Resource Management (Forms, Fees, and Procedure) Regulations 2003

Form 5 Submission on notified proposal for policy statement or plan, change or variation

Clause 6 of Schedule 1, Resource Management Act 1991

To [name of local authority]

Name of submitter: [full name]

This is a submission on the following proposed policy statement (or on the following proposed plan or on a change proposed to the following policy statement or plan or on the following proposed variation to a proposed policy statement or on the following proposed variation to a proposed plan or on the following proposed variation to a change to an existing policy statement or plan) (the proposal):

[name of proposed or existing policy statement or plan and (where applicable) change or variation].

I could/could not* gain an advantage in trade competition through this submission.

*Select one.

*I am/am not† directly affected by an effect of the subject matter of the submission that—

(a)

adversely affects the environment; and

(b)

does not relate to trade competition or the effects of trade competition.

*Delete entire paragraph if you could not gain an advantage in trade competition through this submission.
†Select one.

The specific provisions of the proposal that my submission relates to are:

[give details].

My submission is:

[include

  • whether you support or oppose the specific provisions or wish to have them amended; and

  • reasons for your views].

I seek the following decision from the local authority:

[give precise details].

*I wish/do not wish† to be heard in support of my submission.

*In the case of a submission made on a proposed planning instrument that is subject to a streamlined planning process, you need only indicate whether you wish to be heard if the direction specifies that a hearing will be held.
†Select one.

*If others make a similar submission, I will consider presenting a joint case with them at a hearing.

*Delete if you would not consider presenting a joint case.

.
Signature of submitter
(or person authorised to sign
on behalf of submitter)

.
Date
(A signature is not required if you make your submission by electronic means.)

Electronic address for service of submitter:
Telephone:
Postal address (or alternative method of service under section 352 of the Act):
Contact person: [name and designation, if applicable]

Note to person making submission

If you are making a submission to the Environmental Protection Authority, you should use form 16B. If you are a person who could gain an advantage in trade competition through the submission, your right to make a submission may be limited by clause 6(4) of Part 1 of Schedule 1 of the Resource Management Act 1991.

Please note that your submission (or part of your submission) may be struck out if the authority is satisfied that at least 1 of the following applies to the submission (or part of the submission):

  • it is frivolous or vexatious:

  • it discloses no reasonable or relevant case:

  • it would be an abuse of the hearing process to allow the submission (or the part) to be taken further:

  • it contains offensive language:

  • it is supported only by material that purports to be independent expert evidence, but has been prepared by a person who is not independent or who does not have sufficient specialised knowledge or skill to give expert advice on the matter.

Schedule 1 form 5 heading: amended, on 18 October 2017, by regulation 15(1) of the Resource Management (Forms, Fees, and Procedure) Amendment Regulations 2017 (LI 2017/231).

Schedule 1 form 5 heading: amended, on 1 November 2010, by regulation 19(1) of the Resource Management (Forms, Fees, and Procedure) Amendment Regulations 2010 (SR 2010/279).

Schedule 1 form 5: amended, on 3 September 2020, by regulation 7(1) of the Resource Management (Forms, Fees, and Procedure) Amendment Regulations 2020 (LI 2020/180).

Schedule 1 form 5: amended, on 18 October 2017, by regulation 15(1) of the Resource Management (Forms, Fees, and Procedure) Amendment Regulations 2017 (LI 2017/231).

Schedule 1 form 5: amended, on 14 September 2017, by regulation 15(1) of the Resource Management (Forms, Fees, and Procedure) Amendment Regulations 2017 (LI 2017/231).

Schedule 1 form 5: amended, on 1 November 2010, by regulation 19(1) of the Resource Management (Forms, Fees, and Procedure) Amendment Regulations 2010 (SR 2010/279).

Schedule 1 form 5: amended, on 1 June 2006, by regulation 10(2) of the Resource Management (Forms, Fees, and Procedure) Amendment Regulations 2006 (SR 2006/99).