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Full Name Age
Postal Address
Email
3. Full Name Age
Postal Address
Email
4. Full Name Age
Postal Address
Email
Gender
Gender
Gender
Male Female DeceasedGender diverse
Under 'Gender', please write either 'M' (male) 'F' (female) or 'GD' (gender diverse).
tick as appropriate
The land is not subject to any Trust
The alienation is not in breach of any Trust to which the land is subject
The alienee is a member of the preferred class of alienee being:
Child(ren) or remoter issue of the alienor; or
Whanaunga who are associated in accordance with tikanga Māori with the land; or
Another owner in the land who is a member of the hapū associated with the land; or
A trustee of any of the above three classes of person.
Page 3 For more inform...
DETAILS OF THE DISPUTE:
Please describe in detail the matter that is disputed.
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Grounds for application:
I am a party to a contract or arrangement relating to the proposed transfer; or
I am the transferor/donor of the land or interest; or
I am a trustee for a person entitled to the land or interest
3. Consultation with whānau
I have consulted with my immediate whānau about this application; and
There are no objections from my whānau
4.
SIGNED by the transferor Dated: / /
IN THE PRESENCE OF:
Witness:
(Signature)
Full name:
Occupation or qualification:
Address:
For more information visit www.māorilandcourt.govt.nz
Page 3 MLC 07/24 - 31
SIGNED by the transferee Dated: / /
IN THE PRESENCE OF:
Witness:
(Signature)
Full name:
Occupation or qualification:
Address:
Notes:
(1) If the transfer is of shares in a block, the transferee must be a member of the preferred classes of alienees
– see application form (Fo...
Signed by the applicant(s):
Dated: / /
Dated: / /
Page 3 For more information visit www.māorilandcourt.govt.nz MLC 07/25 - 32
CONTACT DETAILS
Contact Address: ...............................................................................................................................................................................................................................................................................................
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