New Zealand Flag Referendums Bill

  • enacted

Schedule 3 Forms

ss 15(3), 16(3)(b), 38(1)(b)(ii), 43(3)(a), 44(2)(a)

Form 1 Declaration by Returning Officer or by person employed or engaged for purposes of referendum

ss 15(3), 16(3)(b)

*I, [name, place of residence, and occupation], solemnly and sincerely declare that I will faithfully serve in the office of the Returning Officer and will not do anything prohibited by section 50, 52, 58, or 60(2) and (3) of the New Zealand Flag Referendums Act 2015 or section 64 of the Referenda (Postal Voting) Act 2000.

or

*I, [name, place of residence, and occupation], solemnly and sincerely declare that I will faithfully serve in the position for which I am employed/engaged† under section 16 of the New Zealand Flag Referendums Act 2015, and will not do anything prohibited by section 50, 52, 58, or 60(2) and (3) of the New Zealand Flag Referendums Act 2015 or section 64 of the Referenda (Postal Voting) Act 2000.

*Select the paragraph that applies.
†Select one.

[Name, signature]

Declared at [place, date]

Before me: [name, signature]

(Justice of the Peace/lawyer/Returning Officer*)

*Select one.
Notes
1

Sections 50, 52, 58, and 60(2) and (3) of the New Zealand Flag Referendums Act 2015 and section 64 of the Referenda (Postal Voting) Act 2000 are printed on the back of this form and must be read by or to the declarants to whom they apply.

2

A declaration by the Returning Officer must be made before a Justice of the Peace or a lawyer.

Form 2 Declaration of result of referendum

s 38(1)(b)(ii)

I declare the result of the referendum taken over the period commencing on [date] and ending on [date] on the question “What is your choice for the New Zealand flag?” is as follows:

*Votes received for [identify option]: [number]

Dated at [place, date]

[Name, signature]

(Returning Officer)

*Repeat for each option.

Form 3 Notice of opposition to inquiry into conduct of referendum

s 43(3)(a)

In the High Court of New Zealand

Wellington Registry

No: [number of proceeding]

In the matter of a referendum held from [dates of voting period] on [describe question]

Respondent
1

The respondent is a group of [number in group] electors who intend to oppose the application or applications [describe application or applications] for an inquiry into the conduct of the referendum.

2

The name, address, electoral district, and signature of each member of the group are set out in the appendix to this notice.

3

The spokesperson for the respondent is [name, address of spokesperson].

4

The respondent acts—

*(a)

through a lawyer, who is [name, address of lawyer]:

*(b)

through its spokesperson.

*Select the paragraph that applies.
Address for service

The respondent’s address for service is [address].

Signature

[Signature, date]

(spokesperson for respondent/person on behalf of spokesperson for respondent*)

*Select one.

Appendix

Members of respondent group

NameAddressElectoral districtSignature

Form 4 Application for inquiry into conduct of referendum

s 44(2)(a)

In the High Court of New Zealand

Wellington Registry

No: [number of proceeding]

In the matter of a referendum held from [dates of voting period] on [describe question]

Applicant’s details
1

The applicant is a group of [number in group] electors who are dissatisfied with the conduct of the referendum.

2

The name, address, electoral district, and signature of each member of the group are set out in the appendix to this application.

3

The spokesperson for the applicant is [name, address of spokesperson].

4

The applicant acts—

*(a)

through a lawyer, who is [name, address of lawyer]:

*(b)

through its spokesperson.

*Select the paragraph that applies.
Application
5

*The applicant asks for an inquiry into the conduct of the referendum.

or

*The applicant asks for an inquiry into the conduct of [name of person complained of], [office described in section 42 of the New Zealand Flag Referendums Act 2015, if relevant], of [address of person complained of], who was connected with the referendum.

*Select the paragraph that applies.
6

The specific grounds on which the applicant is dissatisfied with the conduct of the referendum are as follows: [state specific grounds].

7

*The applicant asks the court to determine the total number of valid votes recorded for each option.

or

*The applicant asks the court to declare the referendum void.

*Select the paragraph that applies.
Address for service
8

The applicant’s address for service is [address].

Signature

[Signature, date]

*Spokesperson for applicant

*Person on behalf of spokesperson for applicant.

*Select one.

Appendix

Members of applicant group

NameAddressElectoral districtSignature