✨ Customs Licence Application Form
NEW ZEALAND GAZETTE, No. 25 — 9 MARCH 2017
10 Full Name and Address of each company director/partner/trustees (if applicable):
11 Full Premises Name:
Trading as (where applicable): _____
12 Contact Details for the area to be licensed
Contact numbers:
Email address:
13 Physical Address of area to be licenced:
Street Number: ____ Unit Number: ____ Floor Level:
Property Name: _ Property Type: ___
Street Name: ____ Street Type: __
Suburb: __ Town/City: ____
State: Country: _ Postcode: ___
14 Postal Address of area to be licenced (if not same as above):
Street Number: ____ Unit Number: ____ Floor Level:
Property Name: _ Property Type: ___
PO Box: __ Private Bag:
Street Name: ____ Street Type: __
Suburb: __ Town/City: ____
State: Country: _ Postcode: ___
15 Billing Address of area to be licenced (if not same as above):
Street Number: ____ Unit Number: ____ Floor Level:
Property Name: _ Property Type: ___
PO Box: __ Private Bag:
Street Name: ____ Street Type: __
Suburb: __ Town/City: ____
State: Country: _ Postcode: ___
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NZ Gazette 2017, No 25
✨ LLM interpretation of page content
🏭
Application for Customs controlled area licence
(continued from previous page)
🏭 Trade, Customs & IndustryCustoms, Licence Application, Form C11, Customs and Excise Act 1996