or certificate of approval that has been suspended?*YESNOHave you ever had an order made in relation to you under section 34(1)(b) of the Criminal Procedure (Mentally Impaired Persons) Act 2003, section 118 of the Criminal Justice Act 1985, or section 39J of the Criminal Justice Act 1954 (being an order imposed, instead of passing sentence, that you be treated or cared for in a manner that your mental impairment requires, either in your own interest, or the safety of the public, or for the safety of the public, or for the safety or a person or class of person)?*YESNOAre you currently subject to a court order that requires you to be detained in a hospital because of a mental condition?*YESNOIf you have answered YES to a ground for disqualification you can provide further information to support your application (for example, evidence of your character, circumstances, or background). Step 7. Training disqualification criteriaHave you met any requirements prescribed in regulations made under section 114 (1)(h)(i) of the Private Security Personnel and Private Investigators Act 2010, (which relate to the mandatory training required for licences and certificates of approval)?*YESNOIf you have answered Yes, please email a copy of your NZQA record of achievement separately to this application to [email protected] with your FULL NAME IN THE SUBJECT LINE.Have you met any requirements prescribed by the Licensing Authority to meet the requirements of sections 26 or 47 of the Private Security Personnel and Private Investigators Act 2010 (which relate to competency, knowledge and skills required for licences and certificates)?*YESNOIf you have answered Yes, please email competency evidence to support your application separate to this application to [email protected] with your FULL NAME IN THE SUBJECT LINE. Examples of evidence for the restricted classes can be found at https://www.justice.govt.nz/tribunals/licences-certificates/pspla/training-and-skills/Step 8. Overseas mental health orders and convictions Section 46 of the Private Security Personnel and Private Investigators Act 2010 also requires that you specify if you have had an overseas mental health order or conviction. You may provide further information to support your application (for example, information about your character, circumstances, or background) if you have specified a conviction or order as follows: You can find more information at www.PSPLA.govt.nz Please answer each individual question below.Have you ever had an order imposed in relation to you by any court or tribunal outside of New Zealand, instead of passing sentence, that you be treated or cared for in relation to your mental impairment?*YESNOHave you ever been convicted of an offence outside of New Zealand?*YESNOIf you have answered YES provide further information below: Step 9. Certificate and badge collection Which branch of NZ Post would you prefer to pick up your certificate of approval and ID badge from (should your application be successful?) – a list of branches can be found at www.pspla.govt.nz Location*Step 10. Consent and certification Name* First Last Date* Date Format: DD slash MM slash YYYY Consent* I consent to the Ministry of Justice undertaking a criminal history check using the information contained in my application. I certify that the above particulars are true and correct.