An application form for a certificate of no impediment under section 25 of the Act must require the following information:
(a) the applicant's full name and full name at birth (if different from current name):
(b) the applicant's date and place of birth:
(c) if not born in New Zealand, the year of arrival of the applicant in New Zealand:
(d) the applicant's usual residential address (in full):
(e) if the applicant has been in a civil union or married, the date and place of the solemnisation of the applicant's last civil union or marriage, and how and when that civil union or marriage was dissolved:
(f) the full names and full names at birth (if different from current names) of the applicant's parents:
(g) if either or both of the applicant's parents are living in New Zealand, their usual residential address:
(h) if neither of the applicant's parents are living in New Zealand, the name and address of a relative or friend in New Zealand who has known the applicant for at least 12 months:
(i) the full name and full name at birth (if different from current name) of the proposed other party to the civil union:
(j) the date and place of birth of the proposed other party to the civil union:
(k) the country (and, if applicable, the state) where the civil union will be solemnised:
(l) the applicant's signature:
(m) the date of signing the application and the place where it is signed.