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LIST OF AFFECTED PARTIES
The names and contact details of persons, groups or authorities who you think have an interest that might
be affected by this application.
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Preferred place of hearing:
Signature of Applicant(s):
Dated: / /
Dated: / /
CONTACT DETAILS
CContact Address: .................................................................................................................................................................................................................................................................
DECEASED OWNER'S PARENTS, BROTHERS, AND SISTERS
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Phone Number(s):
Home: Work:
Mobile:
Email Address:
NOTE: Where email addresses are given these may be used as a means of notice and service.
This form is used to apply to the Māori Appellate Court for leave to appeal a decision after the time limit for
filing an appeal has expired, in accordance with section 58(3) of Te Ture Whenua Māori Act 1993 and rule
8.14(2) of the Māori Land Court Amendment Rules 2026.
UPON THE FOLLOWING GROUNDS: (State grounds, or refer to an attached statement of grounds)
.....................................................................................................................................................................................................................................................................................................................................
.....................................................................................
Signature and contact details
Signature Date
Phone email
For office use only
Deputy Registrar (full name)
The request for the fee to be remitted, reduced, or refunded is approved declined
For the following reason(s) pursuant to Regulation 7(1)(a) of the Māori Land Court fees regulations 2013:
Signature Date
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Consents of all trustees must be filed.
3. Consents must be evidenced by-
a. completion of this form; or
b. consent at a family meeting evidenced by minutes of that meeting; or
c. completion and production of separate forms of consent.
4.